Sample records for diabetes field study

  1. Application to the Diabetic Retinopathy Study

    E-print Network

    Heckman, Nancy E.

    Chapter 4 Application to the Diabetic Retinopathy Study In this chapter we apply the log hazard regression model to data collected to study the effect of laser treatment on diabetic retinopathy (see Diabetic Retinopathy Study Research Group, 1981). We give a description of this study in Section 4

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

    Microsoft Academic Search

    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

    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

  3. Introduction The Diabetic Retinopathy Study estab-

    E-print Network

    Palanker, Daniel

    Introduction The Diabetic Retinopathy Study estab- lished panretinal photocoagulation (PRP) as an effective treatment for proliferative diabetic retinopathy (ET- DRS, 1991). While the exact mecha- nism produced in patients with proliferative diabetic retinopathy scheduled for PRP using 100-, 20- and 10-ms

  4. Macular blood flow during pregnancy in patients with early diabetic retinopathy measured by blue-field entoptic simulation

    Microsoft Academic Search

    Timo Hellstedt; Risto Kaaja; Kari Teramo; Ilkka Immonen

    1996-01-01

    • Purpose: To study macular capillary blood flow velocity during pregnancy and postpartum in diabetic women with minimal diabetic retinopathy. • Methods: Macular capillary blood velocity was measured using the blue-field entoptic simulation technique in 17 type I diabetic pregnant women with minimal background retinopathy and 10 healthy pregnant women at the 12th and 32nd–36th weeks of pregnancy and 3

  5. Macular capillary blood flow velocity by blue-field entoptoscopy in diabetic and healthy women during pregnancy and the postpartum period

    Microsoft Academic Search

    Sirpa Loukovaara; Risto Kaaja; Ilkka Immonen

    2002-01-01

    Purpose. To study macular capillary blood flow velocity in diabetic and healthy women during pregnancy and the postpartum period. Methods. A prospective study of 46 pregnant women with insulin-dependent diabetes and 11 healthy pregnant women was performed. Macular capillary blood flow velocity was measured by blue-field entoptic simulation. Diabetic retinopathy was graded from colour fundus photographs. Results. In diabetic women,

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

    NASA Astrophysics Data System (ADS)

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

    2009-07-01

    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.

  7. 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

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

    2001-01-01

    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.

  8. The diabetes education study group and its activities to improve the education of people with diabetes in Europe

    Microsoft Academic Search

    Aldo Maldonato; Pesach Segal; Alain Golay

    2001-01-01

    In this article the activities of the diabetes education study group (DESG) are presented. It is an important example of the coordination of the European patient education in the field of diabetes. Given the therapeutic role of patient education, doctors must be involved in the entire process, as members of the multi-professional team, who carry the responsibility for the planning

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

    Microsoft Academic Search

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

    1995-01-01

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

  10. Diabetes

    MedlinePLUS

    ... version of this page please turn Javascript on. Diabetes What is Diabetes? Too Much Glucose in the Blood Diabetes means ... high, causing pre-diabetes or diabetes. Types of Diabetes There are three main kinds of diabetes: type ...

  11. Study Reinforces Link Between Low Birth Weight, Diabetes Risk

    MedlinePLUS

    ... please enable JavaScript. Study Reinforces Link Between Low Birth Weight, Diabetes Risk Possible reasons include insulin resistance, ... Preidt Thursday, January 8, 2015 Related MedlinePlus Pages Birth Weight Diabetes in Children and Teens Diabetes Type ...

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

    PubMed Central

    Gonder-Frederick, Linda A.; Zrebiec, John F.; Bauchowitz, Andrea U.; Ritterband, LeeM.; Magee, Joshua C.; Cox, Daniel J.; Clarke, William L.

    2009-01-01

    OBJECTIVE We developed a field procedure using personal digital assistant (PDA) technology to test the hypothesis that naturally occurring episodes of hypo- and hyperglycemia are associated with deterioration in cognitive function in children with type 1 diabetes. RESEARCH DESIGN AND METHODS A total of 61 children aged 6–11 years with type 1 diabetes received a PDA programmed with two brief cognitive tests (mental math and choice reaction time), which they completed just before home glucose readings. The computer recorded time to complete each test and number of correct responses. Children completed several trials per day over 4–6 weeks for a total of 70 trials. Performance variables were compared across glucose ranges. Individual impairment scores (IISs) were also computed for each child by calculating the SD between performance during euglycemia and that during glucose extremes. RESULTS Time to complete both mental math and reaction time was significantly longer during hypoglycemia. During hyperglycemia, time to complete math was significantly longer and reaction time was marginally significant (P = 0.053). There were no differences on task accuracy. Decline in mental math performance was equivalent at glucose levels <3.0 and >22.2 mmol/l. IISs varied greatly across children, with no age or sex differences. CONCLUSIONS A decrease in mental efficiency occurs with naturally occurring hypo- and hyperglycemic glucose fluctuations in children with type 1 diabetes, and this effect can be detected with a field procedure using PDA technology. With blood glucose levels >22.2 mmol/l, cognitive deterioration equals that associated with significant hypoglycemia. PMID:19324943

  13. Understanding of diabetes prevention studies: questionnaire survey of professionals in diabetes care

    Microsoft Academic Search

    I. Mühlhauser; J. Kasper; G. Meyer

    2006-01-01

    Aims\\/hypothesis  Diabetes prevention studies have reported reductions of diabetes risk by up to 60%. Since the underlying metabolic changes are small, the clinical significance of this effect may be overestimated. The present survey explores the extent to which different formats of presenting study results may influence diabetes healthcare professionals’ perceptions of the importance of intervention effects on diabetes risk.Subjects, materials and

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

    Microsoft Academic Search

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

    1989-01-01

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

  15. STUDY ON ST-SEGMENT ELEVATION ACUTE MYOCARDIAL INFARCTION (STEMI) IN DIABETIC AND NON-DIABETIC PATIENTS

    Microsoft Academic Search

    M. Javed Iqbal; M. Azhar; M. Tariq Javed; Ifaat Tahira

    2008-01-01

    Objective: To compare some epidemiological and other parameters between diabetic and non-diabetic subjects admitted with STEMI. Methodology: Two hundred and forty patients were included in the study, 76 (32%) were diabetic, and 164 (68%) were non-diabetic. Results: Among diabetic patients 11\\/76 were newly diagnosed. The male to female ratio in diabetic was 1.5:1 (P=0.02), while in non-diabetic it was 5.8:1

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

    NASA Astrophysics Data System (ADS)

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

    2009-04-01

    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.

  17. Night Shift May Boost Black Women's Diabetes Risk, Study Finds

    MedlinePLUS

    ... page, please enable JavaScript. Night Shift May Boost Black Women's Diabetes Risk, Study Finds Odds are highest ... Preidt Monday, January 12, 2015 Related MedlinePlus Pages African American Health Diabetes Women's Health MONDAY, Jan. 12, 2015 ( ...

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

    PubMed

    Southwood, Robin L

    2010-01-01

    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

  19. Is questionnaire information valid in the study of a chronic disease such as diabetes? The Nord-Trøndelag diabetes study

    Microsoft Academic Search

    K Midthjell; J Holmen; A Bjørndal; G Lund-Larsen

    1992-01-01

    STUDY OBJECTIVE--The aim was to validate information about diabetes mellitus collected by questionnaire in a large epidemiological survey. DESIGN--Questions on diabetes diagnosis, medical treatment for diabetes, diabetes duration, and hypertension treatment were selected from the Nord-Trøndelag health survey questionnaires. One of the municipalities was selected for the validation study. SETTING--The health survey 1984-86 addressed all inhabitants > or = 20

  20. Sexual Dysfunction in Type II Diabetic Females: A Comparative Study

    Microsoft Academic Search

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

    2002-01-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2012-11-15

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

  3. Validity of Diabetes Self-Reports in the Saku Diabetes Study

    PubMed Central

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

    2013-01-01

    Background Diabetes is an important risk factor for cardiovascular disease, certain types of cancer, and death, and self-reports are one of the most convenient methods for ascertaining diabetes status. We evaluated the validity of diabetes self-reports among Japanese who participated in a health checkup. Methods Self-reported diabetes was cross-sectionally compared with confirmed diabetes among 2535 participants aged 28 to 85 years in the Saku cohort study. Confirmed diabetes was defined as the presence of at least 1 of the following: fasting plasma glucose (FPG) level of 126 mg/dL or higher, 2-hour post-load glucose (2-hPG) level of 200 mg/dL or higher after a 75-gram oral glucose tolerance test, glycated hemoglobin (HbA1c) level of 6.5% or higher, or treatment with hypoglycemic medication(s). Results Of the 251 participants with self-reported diabetes, 121 were taking hypoglycemic medication(s) and an additional 69 were classified as having diabetes. Of the 2284 participants who did not self-report diabetes, 80 were classified as having diabetes. These data yielded a sensitivity of 70.4%, a specificity of 97.3%, a positive predictive value of 75.7%, and a negative predictive value of 96.5%. The frequency of participants with undiagnosed diabetes was 3.0%. Of these, 64.2% had FPG within the normal range and were diagnosed by 2-hPG and/or HbA1c. Conclusions Our findings provide additional support for the use of self-reported diabetes as a measure of diabetes in epidemiologic studies performed in similar settings in Japan if biomarker-based diagnosis is difficult. PMID:23774288

  4. Sweet taste sensitivity in pre-diabetics, diabetics and normoglycemic controls: a comparative cross sectional study

    PubMed Central

    2014-01-01

    Background Increasing prevalence of pre-diabetes is an emerging public health problem. Decrease in sweet taste sensitivity which can lead to an increase in sugar intake might be a factor driving them to overt diabetes. The aim of the present study was to assess the sweet taste sensitivity in pre-diabetics in comparison with diabetics and with normoglycemic controls. Methods Forty pre-diabetics, 40 diabetics and 34 normoglycemic controls were studied. The three groups were matched for age, sex and BMI. The division into groups was based on their glycated hemoglobin levels. The detection and recognition thresholds were determined by the multiple forced-choice method using sucrose solutions prepared in ¼ log dilutions. The intensities of perceived sensations for a series of suprathreshold concentrations of sucrose solutions prepared in ½ log dilution were determined by rating on a visual analogue scale. Statistical analyses were performed by SPSS version 21. Results The mean (SD) detection thresholds of diabetic, pre-diabetic and normoglycemic groups were 0.025 (0.01), 0.018 (0.01) and 0.015 (0.01) respectively with a significant increase in diabetic group compared to normoglycemic group (p?=?0.03). The mean recognition thresholds were not different among the three groups. When the intensity ratings for suprathreshold concentrations of sucrose were compared between the three groups, for all suprathreshold concentrations tested, significant differences were observed across the four concentrations (p?diabetic group had significantly lower suprathreshold ratings than the normoglycemic group (p?diabetic group were between the normoglycemic and diabetic groups, the differences were not significant. Conclusions This is the first study to demonstrate the sweet taste sensitivity in pre-diabetics. The findings of the present study do not support the hypothesis of decreased sweet taste sensitivity of pre-diabetics. However, the results confirm the previous findings of blunted taste response in diabetics. The observation of pre-diabetics having intermediate values for all taste thresholds and suprathreshold ratings warrants a future investigation with a larger pre-diabetic sample recruited with more specific screening criteria to test this hypothesis further. PMID:25123551

  5. [A comparative study of social representations of diabetes mellitus and diabetic foot].

    PubMed

    Mantovani, Alessandra Madia; Fregonesi, Cristina Elena Prado Teles; Pelai, Elisa Bizetti; Mantovani, Aline Madia; Savian, Nathalia Ulices; Pagotto, Priscila

    2013-12-01

    The study aimed to investigate social representations of the terms "diabetes" and "diabetic foot" in different populations. Participants were divided into groups: diabetics (GD); non- diabetics (GN); and non-diabetic healthcare professionals (GP). Personal data were collected, and subjects answered two questions that were expected to evoke five words that came to mind when they thought of "diabetes" and then "diabetic foot". The evoked material was analyzed with the software Ensemble de Programmes Permettant l'Analyse dês Èvocations. A total of 161 subjects participated, including GD (n = 72) with a mean age of 56.12 ± 5.49 years; GN (n = 38) with a mean age of 54.29 ± 7.91 years; and GP (n = 51) with 34.95 ± 7.52 years. The term "diabetes" evoked 297 words in GD, 172 in GN, and 235 words in GP. The term "diabetic foot" evoked 180 words in GD, 90 in GN, and 236 in GP. The groups proved to be anxious for more information, thus confirming the need for awareness-raising and educational programs on diabetes, covering comprehensive issues concerning the disease. PMID:24356689

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

    Microsoft Academic Search

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

    1989-01-01

    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,

  7. Diabetes

    MedlinePLUS

    ... prevent or delay the start of type 2 diabetes. Type 1 diabetes cannot be prevented. ... Elsevier; 2011:chap 31. Eisenbarth GS, Buse JB. Type 1 diabetes mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen ...

  8. Selenium and diabetes - evidence from animal studies

    PubMed Central

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

    2013-01-01

    Whereas selenium was found to act as an insulin-mimic and to be anti-diabetic in earlier studies, recent animal experiments and human trials have shown unexpected risk of prolonged high Se intake in potentiating insulin resistance and type 2 diabetes. Elevating dietary Se intakes (0.4 to 3.0 mg/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, the high Se intake elevated activity or production of selenoproteins including GPx1, MsrB1, SelS, and SelP. This up-regulation diminished intracellular reactive oxygen species (ROS) and then dys-regulated key regulators of ? cells and insulin synthesis and secretion, leading to chronic hyperinsulinaemia. Over-scavenging 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 for 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 effect of high Se intakes. Furthermore, a potential interactive role of high Se intakes in the interphase of carcinogenesis and diabetogenesis should be explored to make the optimal use of Se in human nutrition and health. PMID:23867154

  9. Implementation salvage experiences from the Melbourne diabetes prevention study

    PubMed Central

    2012-01-01

    Background Many public health interventions based on apparently sound evidence from randomised controlled trials encounter difficulties when being scaled up within health systems. Even under the best of circumstances, implementation is exceedingly difficult. In this paper we will describe the implementation salvage experiences from the Melbourne Diabetes Prevention Study, which is a randomised controlled trial of the effectiveness and cost-effectiveness nested in the state-wide Life! Taking Action on Diabetes program in Victoria, Australia. Discussion The Melbourne Diabetes Prevention Study sits within an evolving larger scale implementation project, the Life! program. Changes that occurred during the roll-out of that program had a direct impact on the process of conducting this trial. The issues and methods of recovery the study team encountered were conceptualised using an implementation salvage strategies framework. The specific issues the study team came across included continuity of the state funding for Life! program and structural changes to the Life! program which consisted of adjustments to eligibility criteria, referral processes, structure and content, as well as alternative program delivery for different population groups. Staff turnover, recruitment problems, setting and venue concerns, availability of potential participants and participant characteristics were also identified as evaluation roadblocks. Each issue and corresponding salvage strategy is presented. Summary The experiences of conducting such a novel trial as the preliminary Melbourne Diabetes Prevention Study have been invaluable. The lessons learnt and knowledge gained will inform the future execution of this trial in the coming years. We anticipate that these results will also be beneficial to other researchers conducting similar trials in the public health field. We recommend that researchers openly share their experiences, barriers and challenges when conducting randomised controlled trials and implementation research. We encourage them to describe the factors that may have inhibited or enhanced the desired outcomes so that the academic community can learn and expand the research foundation of implementation salvage. PMID:22992417

  10. Medical management of diabetic retinopathy: fenofibrate and ACCORD Eye studies

    Microsoft Academic Search

    A D Wright; P M Dodson

    2011-01-01

    The approach of all ophthalmologists, diabetologists and general practitioners seeing patients with diabetic retinopathy should be that good control of blood glucose, blood pressure and plasma lipids are all essential components of modern medical management. The more recent data on the use of fenofibrate in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) and The Action to Control Cardiovascular

  11. Diabetic foot risk factors in type 2 diabetes patients: a cross-sectional case control study

    PubMed Central

    2014-01-01

    Background Diabetic foot is a serious condition in patients with a long lasting diabetes mellitus. Diabetic foot treated improperly may lead not only to delayed ulceration healing, generalized inflammation, unnecessary surgical intervention, but also to the lower limb amputation. The aim of this study was to compare diabetic foot risk factors in population with type 2 diabetes and risk factors for diabetes in healthy subjects. Methods The study included 900 subjects: 145 with diabetic foot, 293 with type 2 diabetes without diabetic foot and 462 healthy controls matched in terms of mean age, gender structure and cardiovascular diseases absence. Study was conducted in Gastroenterology and Metabolic Diseases Department, Medical University of Warsaw, Poland. In statistical analysis a logistic regression model, U Mann-Whitney’s and t-Student test were used. Results The binomial logit models analysis showed that the risk of diabetic foot in patients with type 2 diabetes was decreased by patient’s age (odds ratio [OR] = 0.94; 95% confidence interval [CI]: 0.92-0.96; p = 0.00001) and hyperlipidaemia (OR = 0.54; 95% CI: 0.36-0.81; p = 0.01). In contrast, male gender (OR = 2.83; 95% CI: 1.86-4.28; p = 0.00001) diabetes duration (OR = 1.04; 95% CI: 1.03-1.06; p = 0.0003), weight (OR = 1.04; 95% CI: 1.03-1.06; p = 0.00001), height (OR = 1.08; 95% CI: 1.05-1.11; p = 0.00001) and waist circumference (OR = 1.028; 95% CI: 1.007-1.050; p = 0.006) increase the risk of diabetic foot. The onset of type 2 diabetes in healthy subjects was increased by weight (OR = 1.035; 95% CI: 1.024-1.046; p = 0.00001), WC (OR = 1.075; 95% CI: 1.055-1.096; p = 00001), hip circumference (OR = 1.03; 95% CI: 1.01-1.05; p = 0.005), overweight defined with body mass index (BMI) above 24,9 kg/m2 (OR = 2.49; 95% CI: 1.77-3.51; p = 0.00001) and hyperlipidaemia (OR = 3.53; 95% CI: 2.57-4.84; p = 0.00001). Conclusions Risk factors for Type 2 diabetes and diabetic foot are only partially common. Study proved that patients who are prone to developing diabetic foot experience different risk factors than patients who are at risk of diabetes. Identification of relationship between diabetic foot and diabetes risk factors in appropriate groups may help clinicians to focus on certain factors in diabetic foot prevention. PMID:25114882

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

    Microsoft Academic Search

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

    1995-01-01

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

  13. Diabetes

    NSDL National Science Digital Library

    Dr. Leslie Nader (MSMR)

    1993-04-14

    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.

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

    Microsoft Academic Search

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

    2011-01-01

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

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

    Microsoft Academic Search

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

    2010-01-01

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

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

    PubMed

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

    2014-04-01

    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

  17. Connection Between Diabetes, Advanced Breast Cancer Detected in Study

    MedlinePLUS

    ... page, please enable JavaScript. Connection Between Diabetes, Advanced Breast Cancer Detected in Study Findings suggest need to modify ... Preidt Friday, March 27, 2015 Related MedlinePlus Pages Breast Cancer Diabetes FRIDAY, March 27, 2015 (HealthDay News) -- Women ...

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

    Microsoft Academic Search

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

    2003-01-01

    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

  19. The Value of National Diabetes Registries: SEARCH for Diabetes in Youth Study

    Microsoft Academic Search

    Dana Dabelea; Elizabeth J. Mayer-Davis; Giuseppina Imperatore

    2010-01-01

    Diabetes mellitus is one of the most common severe chronic diseases of childhood. Much of our knowledge of the epidemiology\\u000a of diabetes in young people has been generated by large collaborative efforts based on standardized registry data, such as\\u000a the DIAMOND Project worldwide and the EURODIAB study in Europe. These registries showed that although at the start of the\\u000a 20th

  20. Epidemiological study of prevalence of chlorpropamide alcohol flushing in insulin dependent diabetics, non-insulin dependent diabetics, and non-diabetics

    Microsoft Academic Search

    S Ng Tang Fui; H Keen; R J Jarrett; C Strakosch; T Murrells; P Marsden; R Stott

    1983-01-01

    An epidemiological study was carried out to compare the prevalence of facial flushing in non-diabetics, patients with insulin dependent diabetes, and patients with non-insulin dependent diabetes in response to 40 ml sherry taken 12 hours after 250 mg chlorpropamide or placebo, administered double blind in randomised order. A flush after chlorpropamide but not placebo was reported by 6.2% of non-diabetics

  1. Is microalbuminuria part of the prediabetic state? The Mexico City Diabetes Study

    Microsoft Academic Search

    S. M. Haffner; C. Gonzales; R. A. Valdez; L. Mykkänen; H. P. Hazuda; B. D. Mitchell; A. Monterrosa; M. P. Stern

    1993-01-01

    Summary  Microalbuminuria is associated with increased cardiovascular mortality in both diabetic and non-diabetic subjects. A number\\u000a of studies have indicated that insulin resistance, increased blood pressure and dyslipidaemia precede the onset of clinical\\u000a diabetes. We examined various correlates of microalbuminuria in 1,298 non-diabetic subjects who participated in the Mexico\\u000a city Diabetes Study, a population-based study of diabetes and cardiovascular risk factors.

  2. A community-based follow-up study on diabetic retinopathy among type 2 diabetics in Kinmen

    Microsoft Academic Search

    Tao-Hsin Tung; Shih-Jen Chen; Jorn-Hon Liu; Fenq-Lih Lee; An-Fei Li; Mong-Ping Shyong; Pesus Chou

    2005-01-01

    The purpose of this follow-up study was conducted to assess the incidence and risk factors of diabetic retinopathy (DR) among type 2 diabetics in Kinmen, Taiwan. A penal of eye screening regimes were performed yearly for 971 type 2 diabetics by two senior ophthalmologists using indirect ophthalmoscopy and 45-degree color fundus photography to examine fundus after dilating pupils from 1999

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

    ERIC Educational Resources Information Center

    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

    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…

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

    Microsoft Academic Search

    Vibeke Sundling; Pål Gulbrandsen; Jak Jervell; Jørund Straand

    2008-01-01

    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

  5. Current Status of Diabetic Peripheral Neuropathy in Korea: Report of a Hospital-Based Study of Type 2 Diabetic Patients in Korea by the Diabetic Neuropathy Study Group of the Korean Diabetes Association

    PubMed Central

    Won, Jong Chul; Kim, Sang Soo; Cha, Bong-Yun

    2014-01-01

    Diabetic peripheral neuropathy (DPN) is the most common complication associated with diabetes. DPN can present as a loss of sensation, may lead to neuropathic ulcers, and is a leading cause of amputation. Reported estimates of the prevalence of DPN vary due to differences in study populations and diagnostic criteria. Furthermore, the epidemiology and clinical characteristics of DPN in Korean patients with type 2 diabetes mellitus (T2DM) are not as well understood as those of other complications of diabetes such as retinal and renal disease. Recently, the Diabetic Neuropathy Study Group of the Korean Diabetes Association (KDA) conducted a study investigating the impact of DPN on disease burden and quality of life in patients with T2DM and has published some data that are representative of the nation. This review investigated the prevalence and associated clinical implications of DPN in Korean patients with diabetes based on the KDA study. PMID:24627824

  6. Factors Affecting the Decline in Incidence of Diabetes in the Diabetes Prevention Program Outcomes Study (DPPOS).

    PubMed

    Hamman, Richard F; Horton, Edward; Barrett-Connor, Elizabeth; Bray, George A; Christophi, Costas A; Crandall, Jill; Florez, Jose C; Fowler, Sarah; Goldberg, Ronald; Kahn, Steven E; Knowler, William C; Lachin, John M; Murphy, Mary Beth; Venditti, Elizabeth

    2015-03-01

    During the first 7 years of the Diabetes Prevention Program Outcomes Study (DPPOS), diabetes incidence rates, when compared with the Diabetes Prevention Program (DPP), decreased in the placebo (-42%) and metformin (-25%), groups compared with the rates in the intensive lifestyle intervention (+31%) group. Participants in the placebo and metformin groups were offered group intensive lifestyle intervention prior to entering the DPPOS. The following two hypotheses were explored to explain the rate differences: "effective intervention" (changes in weight and other factors due to intensive lifestyle intervention) and "exhaustion of susceptible" (changes in mean genetic and diabetes risk scores). No combination of behavioral risk factors (weight, physical activity, diet, smoking, and antidepressant or statin use) explained the lower DPPOS rates of diabetes progression in the placebo and metformin groups, whereas weight gain was the factor associated with higher rates of progression in the intensive lifestyle intervention group. Different patterns in the average genetic risk score over time were consistent with exhaustion of susceptibles. Results were consistent with exhaustion of susceptibles for the change in incidence rates, but not the availability of intensive lifestyle intervention to all persons before the beginning of the DPPOS. Thus, effective intervention did not explain the lower diabetes rates in the DPPOS among subjects in the placebo and metformin groups compared with those in the DPP. PMID:25277389

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

    PubMed Central

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

    2014-01-01

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

  8. More Clinical Lessons from the FIELD Study

    Microsoft Academic Search

    Sergio Fazio

    2009-01-01

    Introduction  The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study investigated the effect of fenofibrate treatment\\u000a in 9,795 patients with type 2 diabetes.\\u000a \\u000a \\u000a \\u000a Results and discussion  Reduction in major coronary events (the primary endpoint) and total cardiovascular disease (CVD) events (the secondary endpoint)\\u000a was similar (relative risk reduction 11%), but only significant for total CVD events (p?=?0.035). The benefit of fenofibrate

  9. Effect of normobaric hyperoxic therapy on tissue oxygenation in diabetic feet: a pilot study.

    PubMed

    Moon, Kyung-Chul; Han, Seung-Kyu; Lee, Ye-Na; Jeong, Seong-Ho; Dhong, Eun-Sang; Kim, Woo-Kyung

    2014-11-01

    Adequate tissue oxygenation is an essential factor in diabetic foot management. Hyperbaric oxygen (HBO) therapy has been successfully used as adjunctive treatment to improve the healing of diabetic foot ulcers. However, the clinical uses of HBO therapy are limited due to the low availability of HBO chambers, poor patient compliance, and high oxidative potential. Normobaric hyperoxic (NBO) therapy may be a potentially attractive alternative to HBO therapy because of its high availability, good patient compliance, and few technical requirements. Several studies on NBO therapy to attenuate infarct volume after stroke have provided compelling evidence. However, there have been no reports regarding the effect of NBO therapy in the field of wound healing. The purpose of this study was to evaluate the effect of NBO therapy on tissue oxygenation of diabetic feet. This study included 100 patients with diabetic foot ulcers (64 males and 36 females). Transcutaneous partial oxygen tension (TcPO?) values of diabetic feet were measured before, during, and after NBO therapy. The mean TcPO? values before, during, and after therapy were 46.6 ± 21.5, 88.9 ± 48.0, and 49.9 ± 23.8 mmHg (p < 0.001), respectively. The lower the initial TcPO? level, the more TcPO? increased. The results reveal that NBO therapy significantly increases the tissue oxygenation level of diabetic feet. PMID:25086687

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

    PubMed Central

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

    2010-01-01

    Background Metabolomics is the rapidly evolving field of the comprehensive measurement of ideally all endogenous metabolites in a biological fluid. However, no single analytic technique covers the entire spectrum of the human metabolome. Here we present results from a multiplatform study, in which we investigate what kind of results can presently be obtained in the field of diabetes research when combining metabolomics data collected on a complementary set of analytical platforms in the framework of an epidemiological study. Methodology/Principal Findings 40 individuals with self-reported diabetes and 60 controls (male, over 54 years) were randomly selected from the participants of the population-based KORA (Cooperative Health Research in the Region of Augsburg) study, representing an extensively phenotyped sample of the general German population. Concentrations of over 420 unique small molecules were determined in overnight-fasting blood using three different techniques, covering nuclear magnetic resonance and tandem mass spectrometry. Known biomarkers of diabetes could be replicated by this multiple metabolomic platform approach, including sugar metabolites (1,5-anhydroglucoitol), ketone bodies (3-hydroxybutyrate), and branched chain amino acids. In some cases, diabetes-related medication can be detected (pioglitazone, salicylic acid). Conclusions/Significance Our study depicts the promising potential of metabolomics in diabetes research by identification of a series of known and also novel, deregulated metabolites that associate with diabetes. Key observations include perturbations of metabolic pathways linked to kidney dysfunction (3-indoxyl sulfate), lipid metabolism (glycerophospholipids, free fatty acids), and interaction with the gut microflora (bile acids). Our study suggests that metabolic markers hold the potential to detect diabetes-related complications already under sub-clinical conditions in the general population. PMID:21085649

  11. Correlation between diabetic lower-extremity arterial disease and diabetic neuropathy in patients with type II diabetes: an exploratory study

    PubMed Central

    Sun, Peng; Guo, Jianchao; Xu, Na

    2015-01-01

    The lower-extremity vascular injuries and neuropathy are the most salient complications of diabetes which could lead to the poor prognosis, especially for the type II diabetes. The lower extremity vascular injuries and neuropathy usually coexist, yet their correlation in the pathogenesis of lower extremity lesions has received little attention in previous studies. To investigate the correlation between the degree of lower-extremity arterial injuries and lower-extremity neurological functional status in patients with type II diabetes, 32 patients with type II diabetes were examined for the mean flow velocity of the femoral artery and popliteal artery of lower extremeties, while the motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) of the bilateral common peroneal nerve, sural nerve and posterior tibial nerve were simultaneously examined. Results showed that there was moderate correlation between the mean flow velocity of lower-extremity arteries and MCV/SCV. In particular, the MCV of the right tibial nerve was strongly correlated with the average velocity of the right popliteal artery (P < 0.05). PMID:25785144

  12. Diabetes

    MedlinePLUS

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

  13. Magnitude and determinants of glaucoma in type II diabetics: A hospital based cross-sectional study in Maharashtra, India

    PubMed Central

    Dharmadhikari, Sheetal; Lohiya, Kavita; Chelkar, Vidya; Kalyani, V. K. S.; Dole, Kuldeep; Deshpande, Madan; Khandekar, Rajiv; Kulkarni, Sucheta

    2015-01-01

    Background: Glaucoma and diabetes have a common pathogenesis. We estimated the magnitude and determinants of glaucoma in adults with type II diabetes who presented to a tertiary level eye center in 2010. Study Type: A cross-sectional survey. Methods: Diabetes was diagnosed by history and measurement of blood sugar levels. Glaucoma was diagnosed by assessing optic disc morphology, visual fields, and intraocular pressure. Data were collected on patient demographics, clinical characteristics of diabetes and ocular status through interviews and measurements. The prevalence of glaucoma in diabetics was estimated, and variables were analyzed for an association to glaucoma. The 95% confidence intervals (CIs) were calculated. Statistical significance was indicated by P < 0.05. Results: The study cohort was comprised of 841 diabetics. The mean age of the cohort was 53.8 ± 10.7 years. There were 320 (38%) females. The prevalence of glaucoma was 15.6% (95% CI: 13.1-18.1). More than 75% of the diabetics had no evidence of diabetic retinopathy (DR). Half of the diabetics with glaucoma had primary open angle glaucoma. The presence of glaucoma was significantly associated to the duration of diabetes (Chi-square = 10.1, degree of freedom = 3, P = 0.001). The presence of DR was not significantly associated to the presence of glaucoma (odds ratio [OR] = 1.4 [95% CI: 0.88-1.2]). The duration of diabetes (adjusted OR = 1.03) was an independent predictor of glaucoma in at least one eye. Conclusions: More than one-sixth of diabetics in this study had glaucoma. Opportunistic screening for glaucoma during DR screening results in an acceptable yield of glaucoma cases. PMID:25709269

  14. Risk factors for renal replacement therapy in the Early Treatment Diabetic Retinopathy Study (ETDRS), Early Treatment Diabetic Retinopathy Study Report No. 26

    Microsoft Academic Search

    MICHAEL CUSICK; Emily Y. Chew; BYRON HOOGWERF; ELVIRA AGRÓN; LIELING WU; ANNA LINDLEY; Frederick L. Ferris; Emily Y. Chew M. D

    2004-01-01

    Risk factors for renal replacement therapy in the Early Treatment Diabetic Retinopathy Study (ETDRS), Early Treatment Diabetic Retinopathy Study Report No. 26.BackgroundDiabetes is a leading cause of end-stage renal disease (ESRD). The purpose of this study is to assess the risk factors for renal replacement therapy (RRT) in the Early Treatment Diabetic Retinopathy Study (ETDRS).MethodsWe examined demographic, clinical, and laboratory

  15. Studies on the Cost of Diabetes Thomas J Songer, PhD, MSc

    E-print Network

    Songer, Thomas J.

    of the economic cost of diabetes mellitus in the United States, by study 21 3. Estimates of direct costsStudies on the Cost of Diabetes Thomas J Songer, PhD, MSc Lorraine Ettaro, BS and the Economics of Diabetes Project Panel Prepared for Division of Diabetes Translation Centers for Disease Control

  16. Optomap ultrawide field imaging identifies additional retinal abnormalities in patients with diabetic retinopathy

    PubMed Central

    Price, Liam D; Au, Stephanie; Chong, N Victor

    2015-01-01

    Purpose To compare diabetic retinopathy (DR) severity grading between Optomap ultrawide field scanning laser ophthalmoscope (UWFSLO) 200° images and an Early Treatment Diabetic Retinopathy Study (ETDRS) seven-standard field view. Methods Optomap UWFSLO images (total: 266) were retrospectively selected for evidence of DR from a database of eye clinic attendees. The Optomap UWFSLO images were graded for DR severity by two masked assessors. An ETDRS seven-field mask was overlaid on the Optomap UWFSLO images, and the DR grade was assessed for the region inside the mask. Any interassessor discrepancies were adjudicated by a senior retinal specialist. Kappa agreement levels were used for statistical analysis. Results Fifty images (19%) (P<0.001) were assigned a higher DR level in the Optomap UWFSLO view compared to the ETDRS seven-field view, which resulted in 40 images (15%) (P<0.001) receiving a higher DR severity grade. DR severity grades in the ETDRS seven-field view compared with the Optomap UWFSLO view were identical in 85% (226) of the images and within one severity level in 100% (266) of the images. Agreement between the two views was substantial: unweighted ? was 0.74±0.04 (95% confidence interval: 0.67–0.81) and weighted ? was 0.80±0.03 (95% confidence interval: 0.74–0.86). Conclusion Compared to the ETDRS seven-field view, a significant minority of patients are diagnosed with more severe DR when using the Optomap UWFSLO view. The clinical significance of additional peripheral lesions requires evaluation in future prospective studies using large cohorts. PMID:25848202

  17. 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

    2014-01-01

    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

  18. Streptozotocin-induced type 1 diabetes in rodents as a model for studying mitochondrial mechanisms of diabetic ? cell glucotoxicity

    PubMed Central

    Wu, Jinzi; Yan, Liang-Jun

    2015-01-01

    Chronic hyperglycemia and the corresponding glucotoxicity are the main pathogenic mechanisms of diabetes and its complications. Streptozotocin (STZ)-induced diabetic animal models are useful platforms for the understanding of ? cell glucotoxicity in diabetes. As diabetes induced by a single STZ injection is often referred to as type 1 diabetes that is caused by STZ’s partial destruction of pancreas, one question often being asked is whether the STZ type 1 diabetes animal model is a good model for studying the mitochondrial mechanisms of ? cell glucotoxicity. In this mini review, we provide evidence garnered from the literature that the STZ type 1 diabetes is indeed a suitable model for studying mitochondrial mechanisms of diabetic ? cell glucotoxicity. Evidence presented includes: 1) continued ? cell derangement is due to chronic hyperglycemia after STZ is completely eliminated out of the body; 2) STZ diabetes can be reversed by insulin treatment, which indicates that ? cell responds to treatment and shows ability to regenerate; and 3) STZ diabetes can be ameliorated or alleviated by administration of phytochemicals. In addition, mechanisms of STZ action and fundamental gaps in understanding mitochondrial mechanisms of ? cell dysfunction are also discussed. PMID:25897251

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

    PubMed Central

    2013-01-01

    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

  20. Comparison of peripheral arterial reconstruction in diabetic and non-diabetic patients: a prospective clinic-based study

    Microsoft Academic Search

    Alfonso L. Calle-Pascual; Alejandra Durán; Angel Diaz; Guillermo Moñux; Francisco J. Serrano; Nuria Garcia de la Torre; Immaculada Moraga; Jose R. Calle; Aniceto Charro; Juan P. Marañes

    2001-01-01

    To assess the efficacy and safety of lower extremity arterial reconstruction in diabetic and non-diabetic subjects during a 3-year period. A prospective clinic-based study between 1994–1999 in Area 7, Madrid, with a population of 569?307 and an estimated diabetic population of 37?932 (15?505 men and 22?427 women). The level of arterial reconstruction and associated risk factors were ascertained. Results: A

  1. Health behaviour and its determinants among insulin-dependent diabetics. Results of the diabetes Warsaw study.

    PubMed

    Wysocki, M; Czyzyk, A; Slonska, Z; Krolewski, A; Janeczko, D

    1978-06-01

    Health behaviour of a group of insulin-dependent diabetics and some factors influencing it have been described and analyzed. Aspects of health behaviour measured were: adherence to diet, insulin injection technique, urine self-testing and the pattern of action adopted in response to hypo- and hyperglycemia. Data were collected in 1975, from 170 insulin-dependent diabetics, aged 18-41, with known diabetes of from 6 months to 12 years duration. A standard questionnaire included items on health behaviour, knowledge of the disease and other factors. Of the subjects studied only 40% stated that they adhered to diet prescription. Occasional insulin injections were missed by 15%. Half the patients restricted diet or increased insulin dose in hyperglycemia but only 18% regularly tested urine for sugar. An important determinant of health behaviour was the level of understanding of the disease, which was found to be low among 58%. The present health education system for diabetic patients in Poland is discussed. PMID:680311

  2. [A study on the pathogenesis of hyporeninemia in diabetics].

    PubMed

    Yamaguchi, M

    1994-08-20

    Hyporeninemic hypoaldosteronism has mainly been described in patients with diabetes mellitus. In order to elucidate the mechanisms of hyporeninemia in diabetic patients, the author studied the response of active renin concentration (ARC) and inactive renin concentration (IRC) to the administration of captopril or sodium depletion in patients with diabetes mellitus and glomerulonephritis and in normal subjects. The diabetic patients were separated into four groups: Group 0, diabetic patients without neuropathy or nephropathy; Group I, those with neuropathy without nephropathy; Group II, those without neuropathy with nephropathy; Group III, those with neuropathy and nephropathy. Diabetic patients with some complications had slightly lower plasma active renin levels than those without complications. The mean increase in plasma active renin after captopril (delta ARC) and sodium depletion was lower in group I than in group 0, and there was no difference between group II and group 0. There was no correlation between delta ARC and creatinine clearance (Ccr) in diabetes mellitus. Plasma prorenin was higher in group I than in group 0, and there was no difference between group II and group 0. No significant change of prorenin after captopril was observed in all groups, but the mean increase in plasma inactive renin after sodium depletion was slightly higher in groups I and III than in groups 0 and II. ARC/IRC was significantly lower in group I than in group 0, and there was no difference between group II and group 0. There was no correlation between ARC/IRC and Ccr in diabetes mellitus, but significant correlation between ARC/IRC and postural change in systolic blood pressure. In three diabetic patients with hyporeninemic hypoaldosteronism, the postural fall in systolic blood pressure was significant, and ARC/IRC was significantly low, but IRC was not high. These results suggest that autonomic dysfunction is a major factor in an impairment of the processing of prorenin to active renin in diabetic patients, and severe autonomic dysfunction may impair the biosynthesis of prorenin in patients with hyporeninemic hypoaldosteronism. PMID:7958107

  3. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice.

    PubMed

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

    1990-08-01

    The effects on glucose homeostasis of eleven plants used as traditional treatments for diabetes mellitus were evaluated in normal and streptozotocin diabetic mice. Dried leaves of agrimony (Agrimonia eupatoria), alfalfa (Medicago sativa), blackberry (Rubus fructicosus), celandine (Chelidonium majus), eucalyptus (Eucalyptus globulus), lady's mantle (Alchemilla vulgaris), and lily of the valley (Convallaria majalis); seeds of coriander (Coriandrum sativum); dried berries of juniper (Juniperus communis); bulbs of garlic (Allium sativum) and roots of liquorice (Glycyrhizza glabra) were studied. Each plant material was supplied in the diet (6.25% by weight) and some plants were additionally supplied as decoctions or infusions (1 g/400 ml) in place of drinking water to coincide with the traditional method of preparation. Food and fluid intake, body weight gain, plasma glucose and insulin concentrations in normal mice were not altered by 12 days of treatment with any of the plants. After administration of streptozotocin (200 mg/kg i.p.) on day 12 the development of hyperphagia, polydipsia, body weight loss, hyperglycaemia and hypoinsulinaemia were not affected by blackberry, celandine, lady's mantle or lily of the valley. Garlic and liquorice reduced the hyperphagia and polydipsia but did not significantly alter the hyperglycaemia or hypoinsulinaemia. Treatment with agrimony, alfalfa, coriander, eucalyptus and juniper reduced the level of hyperglycaemia during the development of streptozotocin diabetes. This was associated with reduced polydipsia (except coriander) and a reduced rate of body weight loss (except agrimony). Alfalfa initially countered the hypoinsulinaemic effect of streptozotocin, but the other treatments did not affect the fall in plasma insulin. The results suggest that certain traditional plant treatments for diabetes, namely agrimony, alfalfa, coriander, eucalyptus and juniper, can retard the development of streptozotocin diabetes in mice. PMID:2210118

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

    NASA Astrophysics Data System (ADS)

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

    2008-08-01

    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.

  5. Lessons from the look action for health in diabetes study.

    PubMed

    Korytkowski, Mary T

    2013-12-01

    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

  6. Diabetes Education Needs of Chinese Australians: A Qualitative Study

    ERIC Educational Resources Information Center

    Choi, Tammie S. T.; Walker, Karen Z.; Ralston, Robin A.; Palermo, Claire

    2015-01-01

    Objective: The aim of this study was to evaluate a type 2 diabetes education programme for Chinese Australians, based on the experience of participants and by exploring the unique needs of Chinese patients, their health beliefs and their cultural behaviours. Design and setting: A qualitative ethnographic study was undertaken in a community health…

  7. Zimbabwean diabetics' beliefs about health and illness: an interview study

    Microsoft Academic Search

    Katarina Hjelm; Esther Mufunda

    2010-01-01

    BACKGROUND: Diabetes mellitus (DM) is increasing globally, with the greatest increase in Africa and Asia. In Zimbabwe a threefold increase was shown in the 1990s. Health-related behaviour is important in maintaining health and is determined by individual beliefs about health and illness but has seen little study. The purpose of the study was to explore beliefs about health and illness

  8. 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

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

    2006-01-01

    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

  9. Atorvastatin prevents type 2 diabetes mellitus--an experimental study.

    PubMed

    Madhu, Sri Venkata; Aslam, Mohammad; Galav, Vikas; Bhattacharya, Swapan Kumar; Jafri, Aiman Abbas

    2014-04-01

    Recent reports of increased diabetes risk have raised concerns regarding the use of statins. The present study was therefore planned to clarify whether atorvastatin can prevent diabetes development in a rat model of type 2 diabetes mellitus. Eight week old male Wistar rats were randomized into three groups (n = 12 each group). Group A was given standard chow diet, while group B and group C were offered high sucrose diet. In addition to high sucrose diet, group C was given atorvastatin (20mg/kg/day) from beginning of study till 26th week. After 26 weeks, a low dose of streptozotocin (15 mg/kg, i.p.) was given to all 3 groups and further followed for 4 weeks. Oral glucose tolerance tests were done at week 4, 26 and week 30. Development of impaired glucose tolerance at week 26 (16.66% vs 100%, P = <0.001) and diabetes at week 30 (16.66% vs 81.81%, P = 0.002) was significantly lower in rats pretreated with atorvastatin along with high sucrose diet viz group C compared to group B rats who received high sucrose diet only respectively. Also, metabolic indices like body weight, hypertriglyceridemia, glucose area under the curve (Gl-AUC) were significantly lower in group C compared to group B (P = <0.05) while insulin resistance (HOMA-IR) was also lower in group C (P = 0.05). This study clearly demonstrates for the first time in a rat model of type 2 diabetes mellitus that atorvastatin prevents development of type 2 diabetes. PMID:24530420

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

    Microsoft Academic Search

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

    1992-01-01

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

  11. Primary and Specialty Medical Care Among Ethnically Diverse, Older Rural Adults With Type 2 Diabetes: The ELDER Diabetes Study

    ERIC Educational Resources Information Center

    Bell, Ronny A.; Quandt, Sara A.; Arcury, Thomas A.; Snively, Beverly M.; Stafford, Jeanette M.; Smith, Shannon L.; Skelly, Anne H.

    2005-01-01

    Purpose: Residents in rural communities in the United States, especially ethnic minority group members, have limited access to primary and specialty health care that is critical for diabetes management. This study examines primary and specialty medical care utilization among a rural, ethnically diverse, older adult population with diabetes.…

  12. Primary and Specialty Medical Care among Ethnically Diverse, Older Rural Adults with Type 2 Diabetes: The ELDER Diabetes Study

    ERIC Educational Resources Information Center

    Bell, Ronny A.; Quandt, Sara A.; Arcury, Thomas A.; Snively, Beverly M.; Stafford, Jeanette M.; Smith, Shannon L.; Skelly, Anne H.

    2005-01-01

    Purpose: Residents in rural communities in the United States, especially ethnic minority group members, have limited access to primary and specialty health care that is critical for diabetes management. This study examines primary and specialty medical care utilization among a rural, ethnically diverse, older adult population with diabetes.…

  13. The 30Year Natural History of Type 1 Diabetes Complications The Pittsburgh Epidemiology of Diabetes Complications Study Experience

    Microsoft Academic Search

    Georgia Pambianco; Tina Costacou; Demetrius Ellis; Dorothy J. Becker; Ronald Klein; Trevor J. Orchard

    Declining incidences in Europe of overt nephropathy, pro- liferative retinopathy, and mortality in type 1 diabetes have recently been reported. However, comparable data for the U.S. and trend data for neuropathy and macrovascular complications are lacking. These issues are addressed us- ing the prospective observational Pittsburgh Epidemiology of Childhood-Onset Diabetes Complications Study. Partic- ipants were stratified into five cohorts by

  14. Diabetes and Cognitive Deficits in Chronic Schizophrenia: A Case-Control Study

    PubMed Central

    Han, Mei; Huang, Xu-Feng; Chen, Da Chun; Xiu, Meihong; Kosten, Thomas R.; Zhang, Xiang Yang

    2013-01-01

    Cognitive impairment occurs in both schizophrenia and diabetes. There is currently limited understanding whether schizophrenia with diabetes has more serious cognitive deficits than schizophrenia without diabetes or diabetes only. This study assessed cognitive performance in 190 healthy controls, 106 diabetes only, 127 schizophrenia without diabetes and 55 schizophrenia with diabetes. This study was conducted from January 2008 to December 2010. Compared to healthy controls, all patient groups had significantly decreased total and five index RBANS scores (all p<0.01–p<0.001), except for the visuospatial/constructional index. Schizophrenia with diabetes performed worse than schizophrenia without diabetes in immediate memory (p<0.01) and total RBANS scores (<0.05), and showed a trend for decreased attention (p?=?0.052) and visuospatial/constructional capacity (p?=?0.063). Schizophrenia with diabetes performed worse than diabetes only in immediate memory (p<0.001) and attention (p<0.05), and showed a trend for decreased total RBANS scores (p?=?0.069). Regression analysis showed that the RBANS had modest correlations with schizophrenia’ PANSS scores, their duration of current antipsychotic treatment, and diagnosis of diabetes. Schizophrenia with co-morbid diabetes showed more cognitive impairment than schizophrenia without diabetes and diabetes only, especially in immediate memory and attention. PMID:23840437

  15. Diabetes Patients Lax with Meds If Diagnosed with Cancer, Study Finds

    MedlinePLUS

    ... features on this page, please enable JavaScript. Diabetes Patients Lax With Meds If Diagnosed With Cancer, Study ... new study included more than 16,000 diabetes patients, average age 68, taking drugs to lower their ...

  16. Small Study Links Lack of Sleep to Type 2 Diabetes Risk

    MedlinePLUS

    ... JavaScript. Small Study Links Lack of Sleep to Type 2 Diabetes Risk Experts say shortchanging nightly snooze affects hormone ... reported connections between restricted sleep, weight gain and type 2 diabetes," said study senior author Dr. Esra Tasali in ...

  17. Pulsed electromagnetic fields inhibit bone loss in streptozotocin-induced diabetic rats.

    PubMed

    Zhou, Jun; Li, Xinhong; Liao, Ying; Feng, Weibing; Fu, Chengxiao; Guo, Xin

    2015-05-01

    Evidences have shown that pulsed electromagnetic fields (PEMFs) can partially prevent bone loss in streptozotocin (STZ)-induced diabetic rats. However, the precise mechanisms accounting for these favorable effects are unclear. This study aimed to investigate the effects of PEMFs on bone mass and receptor activator of nuclear factor ?B ligand (RANKL)/osteoprotegerin (OPG) and Wnt/?-catenin signaling pathway in STZ rats. Thirty 3-month-old Sprague Dawley rats were randomly divided into the following three groups (n = 10): control group (injection of saline vehicle), DM group (injection of STZ), and PEMFs group (injection of STZ + PEMFs exposure). One week following injection of STZ, rats in the PEMFs group were subject to PEMFs stimulus for 40 min/day, 5 days/week, and lasted for 12 weeks. After 12 week intervention, the results showed that PEMFs increased serum bone-specific alkaline phosphatase level and bone mineral density, and inhibited deterioration of bone microarchitecture and strength in STZ rats. Furthermore, PEMFs up-regulated the mRNA expressions of low-density lipoprotein receptor-related protein 5, ?-catenin and runt-related gene 2 (Runx2), and down-regulated dickkopf1 in STZ rats. However, mRNA expressions of RANKL and OPG were not affected by PEMFs. PEMFs can prevent the diabetes-induced bone loss and reverse the deterioration of bone microarchitecture and strength by restoring Runx2 expression through regulation of Wnt/?-catenin signaling, regardless of its no glucose lowering effect. PMID:25273319

  18. Risk perception and self-management in urban, diverse adults with type 2 diabetes: the improving diabetes outcomes study

    PubMed Central

    Gonzalez, Jeffrey S.; Cohen, Hillel W.; Walker, Elizabeth A.

    2015-01-01

    Purpose The relationship between risk perceptions and diabetes self-care remains ambiguous. This study aimed to assess baseline, one-year follow-up and change score relationships among perceived risk, diabetes self-care and glycemic control for adult individuals participating in a behavioral intervention that improved glycemic control relative to the active control. Methods One-year randomized trial compared a behavioral telephonic intervention with a print only intervention. Participants (N = 526): members of a union/employer sponsored health benefit plan, HbA1c ? 7.5%, prescribed at least one oral diabetes medication. Participants rated perceived risk of diabetes and its complications and diabetes self-care at baseline and one year. Data were collected in a large urban area in the United States. Results There were no relationships between risk perceptions and glycemic control during the study. Baseline perceived risk predicted follow-up self-care. Additionally, participants assigned to the intervention group showed significant changes in dietary and exercise adherence at high levels of risk knowledge and low levels of optimistic bias. Conclusions Perceived risk relates to dietary, exercise and medication adherence in diabetes. The perceived risk construct might foster a more coherent conceptualization of the relationship between one’s diabetes, possible complications, and diabetes self-care behaviors. PMID:23385488

  19. What’s distressing about having type 1 diabetes? A qualitative study of young adults’ perspectives

    PubMed Central

    2013-01-01

    Background Diabetes distress is a general term that refers to the emotional burdens, anxieties, frustrations, stressors and worries that stem from managing a severe, complex condition like Type 1 diabetes. To date there has been limited research on diabetes-related distress in younger people with Type 1 diabetes. This qualitative study aimed to identify causes of diabetes distress in a sample of young adults with Type 1 diabetes. Methods Semi-structured interviews with 35 individuals with Type 1 diabetes (23–30 years of age). Results This study found diabetes related-distress to be common in a sample of young adults with Type 1 diabetes in the second phase of young adulthood (23–30 years of age). Diabetes distress was triggered by multiple factors, the most common of which were: self-consciousness/stigma, day-to-day diabetes management difficulties, having to fight the healthcare system, concerns about the future and apprehension about pregnancy. A number of factors appeared to moderate distress in this group, including having opportunities to talk to healthcare professionals, attending diabetes education programmes and joining peer support groups. Young adults felt that having opportunities to talk to healthcare professionals about diabetes distress should be a component of standard diabetes care. Conclusions Some aspects of living with diabetes frequently distress young adults with Type 1 diabetes who are in their twenties. Clinicians should facilitate young adults’ attendance at diabetes education programmes, provide them with opportunities to talk about their diabetes-related frustrations and difficulties and, where possible, assist in the development of peer-support networks for young adults with diabetes. PMID:23885644

  20. 49 CFR 391.64 - Grandfathering for certain drivers participating in vision and diabetes waiver study programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  1. 49 CFR 391.64 - Grandfathering for certain drivers participating in vision and diabetes waiver study programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  2. 49 CFR 391.64 - Grandfathering for certain drivers participating in vision and diabetes waiver study programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  3. 49 CFR 391.64 - Grandfathering for certain drivers participating in vision and diabetes waiver study programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  4. 49 CFR 391.64 - Grandfathering for certain drivers participating in vision and diabetes waiver study programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  5. Personal history of diabetes, genetic susceptibility to diabetes, and risk of brain glioma: a pooled analysis of observational studies

    PubMed Central

    Kitahara, Cari M.; Linet, Martha S.; Brenner, Alina V.; Wang, Sophia S.; Melin, Beatrice S.; Wang, Zhaoming; Inskip, Peter D.; Beane Freeman, Laura E.; Braganza, Melissa Z.; Carreón, Tania; Feychting, Maria; Gaziano, J. Michael; Peters, Ulrike; Purdue, Mark P.; Ruder, Avima M.; Sesso, Howard D.; Shu, Xiao-Ou; Waters, Martha A.; White, Emily; Zheng, Wei; Hoover, Robert N.; Fraumeni, Joseph F.; Chatterjee, Nilanjan; Yeager, Meredith; Chanock, Stephen J.; Hartge, Patricia; Rajaraman, Preetha

    2013-01-01

    Background Brain glioma is a relatively rare and fatal malignancy in adulthood with few known risk factors. Some observational studies have reported inverse associations between diabetes and subsequent glioma risk, but possible mechanisms are unclear. Methods We conducted a pooled analysis of original data from five nested case-control studies and two case-control studies from the U.S. and China that included 962 glioma cases and 2,195 controls. We examined self-reported diabetes history in relation to glioma risk, as well as effect modification by seven glioma risk-associated single-nucleotide polymorphisms (SNPs). We also examined the associations between 13 diabetes risk-associated SNPs, identified from genome-wide association studies, and glioma risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable-adjusted logistic regression models. Results We observed a 42% reduced risk of glioma for individuals with a history of diabetes (OR=0.58, 95% CI: 0.40–0.84). The association did not differ by sex, study design, or after restricting to glioblastoma, the most common histological sub-type. We did not observe any significant per-allele trends among the 13 diabetes-related SNPs examined in relation to glioma risk. Conclusion These results support an inverse association between diabetes history and glioma risk. The role of genetic susceptibility to diabetes cannot be excluded, and should be pursued in future studies together with other factors that might be responsible for the diabetes-glioma association. Impact These data suggest the need for studies that can evaluate, separately, the association between type 1 and type 2 diabetes and subsequent risk of adult glioma. PMID:24220915

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed

    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

    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

  8. Questions and Answers about the Diabetes Prevention Program Outcomes (DPPOS) Study

    MedlinePLUS

    ... For Reporters Media Contacts Questions & Answers about the Diabetes Prevention Program Outcomes (DPPOS) Study Page Content October 2009 What is the Diabetes Prevention Program (DPP)? The DPP was a randomized, ...

  9. Study Ties Frequent Antibiotic Use to Higher Odds for Type 2 Diabetes

    MedlinePLUS

    ... suggested to influence the mechanisms behind obesity, insulin resistance [a precursor to diabetes] and diabetes in both animal and human models. Previous studies have shown that antibiotics can alter the digestive ecosystem." Two other experts ...

  10. Study Suggests Link Between Adult Diabetes, Exposure to Smoke in Womb

    MedlinePLUS

    ... on this page, please enable JavaScript. Study Suggests Link Between Adult Diabetes, Exposure to Smoke in Womb ... to 54, in California. They found a strong link between their diabetes and parental smoking during pregnancy. ...

  11. Diabetic sexual dysfunction: A comparative study of 160 insulin treated diabetic men and women and an age-matched control group

    Microsoft Academic Search

    Søren Buus Jensen

    1981-01-01

    Sexual dysfunction is a well-known complication in diabetic men, though only a few studies concern sexual dysfunction in diabetic women. Most previous studies are noncomparative. This study reports results from a comparative study of 160 consecutive insulin-treated diabetic outpatients (80 men and 80 women) and a control group (40 men and 40 women) seeing their general practitioner. The age range

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

    Microsoft Academic Search

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

    1998-01-01

    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

  13. Asymptomatic bacteriuria in type 2 Iranian diabetic women: a cross sectional study

    Microsoft Academic Search

    Mohammad Ali Boroumand; Leila Sam; Seyed Hesameddin Abbasi; Mojtaba Salarifar; Ebrahim Kassaian; Saeedeh Forghani

    2006-01-01

    BACKGROUND: The risk of developing infection in diabetic patients is higher and urinary tract is the most common site for infection. Serious complications of urinary infection occur more commonly in diabetic patients. To study the prevalence and associates of asymptomatic bacteriuria (ASB) in women with type 2 diabetes mellitus in the Iranian population, this study was conducted. METHODS: Between February

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

    Microsoft Academic Search

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

    2009-01-01

    BACKGROUND: To determine the prevalence and characteristics of diabetic retinopathy (DR) among Iranian patients with diabetes. METHODS: Design: population-based cross-sectional study. Participants: patients with diabetes aged 25 to 64 years in Tehran province, Iran. This survey was conducted from April to October 2007. The study sample was derived from the first national survey of risk factors for non-communicable disease. Diabetes

  15. Prevalence of retinopathy among adults with self-reported diabetes mellitus: the Sri Lanka diabetes and Cardiovascular Study

    PubMed Central

    2014-01-01

    Background At present there are no large scale nationally-representative studies from Sri Lanka on the prevalence and associations of Diabetic Retinopathy (DR). The present study aims to evaluate the prevalence and risk factors for DR in a community-based nationally-representative sample of adults with self-reported diabetes mellitus from Sri Lanka. Methods A cross-sectional community-based national study among 5,000 adults (?18 years) was conducted in Sri Lanka, using a multi-stage stratified cluster sampling technique. An interviewer-administered questionnaire was used to collect data. Ophthalmological evaluation of patients with ‘known’ diabetes (previously diagnosed at a government hospital or by a registered medical practitioner) was done using indirect ophthalmoscopy. A binary-logistic regression analysis was performed with ‘presence of DR’ as the dichotomous dependent variable and other independent covariates. Results Crude prevalence of diabetes was 12.0% (n?=?536), of which 344 were patients with ‘known’ diabetes. Mean age was 56.4?±?10.9 years and 37.3% were males. Prevalence of any degree of DR was 27.4% (Males-30.5%, Females-25.6%; p?=?0.41). In patients with DR, majority had NPDR (93.4%), while 5.3% had maculopathy. Patients with DR had a significantly longer duration of diabetes than those without. In the binary-logistic regression analysis in all adults duration of diabetes (OR:1.07), current smoking (OR:1.67) and peripheral neuropathy (OR:1.72) all were significantly associated with DR. Conclusions Nearly 1/3rd of Sri Lankan adults with self-reported diabetes are having retinopathy. DR was associated with diabetes duration, cigarette smoking and peripheral neuropathy. However, further prospective follow up studies are required to establish causality for identified risk factors. PMID:25142615

  16. Diabetic Neuropathy: A Clinical and Neuropathological Study of 107 Patients

    PubMed Central

    Younger, David S.

    2010-01-01

    One hundred seven patients were retrospectively studied from 1992 to 2002 with diabetic neuropathy that underwent peripheral nerve biopsy. Nerve biopsy revealed the underlying histopathology, including cell and humoral-mediated immunological lesions in the majority of patients. When combined with clinical and laboratory studies, nerve biopsy has the potential to assist in the selection of patients who may benefit from immunomodulatory therapy. PMID:21152210

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

    PubMed Central

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

    2012-01-01

    Background and Purpose Diabetes increases stroke risk, but whether diabetes status immediately prior to stroke improves prediction, and whether duration is important, are less clear. We hypothesized that diabetes duration independently predicts ischemic stroke. Methods Among 3,298 stroke-free participants in the Northern Manhattan Study (NOMAS), baseline diabetes and age at diagnosis were determined. Incident diabetes was assessed annually (median=9 years). Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals (HR, 95% CI) for incident ischemic stroke using baseline diabetes, diabetes as a time-dependent covariate, and duration of diabetes as a time-varying covariate; models were adjusted for demographic and cardiovascular risk factors. Results Mean age was 69±10 years (52% Hispanic, 21% white, and 24% black); 22% were diabetic at baseline and 10% developed diabetes. There were 244 ischemic strokes, and both baseline diabetes (HR 2.5, 95% CI 1.9-3.3) and diabetes considered as a time-dependent covariate (HR 2.4, 95% CI 1.8-3.2) were similarly associated with stroke risk. Duration of diabetes was associated with ischemic stroke (adjusted HR=1.03 per year with diabetes, 95% CI=1.02-1.04). Compared to non-diabetic participants, those with diabetes for 0-5 years (adjusted HR=1.7, 95% CI=1.1-2.7), 5-10 years (adjusted HR=1.8, 95% CI=1.1-3.0), and ?10 years (adjusted HR=3.2, 95% CI=2.4-4.5) were at increased risk. Conclusion Duration of diabetes is independently associated with ischemic stroke risk adjusting for risk factors. The risk increases 3% each year, and triples with diabetes ?10 years. PMID:22382158

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

    PubMed Central

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

    2014-01-01

    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. PMID:25395912

  19. Urban-rural differences in atherogenic dyslipidaemia (URDAD Study): a retrospective report on diabetic and non-diabetic subjects of Northern India.

    PubMed

    Agrawal, Poonam; Reddy, Varikasuvu Seshadri; Madaan, Himanshu; Patra, Surajeet Kumar; Garg, Renu

    2014-09-01

    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. PMID:25395912

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

    E-print Network

    Paris-Sud XI, Université de

    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

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

    E-print Network

    Boyer, Edmond

    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

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

    E-print Network

    Boyer, Edmond

    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

  3. Ghrelin enhances gastric emptying in diabetic gastroparesis: a double blind, placebo controlled, crossover study

    Microsoft Academic Search

    C D R Murray; N M Martin; M Patterson; S A Taylor; M A Ghatei; M A Kamm; C Johnston; S R Bloom; A V Emmanuel

    2005-01-01

    Background: Diabetic gastroparesis is a disabling condition with no consistently effective treatment. In animals, ghrelin increases gastric emptying and reverses postoperative ileus. We present the results of a double blind, placebo controlled, crossover study of ghrelin in gastric emptying in patients with diabetic gastroparesis.Methods: Ten insulin requiring diabetic patients (five men, six type I) referred with symptoms indicative of gastroparesis

  4. Finding Temporal Patterns in Noisy Longitudinal Data: A Study in Diabetic

    E-print Network

    Coenen, Frans

    Finding Temporal Patterns in Noisy Longitudinal Data: A Study in Diabetic Retinopathy Vassiliki is a large longitudinal patient database collected as part of a diabetic retinopathy screening programme. The diabetic retinopathy application, the data warehousing and cleaning process, and the frequent pattern

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

    E-print Network

    Boyer, Edmond

    1 A concept mapping study of nutritional knowledge in diabetic children and their parents and its evolution following education sessions in 5 diabetic children and their mothers, and to evaluate, Diabetes, Concept mapping, Knowledge, patient education hal-00154458,version1-13Jun2007 #12;3 Title

  6. Relation of Stressful Life Events to Metabolic Control Among Adolescents With Diabetes: 5-Year Longitudinal Study

    E-print Network

    Creswell, J. David

    Relation of Stressful Life Events to Metabolic Control Among Adolescents With Diabetes: 5-Year adolescents with Type 1 diabetes (n 132; average age at enrollment 12 years) annually for 5 years. Measures effects on blood glucose. In an older study of 31 adolescents with Type 1 diabetes, neither of two

  7. Study of magnesium, glycosylated hemoglobin and lipid profile in diabetic retinopathy

    Microsoft Academic Search

    Ishrat Kareem; S. A. Jaweed; J. S. Bardapurkar; V. P. Patil

    2004-01-01

    The present study was undertaken in 100 subjects, 30 diabetics without complication (group I), 40 diabetics with retinopathy\\u000a (group II) and 30 non diabetic as normal control group (group III). Blood sugar levels, magnesium, cholesterol and triglyceride\\u000a were analyzed from plasma and serum. The results were correlated with degree of diabetic control from the levels of glycosylated\\u000a hemoglobin. Serum magnesium

  8. UK prospective study of therapies of maturity-onset diabetes

    Microsoft Academic Search

    R. C. Turner; J. I. Mann; G. Iceton; S. Oakes; A. Smith; J. Moore; T. D. R. Hockaday; R. R. Holman; J. Stowers; M. Stowers; L. Murchison; L. Borthwick; D. Wright; M. Fitzgerald; S. Gyde; T. Pilkington; N. Oakley; M. Whitehead; E. Kohner; P. Lawson; R. Hayes; W. Henry; R. Peto; A. Moore; T. Stark; L. Todd

    1983-01-01

    Summary  A multi-centre, prospective randomised study of the therapy of maturity-onset diabetes has been started, and we report progress of the first 286 patients with 1-year followup. Newly presenting patients (aged 25–65 years inclusive) were initially treated by diet and divided into three categories. (1) Forty-one patients (14%) were primary diet failure in that they continued to have symptoms or their

  9. Glomerulopathy in Spontaneously Obese Rhesus Monkeys with Type 2 Diabetes: A Stereological Study

    PubMed Central

    Najafian, Behzad; Masood, Awais; Malloy, Patrick; Campos, Alfonso; Hansen, Barbara C.; Mauer, Michael; Caramori, M. Luiza

    2011-01-01

    Background Animal models provide insights into the diabetic nephropathy pathogenesis, however, available rodent models do not mirror the heterogeneity of lesions in type 2 diabetic (T2DM) patients, and do not progress to end stage renal disease. Previous studies showed that spontaneously obese T2DM rhesus monkeys develop many of the features of human diabetic glomerulopathy, and may progress to ESRD. Here, in order to further characterize diabetic glomerulopathy in this model, we used electron microscopic stereology.. Methods Renal biopsies from 17 diabetic, 17 pre-diabetes/metabolic syndrome (preDM/MS) and 11 non-diabetic monkeys were studied. Fractional volumes of mesangium [Vv(Mes/glom)], mesangial matrix [Vv(MM/glom)] and mesangial cells [Vv(MC/glom)], glomerular basement membrane (GBM) width and peripheral GBM surface density per glomerulus [Sv(PGBM/glom)] were estimated. Glomerular filtration (GFR) and albumin excretion rates (AER) were measured in a limited number of animals. Glomerular structural and biochemical/metabolic data were compared among the groups. Results Diabetic monkeys showed classical diabetic nephropathy changes, including GBM thickening (p=0.001), increased Vv(Mes/glom) (p=0.02), and reduced Sv(PGBM/glom) (p=0.03) compared to non-diabetic monkeys. Increased Vv(Mes/glom) was primarily due to increased Vv(MM/glom) (p=0.03). Glomerular structural parameters inter-relationships in diabetic monkeys mirrored those of human diabetic glomerulopathy. AER was greater (p=0.03) in diabetic vs. non-diabetic monkeys. There was evidence for a positive relationship between AER and Vv(Mes/glom). Conclusions These studies indicate that this primate model shares many features of human diabetic glomerulopathy. Mesangial expansion in this model, similar to human diabetic nephropathy and different from available rodent models of the disease, is primarily due to increased mesangial matrix. PMID:21370383

  10. Intimal medial thickness of the carotid artery in South Indian diabetic and non-diabetic subjects: the Chennai Urban Population Study (CUPS)

    Microsoft Academic Search

    V. Mohan; R. Ravikumar; S. Shanthi Rani; R. Deepa

    2000-01-01

    Aim\\/hypothesis. Increased intimal medial thickness (IMT) of the carotid arteries is considered a useful marker of atherosclerosis. The aim\\u000a of this study was to compare the intimal medial thickness values in urban non-diabetic and diabetic South Indian subjects\\u000a who have a high risk of coronary artery disease.¶Methods. The subjects for this study were 140 diabetic and 103 non-diabetic control subjects

  11. Diabetes in the workplace - diabetic’s perceptions and experiences of managing their disease at work: a qualitative study

    PubMed Central

    2013-01-01

    Background Diabetes represents one of the biggest public health challenges facing the UK. It is also associated with increasing costs to the economy due to working days lost as people with diabetes have a sickness absence rate 2–3 times greater than the general population. Workplaces have the potential to support or hinder self- management of diabetes but little research has been undertaken to examine the relationship between work and diabetes in the UK. This paper seeks to go some way to addressing this gap by exploring the perceptions and experiences of employees with diabetes. Methods Forty three people with diabetes were purposively recruited to ascertain ways in which they managed their disease in the workplace. Semi-structured, interviews were undertaken, tape recorded and transcribed. Analysis was conducted using a constant comparative approach. Results Although respondents had informed managers of their diabetic status they felt that their managers had little concept of the effects of the work environment on their ability to manage their disease. They did not expect support from their managers and were concerned about being stigmatised or treated inappropriately. Work requirements took priority. They had to adapt their disease management to fit their job and reported running their blood glucose levels at higher than optimal levels, thereby putting themselves at higher risk of long term complications. Conclusions Little research has examined the way in which employees with diabetes manage their disease in the workplace. This research shows there is a need to increase the awareness of managers of the short and long term economic benefit of supporting employees with diabetes to manage their disease effectively whist at work. Employees may need individually assessed and tailored support on the job in order to manage their disease effectively. PMID:23617727

  12. A Wetland Field Study

    NSDL National Science Digital Library

    The field projects at this site give students an opportunity to investigate a number of wetland characteristics firsthand: surveying wetland vegetation, soils, water quality and wildlife; documenting the wetland from an artist's perspective; investigating land uses along its periphery; and refining a base map upon which all collected information can be recorded. This resource explains how to organize the field study, thereby securing the interest of the students. It is part of a module that aims to help students get to know the complexities of wetlands, discover wildlife, enjoy the experience of being outdoors, and learn how necessary wetlands are to the health of our environment. For educators and their middle school students, it suggests ways to study wetland characteristics, why wetlands are important, and how students and teachers can help protect a local wetland in any part of the country. An associated set of activities is also available.

  13. Microbial field pilot study

    SciTech Connect

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

    1993-05-01

    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.

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

    Microsoft Academic Search

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

    2011-01-01

    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.

  15. A Clinical Study of Dermatoses in Diabetes to Establish its Markers

    PubMed Central

    Timshina, Dependra Kumar; Thappa, Devinder Mohan; Agrawal, Aparna

    2012-01-01

    Background: Cutaneous manifestations of diabetes mellitus generally appear subsequent to the development of the disease, but they may be the first presenting signs and in some cases they may precede the primary disease manifestation by many years. Aims: The aim of our study was to study the spectrum of dermatoses in diabetics, to know the frequency of dermatoses specific to diabetes mellitus (DM), and to establish the mucocutaneous markers of DM. Material and Methods: The study was conducted at a diabetic clinic and our department between September 2008 and June 2010. Two hundred and twenty-four diabetic patients were included in the study group and those with gestational diabetes were excluded. Healthy age- and sex-matched individuals were taken as controls. Results: The male to female ratio was 1 : 1.21. Type 2 DM was seen in 89.7% and type 1 DM in 10.3% of the patients. Dermatoses were seen in 88.3% of the diabetics compared to 36% in non-diabetic controls (P<0.05). Cutaneous infections were the most common dermatoses followed by acanthosis nigricans and xerosis in diabetics. Type 2 DM was found to have an increased risk of complications than type 1 DM. Complications of diabetes were seen in 43.7% of the diabetic cases. Diabetic dermopathy, loss of hair over the legs, diabetic foot ulcer, and so on, were found to be the cutaneous markers of DM in our group of cases. Conclusion: Dermatoses were more common in diabetics than non-diabetics. Cutaneous infections formed the largest group of dermatoses in DM. PMID:22470203

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

    PubMed Central

    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.

    2015-01-01

    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

  17. Social and economic impact of diabetics in Bangladesh: protocol for a case–control study

    PubMed Central

    2013-01-01

    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

  18. Pharmacokinetics of gentamicin in hemodialysis patients: a comparative study between diabetic and non-diabetic patients

    Microsoft Academic Search

    Mohammed A. Al-Homrany; Yacoub M. Irshaid; Assem K. El Sherif; Haider A. Omar

    2009-01-01

    Diabetic nephropathy is one of the leading causes of end-stage renal disease (ESRD). There is some evidence that differences\\u000a in extracellular fluid volume and capillary permeability do exist between diabetic and non-diabetic patients. This may have\\u000a an impact on the gentamicin volume of distribution and clearance and thus dosing regimen. The pharmacokinetic parameters of\\u000a gentamicin [volume of distribution (Vd), clearance

  19. Insulin secretion and insulin sensitivity in diabetic subgroups: studies in the prediabetic and diabetic state

    Microsoft Academic Search

    D. Tripathy; Å.-L. Carlsson; M. Lehto; B. Isomaa; T. Tuomi; L. Groop

    2000-01-01

    Aims\\/hypothesis. To evaluate insulin sensitivity and insulin secretion in prediabetic and diabetic subjects with mutations in MODY1 (HNF-4?) and MODY3 (HNF-1?) genes, in subjects with GAD antibodies, latent autoimmune diabetes in adults and in subjects with the common form of Type\\u000a II (non-insulin-dependent) diabetes mellitus. Methods. Insulin secretion was measured as the incremental 30-min insulin (I30) and insulin glucose ratio

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

    E-print Network

    Boyer, Edmond

    1 Diabetes Risk Factors, Diabetes Risk Algorithms, and the Prediction of Future Frailty.ac.uk Running head Diabetes risk scores and frailty Key Words Ageing, frailty, diabetes risk scores, diabetes;2 Abstract Objective: To examine whether established diabetes risk factors and diabetes risk algorithms

  1. Sexual dysfunction in younger insulin-treated diabetic females. A comparative study.

    PubMed

    Jensen, S B

    1985-10-01

    The presence of sexual dysfunction was studied comparatively in 80 insulin treated diabetic women, 26-45 years of age, and in an age-matched control group of women without chronic somatic disease or psychiatric illness. We found no significant difference in the incidence of sexual dysfunction between the two groups (27.5% and 25% respectively). In diabetics and controls, the most common symptom of sexual dysfunction was reduced libido (22.5% in both groups) while only 18% complained of orgasmic dysfunction. In diabetics, sexual dysfunction was not correlated to age and diabetes duration. Sexual dysfunction was correlated to peripheral neuropathy but not to retinopathy, nephropathy, reduced beat-to-beat variation, regulation quality, insulin treatment and age at diabetes onset. Nearly half the patients reporting sexual dysfunction were without any late diabetic complications, indicating the influence of psychosocial factors. Somatopsychic reactions (emotional reactions to somatic disease) seem to be of relevance, although diabetic women may have less problems in this area than diabetic men. A better acceptance of the disease might partly explain the difference in sexual complications between diabetic males and females. Diabetic women and their partners should be offered, at least once a year, the possibility to discuss interpersonal relationships and the emotional aspects of living with diabetes. Most sexual problems should be handled in the diabetes clinic and only selected cases referred for sex therapy. PMID:4076508

  2. Microbial Field Pilot Study

    SciTech Connect

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

    1990-11-01

    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.

  3. 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

    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

    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

  4. Pediatric diabetes consortium type 1 diabetes new onset (NeOn) study: Factors associated with HbA1c levels one year after diagnosis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To identify determinants of hemoglobin A1c (HbA1c) levels 1 yr after the diagnosis of type 1 diabetes (T1D) in participants in the Pediatric Diabetes Consortium (PDC) T1D New Onset (NeOn) Study. Diabetes-specific as well as socioeconomic factors during the first year following diagnosis were analyze...

  5. Physician and Nurse Use of Psychosocial Strategies in Diabetes Care Results of the cross-national Diabetes Attitudes, Wishes and Needs (DAWN) study

    Microsoft Academic Search

    MARK PEYROT; RICHARD R. RUBIN; LINDA M. SIMINERIO

    2006-01-01

    OBJECTIVE — To determine the use of psychosocial strategies by health care providers in treating patients with diabetes and the factors associated with use of these strategies. RESEARCH DESIGN AND METHODS — Cross-sectional survey of national samples of generalist and diabetes specialist physicians (n 2,705) and nurses (n 1,122) from the multinational study of Diabetes Attitudes, Wishes and Needs. Respondents

  6. Impaired glucose tolerance precedes but does not predict insulin-dependent diabetes mellitus: a study of identical twins

    Microsoft Academic Search

    S. F. Beer; D. A. Heaton; K. G. M. M. Alberti; D. A. Pyke; R. D. G. Leslie

    1990-01-01

    Summary  Non-diabetic identical twins of insulin-dependent diabetic patients were studied within five years of the diagnosis of their index twin in order to determine whether changes in intermediary metabolism precede the onset of insulin-dependent diabetes mellitus. Two studies were performed: a cross-sectional study of 12 non-diabetic twins and a prospective study of a separate group of 41 non-diabetic twins. Ofthe 12

  7. Microbial field pilot study

    SciTech Connect

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

    1992-03-01

    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.

  8. Microbial field pilot study

    SciTech Connect

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

    1992-03-01

    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.

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

    PubMed Central

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

    2014-01-01

    Background: The management of Diabetes Mellitus and its important complication Diabetic Ketoacidosis is very crucial in today’s world where the prevalence of Diabetes is very high. Medical students are the pillars of our future healthcare system and it is important to evaluate and update their knowledge and awareness regarding these both conditions. Materials and Methods: This study was a cross-sectional; Questionnaire based observational study conducted in a tertiary care hospital. The respondents were final year MBBS students of that college. Study instrument was a self developed, pre-validated, semi-structured questionnaire. Results: A total of 73 questionnaires were considered for analysis, giving a response rate of 90.12% with 43.83% and 56.16% were male and female respondents respectively. About 81.25% and 90.24% of male and female respondents gave correct answer to question related to the best indicator of glycemic control. Lack of knowledge was seen regarding the world Diabetes day. Approximately 37% of the respondent’s parents were diabetic. Only 12 out of 73 respondents were aware about the factors leading to DKA.8 out of 73 were aware about investigations to be done in DKA. Around 43.84% of responders knew regarding the proper screening duration in person with risk of diabetes. Conclusion: From the study it was concluded that most of the students have basic knowledge regarding diabetes mellitus, its clinical features and management etc but only 50 % of the respondent were aware about DKA and further teaching and post teaching evaluation are needed in future direction. PMID:24959462

  10. Design of a Randomized Trial of Diabetes Genetic Risk Testing to Motivate Behavior Change: The Genetic Counseling/Lifestyle Change (GC/LC) Study to Prevent Diabetes

    PubMed Central

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

    2013-01-01

    Background The efficacy of genetic testing for diabetes risk to motivate behavior change for diabetes prevention is currently unknown. Purpose This paper presents key issues in the design and implementation of one of the first randomized trials (the Genetic Counseling/Lifestyle Change for Diabetes Prevention Study) to test whether knowledge of diabetes genetic risk can motivate patients to adopt healthier behaviors. Methods Because individuals may react differently to receiving ‘higher’ vs ‘lower’ genetic risk results, we designed a 3-arm parallel group study to separately test the hypotheses that: (1) patients receiving ‘higher’ diabetes genetic risk results will increase healthy behaviors compared to untested controls, and (2) patients receiving ‘lower’ diabetes genetic risk results will decrease healthy behaviors compared to untested controls. In this paper we describe several challenges to implementing this study, including: (1) the application of a novel diabetes risk score derived from genetic epidemiology studies to a clinical population, (2) the use of the principle of Mendelian randomization to efficiently exclude ‘average’ diabetes genetic risk patients from the intervention, and (3) the development of a diabetes genetic risk counseling intervention that maintained the ethical need to motivate behavior change in both ‘higher’ and ‘lower’ diabetes genetic risk result recipients. Results Diabetes genetic risk scores were developed by aggregating the results of 36 diabetes-associated single nucleotide polymorphisms. Relative risk for type 2 diabetes was calculated using Framingham Offspring Study outcomes, grouped by quartiles into ‘higher’, ‘average (middle two quartiles)’ and ‘lower’ genetic risk. From these relative risks, revised absolute risks were estimated using the overall absolute risk for the study group. For study efficiency, we excluded all patients receiving ’average’ diabetes risk results from the subsequent intervention. This post randomization allocation strategy was justified because genotype represents a random allocation of parental alleles (‘Mendelian randomization’). Finally, because it would be unethical to discourage participants to participate in diabetes prevention behaviors, we designed our two diabetes genetic risk counseling interventions (for ‘higher’ and ‘lower’ result recipients) so that both groups would be motivated despite receiving opposing results. Limitations For this initial assessment of the clinical implementation of genetic risk testing we assessed intermediate outcomes of attendance at a 12-week diabetes prevention course and changes in self-reported motivation. If effective, longer term studies with larger sample sizes will be needed to assess whether knowledge of diabetes genetic risk can help patients prevent diabetes. Conclusions We designed a randomized clinical trial designed to explore the motivational impact of disclosing both higher than average and lower than average genetic risk for type 2 diabetes. This design allowed exploration of both increased risk and false reassurance, and has implications for future studies in translational genomics. PMID:22013171

  11. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice

    Microsoft Academic Search

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

    1990-01-01

    Summary  The effects on glucose homeostasis of eleven plants used as traditional treatments for diabetes mellitus were evaluated in normal and streptozotocin diabetic mice. Dried leaves of agrimony (Agrimonia eupatoria), alfalfa (Medicago saliva), blackberry (Rubus fructicosus), celandine (Chelidonium majus), eucalyptus (Eucalyptus globulus), lady's mantle (Alchemilla vulgaris), and lily of the valley (Convallaria majalis); seeds of coriander (Coriandrum sativum); dried berries of

  12. Cardiovascular comorbidities among public health clinic patients with diabetes: the Urban Diabetics Study

    Microsoft Academic Search

    Jessica M Robbins; David A Webb; Christopher N Sciamanna

    2005-01-01

    BACKGROUND: We sought to determine the frequency and distribution of cardiovascular comorbidities in a large cohort of low-income patients with diabetes who had received primary care for diabetes at municipal health clinics. METHODS: Outpatient data from the Philadelphia Health Care Centers was linked with hospital discharge data from all Pennsylvania hospitals and death certificates. RESULTS: Among 10,095 primary care patients

  13. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study

    PubMed Central

    2011-01-01

    Summary Background In the 2·8 years of the Diabetes Prevention Program (DPP) randomised clinical trial, diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo. We investigated the persistence of these effects in the long term. Methods All active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 5·7 years (IQR 5·5–5·8). 910 participants were from the lifestyle, 924 from the metformin, and 932 were from the original placebo groups. On the basis of the benefits from the intensive lifestyle intervention in the DPP, all three groups were offered group-implemented lifestyle intervention. Metformin treatment was continued in the original metformin group (850 mg twice daily as tolerated), with participants unmasked to assignment, and the original lifestyle intervention group was offered additional lifestyle support. The primary outcome was development of diabetes according to American Diabetes Association criteria. Analysis was by intention-to-treat. This study is registered with ClinicalTrials.gov, number NCT00038727. Findings During the 10·0-year (IQR 9·0–10·5) follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight. The modest weight loss with metformin was maintained. Diabetes incidence rates during the DPP were 4·8 cases per 100 person-years (95% CI 4·1–5·7) in the intensive lifestyle intervention group, 7·8 (6·8–8·8) in the metformin group, and 11·0 (9·8–12·3) in the placebo group. Diabetes incidence rates in this follow-up study were similar between treatment groups: 5·9 per 100 person-years (5·1–6·8) for lifestyle, 4·9 (4·2–5·7) for metformin, and 5·6 (4·8–6·5) for placebo. Diabetes incidence in the 10 years since DPP randomisation was reduced by 34% (24–42) in the lifestyle group and 18% (7–28) in the metformin group compared with placebo. Interpretation During follow-up after DPP, incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group, but the cumulative incidence of diabetes remained lowest in the lifestyle group. Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years. Funding National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). PMID:19878986

  14. Diabetes and breast cancer : the women's healthy eating & living study

    E-print Network

    Erickson, Kirsten Diann

    2011-01-01

    B, et al: Exercise and type 2 diabetes: the American Collegediabetes risk. Unfortunately, the ability to maintain a consistent exerciseand exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes

  15. German New Onset Diabetes in the Young Incident Cohort Study: DiMelli Study Design and First-Year Results

    PubMed Central

    Thümer, Leonore; Adler, Kerstin; Bonifacio, Ezio; Hofmann, Frank; Keller, Manfred; Milz, Christine; Munte, Axel; Ziegler, Anette-Gabriele

    2010-01-01

    BACKGROUND: Diabetes incidence in childhood and youth is increasing worldwide, including autoimmune and non-autoimmune cases. Recent findings suggest that there is a larger than expected proportion of type 2 diabetes in youth, and potential cases of intermediate diabetes phenotypes. Most pediatric diabetes registries focus on type 1 diabetes. Also, there is an absence of reliable data on type 2 diabetes incidence in youth. AIMS: The DiMelli study aims to establish a diabetes incidence cohort registry of patients in Germany, diagnosed with diabetes mellitus before age 20 years. It will be used to characterize diabetes phenotypes by immunologic, metabolic, and genetic markers. DiMelli will assess the contribution of obesity and socio-demographic factors to the development of diabetes in childhood and youth. METHODS: Recruitment of patients started in 2009, and is expected to continue at a rate of 250 patients per year. RESULTS: 84% of the 216 patients recruited within the first year were positive for multiple islet autoantibodies, 12% for one islet autoantibody, and 4% were islet autoantibody-negative. Patients with multiple islet autoantibodies were younger and had lower fasting C-peptide levels, compared to islet autoantibody-negative patients (median age 10.0 vs. 14.1 years, p < 0.01). CONCLUSIONS: Results from the first year of the study show that DiMelli will help to reveal new knowledge on the etiology of diabetes, and the contribution of genetic predisposition and environmental risk factors to the different types of diabetes. PMID:21409312

  16. Association of Restless Legs Syndrome in Type 2 Diabetes: A Case-Control Study

    PubMed Central

    Merlino, Giovanni; Fratticci, Lara; Valente, Mariarosaria; Del Giudice, Angela; Noacco, Claudio; Dolso, Pierluigi; Cancelli, lacopo; Scalise, Anna; Gigli, Gian Luigi

    2007-01-01

    Study Objective: To look for an association between restless legs syndrome (RLS) and type 2 diabetes in a case-control study; to analyze the characteristics of RLS in diabetic patients; and to identify possible risk factors for the development of RLS in diabetic patients. Design: A case-control study. Setting: Diabetic outpatient clinic of a major university hospital. Participants: One hundred twenty-four consecutive outpatients with diabetes and 87 consecutive controls with a previous diagnosis of other endocrine disease. Interventions: RLS was diagnosed using the criteria of the International RLS Study Group, and severity of RLS was assessed using the International RLS Study Group Rating Scale. Characteristics of RLS and several laboratory parameters were investigated in diabetic patients and controls affected by the sleep disorder. A clinical diagnosis of polyneuropathy was assessed to evaluate its role as a risk factor for RLS in diabetic patients. Measurement and Results: RLS was diagnosed in 22 diabetic patients (17.7%) and in only 5 controls (5.5%), 3 of whom had pituitary and 2 had adrenal gland disorders, and RLS was independently associated with type 2 diabetes (P < 0.04). Even if a clinical diagnosis of polyneuropathy was made in only 27% of diabetic patients affected by RLS, after multivariate logistic regression, the presence of polyneuropathy was the only variable associated with RLS in diabetics (odds ratio, 7.88; 95% confidence interval, 1.34–46.28; P < 0.02). RLS in diabetics showed a frequency of positive family history lower than that known for primary RLS, showed a late age of onset, and manifested itself after the diagnosis of diabetes was made. Conclusions: This is the first controlled study confirming a significant association between RLS and type 2 diabetes. In diabetic patients, polyneuropathy represents the main risk factor for RLS. However, polyneuropathy only partially explains the increased prevalence of RLS in type 2 diabetics. Clinical characteristics of RLS in diabetic patients are those of a secondary form. Citation: Merlino G; Fratticci L; Valente M et al. Association of restless legs syndrome in type 2 diabetes: a case-control study. SLEEP 2007;30(7):866–871. PMID:17682657

  17. Neuropathy and Related Findings in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study

    PubMed Central

    Martin, Catherine L.; Albers, James W.; Pop-Busui, Rodica

    2014-01-01

    OBJECTIVE To describe the development and progression of neuropathy and related findings among patients with type 1 diabetes who participated in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. RESEARCH DESIGN AND METHODS The main diabetic peripheral neuropathy (DPN) outcome was assessed using clinical symptoms, signs, and nerve conduction study results during DCCT and repeated in EDIC year 13/14. Cardiovascular autonomic neuropathy (CAN) was assessed by R-R response to paced breathing, Valsalva ratio, and blood pressure response to standing during DCCT and in EDIC years 13/14 and 16/17. Additionally, symptoms reflecting neuropathic pain and autonomic function (including hypoglycemia awareness) were collected yearly in EDIC using standardized questionnaires; peripheral neuropathy was also assessed annually using the Michigan Neuropathy Screening Instrument. Assessments of genitourinary function were collected at EDIC year 10. RESULTS Intensive therapy during the DCCT significantly reduced the risk of DPN and CAN at DCCT closeout (64% and 45%, respectively, P < 0.01). The prevalence and incidence of DPN and CAN remained significantly lower in the DCCT intensive therapy group compared with the DCCT conventional therapy group through EDIC year 13/14. CONCLUSIONS The persistent effects of prior intensive therapy on neuropathy measures through 14 years of EDIC largely mirror those observed for other diabetes complications. DCCT/EDIC provides important information on the influence of glycemic control, and the clinical course of diabetic neuropathy, and, most important, on how to prevent neuropathy in type 1 diabetes. PMID:24356595

  18. Diabetic worker with history of falls: a case study.

    PubMed

    Lurati, Ann R

    2014-05-01

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

  19. Painful diabetic neuropathy.

    PubMed

    Peltier, Amanda; Goutman, Stephen A; Callaghan, Brian C

    2014-01-01

    Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly. These include the use of skin biopsies to measure small unmyelinated fibers, as well as even newer techniques that can measure both small unmyelinated fibers and large myelinated fibers in the same biopsy. The main treatments for painful diabetic neuropathy remain management of the underlying diabetes and drugs for the relief of pain. However, emerging evidence points to major differences between type 1 and type 2 diabetes, including the ability of glycemic control to prevent neuropathy. Enhanced glucose control is much more effective at preventing neuropathy in patients with type 1 diabetes than in those with type 2 disease [corrected]. This dichotomy emphasizes the need to study the pathophysiologic differences between the two types of diabetes, because different treatments may be needed for each condition. The impact of the metabolic syndrome on neuropathy in patients with type 2 diabetes may account for the difference between the two types of diabetes and requires further study. Finally, neuropathic pain is under-recognized and undertreated despite an ever evolving list of effective drugs. Evidence exists to support several drugs, but the optimal sequence and combination of these drugs are still to be determined. PMID:24803311

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

    PubMed Central

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

    2013-01-01

    Objective To explore knowledge and attitudes regarding the links between diabetes and periodontitis of medical and dental healthcare professionals as well as those of people with diabetes. Design Qualitative interview study. Participants 4 people with diabetes, four dental professionals, three general practitioners (GPs) with a specialist interest in diabetes, one GP without a specialist interest in diabetes, three diabetic nurse specialists and two consultant diabetologists. Setting Primary and secondary care in Newcastle upon Tyne. Methods Interviews were audio recorded and transcribed verbatim. Framework analysis was used iteratively to achieve progressive focusing and to develop conceptual ideas. Results 3 inter-related themes emerged: (1) uncertain knowledge—a lack of familiarity about the links between periodontitis and diabetes; (2) unworkable knowledge—that even if the links between periodontitis and diabetes were known, it is impossible for anything to be done for patient benefit given the differing systems that medical and dental health professionals work in and (3) isolated knowledge—the perceived division that exists between the medical and dental professions has the potential to negatively impact on advances in diabetes patient care. The patients simply wanted all the healthcare professionals to be giving the same messages consistently and to help them access the (dental) care they need. Conclusions The research on the links between periodontal disease and diabetes appears to have limited impact on the organisation of diabetes care, and the divisions that exist between the medical and dental professions have the potential to negatively impact on patient care. PMID:23418299

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

    PubMed Central

    2013-01-01

    Background Diabetes mellitus type 2 (DM2) is highly associated with increased risk for chronic kidney disease (CKD), end stage renal disease (ESRD) and cardiovascular morbidity. Epidemiological and genetic studies generate hypotheses for innovative strategies in DM2 management by unravelling novel mechanisms of diabetes complications, which is essential for future intervention trials. We have thus initiated the DIAbetes COhoRtE study (DIACORE). Methods DIACORE is a prospective cohort study aiming to recruit 6000 patients of self-reported Caucasian ethnicity with prevalent DM2 for at least 10 years of follow-up. Study visits are performed in University-based recruiting clinics in Germany using standard operating procedures. All prevalent DM2 patients in outpatient clinics surrounding the recruiting centers are invited to participate. At baseline and at each 2-year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized online questionnaire and physical examination to determine incident micro- and macrovascular DM2 complications, malignancy and hospitalization, with a primary focus on renal events. Confirmatory outcome information is requested from patient records. Blood samples are obtained for a centrally analyzed standard laboratory panel and for biobanking of aliquots of serum, plasma, urine, mRNA and DNA for future scientific use. A subset of the cohort is subjected to extended phenotyping, e.g. sleep apnea screening, skin autofluorescence measurement, non-mydriatic retinal photography and non-invasive determination of arterial stiffness. Discussion DIACORE will enable the prospective evaluation of factors involved in DM2 complication pathogenesis using high-throughput technologies in biosamples and genetic epidemiological studies. PMID:23409726

  2. Diabetes and risk of bladder cancer among postmenopausal women in the Iowa Women's Health Study

    PubMed Central

    Prizment, Anna E.; Anderson, Kristin E.; Yuan, Jian-Min; Folsom, Aaron R.

    2013-01-01

    Purpose Studies have indicated that diabetes is a risk factor for bladder cancer; however, many failed to adjust for confounding variables. An earlier publication from the Iowa Women's Health Study reported a positive association of baseline diabetes with bladder cancer risk between 1986 and 1998, although the number of cases was small (n=112). We re-examined the diabetes–bladder cancer risk association by accounting for 12 more years of follow-up and assessed whether the association varied by diabetes duration, body mass index or waist-to-hip ratio (WHR). Methods Proportional hazards regression was used to estimate the hazard ratio (HR) of bladder cancer (n=277) in relation to diabetes (before enrollment and during follow-up) and diabetes duration using a time-dependent approach. Results In a multivariate time-dependent analysis, the HR for bladder cancer was 1.69 (95% CI, 1.40-2.41) in relation to diabetes among 37,327 postmenopausal women initially free of cancer. There was an interaction between diabetes and WHR (p =0.01). Bladder cancer HR in diabetic women with WHR>0.9 was 2.5 times higher than expected. There was no dose-response relation of bladder cancer risk with diabetes duration. Compared to no diabetes, HR were 1.77. 2.03, and 1.55 for diabetes durations of ?5, 6-10, and >10 years, respectively. Conclusions We confirmed a positive association between diabetes and bladder cancer risk among white post-menopausal women. We also observed a synergistic interaction between diabetes and high WHR in bladder cancer development that might be explained by increased insulin resistance and inflammation related to abdominal obesity. PMID:23296458

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

    PubMed Central

    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

    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

  4. Type 2 diabetes, glucose homeostasis and incident atrial fibrillation: the Atherosclerosis Risk in Communities Study

    PubMed Central

    Huxley, Rachel R.; Alonso, Alvaro; Lopez, Faye L.; Filion, Kristian B.; Agarwal, Sunil K.; Loehr, Laura R.; Soliman, Elsayed Z.; Pankow, James S.; Selvin, Elizabeth

    2011-01-01

    Objective Type 2 diabetes has been inconsistently associated with risk of atrial fibrillation (AF) in previous studies that have frequently been beset by methodological challenges. Design Prospective cohort study. Setting The Atherosclerosis Risk in Communities Study. Participants Detailed medical histories were obtained on 13025 participants. Individuals were categorized as having no diabetes, pre-diabetes or diabetes based on the 2010 American Diabetes Association criteria at study baseline (1990–92). Main Outcome Measures Diagnoses of incident AF were obtained through 2007. Associations between type 2 diabetes and markers of glucose homeostasis with the incidence of AF were estimated using Cox proportional hazards models after adjusting for possible confounders. Results Type 2 diabetes was associated with a significant increase in risk of AF (HR 1.35, 95% confidence interval [CI]: 1.14–1.60) after adjustment for confounders. There was no indication that individuals with pre-diabetes or those with undiagnosed diabetes were at increased risk of AF compared to those without diabetes. We observed a positive linear association between HbA1c and risk of AF in those with and without diabetes: 1.13 (1.07–1.20) and 1.05 (0.96–1.15) per 1% point increase, respectively. There was no association between fasting glucose or insulin (p>0.05) in those without diabetes but a significant association with fasting glucose in those with the condition (p=0.0002). Results were similar in whites and African Americans. Conclusions Diabetes, HbA1c level and poor glycemic control are independently associated with increased risk of AF, but the underlying mechanisms governing the relationship are unknown and warrant further investigation. PMID:21930722

  5. Pilot study using mobile health to coordinate the diabetic patient, diabetologist, and ophthalmologist.

    PubMed

    Tsui, Irena; Drexler, Andrew; Stanton, Annette L; Kageyama, Jennie; Ngo, Elaine; Straatsma, Bradley R

    2014-07-01

    In the United States, more than 25 million adults have diabetes, 40% of diabetics have diabetic retinopathy, and diabetes is the leading cause of blindness in people 20 to 74 years of age. Clinical trials have shown that strict control of blood glucose level and other risk factors delays diabetic retinopathy onset, progression, and vision loss. Patients with Type 1 or Type 2 diabetes mellitus, access to an Apple iPhone or iPad, and no psychological or medical condition that would interfere with the study participated in a nonrandomized clinical trial using SightBook™, a free mobile app that enables self-measurement of visual function and creates a password-protected web account for each patient. Sixty patients enrolled in the clinical trial over a 6 month period. Twenty-six participants were men and 34 were women, with ages from 23 to 72 years (mean 45 ± 15) and diabetes duration of 1.5 to 50 years (mean 15.5 ± 11.5). Thirty-nine (65%) patients reported Type 1 diabetes and 21 (35%) patients reported Type 2 diabetes. Every patient established a personal web account on SightBook and invited participation of treating physicians; 51 (85%) patients completed the validated self-reported outcome assessments. Diabetologist examinations of 49 (82%) patients demonstrated systolic hypertension (?140 mgHg) in 20% and hemoglobin A1c ? 7.0% in 56%. Ophthalmology examinations of 45 patients showed visual acuity in the worse-seeing eye of < 20/40 in 18% and diabetic retinopathy in 42% of patients. This clinical trial used a mobile health app to incorporate diabetic patient self-measurement of vision and coordinate the diabetic patient, diabetologist, and ophthalmologist for control of diabetes and diabetic retinopathy risk factors. PMID:24876413

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

    Microsoft Academic Search

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

    2008-01-01

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

  7. Underuse of an invasive strategy for patients with diabetes with acute coronary syndrome: a nationwide study

    PubMed Central

    Gustafsson, Ida; Hvelplund, Anders; Hansen, Kim Wadt; Galatius, Søren; Madsen, Mette; Jensen, Jan Skov; Tilsted, Hans-Henrik; Terkelsen, Christian Juhl; Jensen, Lisette Okkels; Jørgensen, Erik; Madsen, Jan Kyst; Abildstrøm, Steen Zabell

    2015-01-01

    Background Guidelines recommend an early invasive strategy for patients with diabetes with acute coronary syndromes (ACS). We investigated if patients with diabetes with ACS are offered coronary angiography (CAG) and revascularisation to the same extent as patients without diabetes. Methods and results The study is a nationwide cohort study linking Danish national registries containing information on healthcare. The study population comprises all patients hospitalised with first-time ACS in Denmark during 2005–2007 (N=24?952). Diabetes was defined as claiming of a prescription for insulin and/or oral hypoglycaemic agents within 6?months prior to the ACS event. Diabetes was present in 2813 (11%) patients. Compared with patients without diabetes, patients with diabetes were older (mean 69 vs 67?years, p<0.0001), less often males (60% vs 64%, p=0.0001) and had more comorbidity. Fewer patients with diabetes underwent CAG: cumulative incidence 64% vs 74% for patients without diabetes, HR=0.72 (95% CI 0.69 to 0.76, p<0.0001); adjusted for age, sex, previous revascularisation and comorbidity HR=0.78 (95% CI 0.74 to 0.82, p<0.0001). More patients with diabetes had CAG showing two-vessel or three-vessel disease (53% vs 38%, p<0.0001). However, revascularisation after CAG revealing multivessel disease was less likely in patients with diabetes (multivariable adjusted HR=0.76, 95% CI 0.68 to 0.85, p<0.0001). Conclusions In this nationwide cohort of patients with incident ACS, patients with diabetes were found to be less aggressively managed by an invasive treatment strategy. The factors underlying the decision to defer an invasive strategy in patients with diabetes are unclear and merit further investigation. PMID:25685362

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

    PubMed

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

    2010-07-01

    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

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

    PubMed Central

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

    2010-01-01

    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

  10. 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

    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

    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

  11. Establishment of the Mouse as a Model Animal for the Study of Diabetic Cataracts

    Microsoft Academic Search

    K. R. Hegde; M. G. Henein; S. D. Varma

    2003-01-01

    The purpose of the present study was to investigate the suitability of using the mouse, a species known to have a low lens aldose reductase activity, as a model animal for studying the pathogenesis of diabetic cataract. Earlier studies with diabetic rats whose cataract development is much faster can only partially explain the etiology of cataracts in humans where lens

  12. Wide-field imaging and OCT vs clinical evaluation of patients referred from diabetic retinopathy screening

    PubMed Central

    Manjunath, V; Papastavrou, V; Steel, D H W; Menon, G; Taylor, R; Peto, T; Talks, J

    2015-01-01

    Purpose Compare wide-field Optomap imaging and optical coherence tomography (OCT) with clinical examination in diabetic retinopathy (DR). Methods Patients referred from Diabetic Eye Screening Programmes to three centres underwent dilated ophthalmoscopy and were assigned a DR grade. Wide-field colour imaging and OCT were then examined by the same clinician at that visit and a combined grade was assigned. Independent graders later reviewed the images and assigned an imaging-only grade. These three grades (clinical, combined, and imaging) were compared. The method that detected the highest grade of retinopathy, including neovascularisation, was determined. Results Two thousand and forty eyes of 1023 patients were assessed. Wide-field imaging compared with clinical examination had a sensitivity and specificity of 73% and 96%, respectively, for detecting proliferative DR, 84% and 69% for sight-threatening DR, and 64% and 90% for diabetic macular oedema. Imaging alone found 35 more eyes with new vessels (19% of eyes with new vessels) and the combined grade found 14 more eyes than clinical examination alone. Conclusions Assessment of wide-field images and OCT alone detected more eyes with higher grades of DR compared with clinical examination alone or when combined with imaging in a clinical setting. The sensitivity was not higher as the techniques were not the same, with imaging alone being more sensitive. Wide-field imaging with OCT could be used to assess referrals from DR screening to determine management, to enhance the quality of assessment in clinics, and to follow-up patients whose DR is above the screening referral threshold but does not actually require treatment. PMID:25592127

  13. Wide-field imaging and OCT vs clinical evaluation of patients referred from diabetic retinopathy screening.

    PubMed

    Manjunath, V; Papastavrou, V; Steel, D H W; Menon, G; Taylor, R; Peto, T; Talks, J

    2015-03-01

    PurposeCompare wide-field Optomap imaging and optical coherence tomography (OCT) with clinical examination in diabetic retinopathy (DR).MethodsPatients referred from Diabetic Eye Screening Programmes to three centres underwent dilated ophthalmoscopy and were assigned a DR grade. Wide-field colour imaging and OCT were then examined by the same clinician at that visit and a combined grade was assigned. Independent graders later reviewed the images and assigned an imaging-only grade. These three grades (clinical, combined, and imaging) were compared. The method that detected the highest grade of retinopathy, including neovascularisation, was determined.ResultsTwo thousand and forty eyes of 1023 patients were assessed. Wide-field imaging compared with clinical examination had a sensitivity and specificity of 73% and 96%, respectively, for detecting proliferative DR, 84% and 69% for sight-threatening DR, and 64% and 90% for diabetic macular oedema. Imaging alone found 35 more eyes with new vessels (19% of eyes with new vessels) and the combined grade found 14 more eyes than clinical examination alone.ConclusionsAssessment of wide-field images and OCT alone detected more eyes with higher grades of DR compared with clinical examination alone or when combined with imaging in a clinical setting. The sensitivity was not higher as the techniques were not the same, with imaging alone being more sensitive. Wide-field imaging with OCT could be used to assess referrals from DR screening to determine management, to enhance the quality of assessment in clinics, and to follow-up patients whose DR is above the screening referral threshold but does not actually require treatment. PMID:25592127

  14. Associations between Socioeconomic Status and Major Complications in Type 1 Diabetes: The Pittsburgh Epidemiology of Diabetes Complication (EDC) Study

    PubMed Central

    Secrest, Aaron M.; Costacou, Tina; Gutelius, Bruce; Miller, Rachel G.; Songer, Thomas J.; Orchard, Trevor J.

    2011-01-01

    Purpose To understand the effect of socioeconomic status (SES) on the risk of complications in type 1 diabetes (T1D), we explored the relationship between SES and major diabetes complications in a prospective, observational T1D cohort study. Methods Complete data were available for 317 T1D persons within 4 years of age 28 (ages 24–32) in the Pittsburgh Epidemiology of Diabetes Complications Study. Age 28 was selected to maximize income, education, and occupation potential, and minimize the effect of advanced diabetes complications on SES. Results The incidences over 1–20 years follow-up of end-stage renal disease (ESRD) and coronary artery disease (CAD) were 2–3 times higher for T1D individuals without, compared to those with a college degree (p<0.05 for both), while autonomic neuropathy (AN) incidence was significantly higher for low income and/or non-professional participants (p<0.05 for both). HbA1c was inversely associated only with income level. In sex- and diabetes duration-adjusted Cox models, lower education predicted ESRD (HR=2.9, 95% CI, 1.1–7.7) and CAD (HR=2.5, 1.3–4.9), whereas lower income predicted AN (HR=1.7, 1.0–2.9) and lower extremity arterial disease (HR=3.7, 1.1–11.9). Conclusions These associations, partially mediated by clinical risk factors, suggest that lower SES T1D individuals may have poorer self-management and, thus, more diabetes complications. PMID:21458731

  15. Early aggregation studies of diabetic amyloid in solution

    NASA Astrophysics Data System (ADS)

    Singh, Sadanand; de Pablo, Juan

    2011-03-01

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

  16. Prevalence and Risk Factors of Diabetes and Diabetic Retinopathy in Liaoning Province, China: A Population-Based Cross-Sectional Study

    PubMed Central

    Hu, Yuedong; Teng, Weiping; Liu, Limin; Chen, Kang; Liu, Lei; Hua, Rui; Chen, Jun; Zhou, Yun; Chen, Lei

    2015-01-01

    Aim To evaluate the prevalence and risk factors of diabetes and diabetic retinopathy (DR) in northeast area of China with a population-based study. Methods A population of 3173 (aged from 20 to 80 years old) was stratified by geographical location and age in Liaoning province, China. Prediabetes and diabetes were diagnosed according to the guideline of American Diabetes Association. Retinal photographs were obtained by using digital non-mydriatic camera for the presence and grading of DR according to the modified ETDRS Airlie house classification. Blood samples and comprehensive questionnaires were obtained for evaluation of laboratory results and risk factors. Results The prevalence of prediabetes and diabetes was 20.7% and 10.4%, respectively. Among diabetes patients, DR prevalence was 11.9%. Age, obesity, total cholesterol, triglycerides, hypertension, living in rural areas and diabetes family history are all risk factors for prediabetes and diabetes. Waist-to-hip circumference rate served as a better obesity index to estimate diabetes risk compared with body mass index and waist circumference. Among all risk factors that we investigated, only the length of diabetes history was associated with the incidence of DR. However, DR prevalence in the newly discovered patients in rural areas was significantly higher than that in urban areas. Conclusion According to this study, 1 in 10 people has diabetes, 2 in 10 people have prediabetes, and 1 in 10 diabetics has DR in Liaoning province. In rural areas, diabetes was poorly recognized with limited medical resources, which probably resulted in more diabetes patient at a high risk of DR. PMID:25785633

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

    Microsoft Academic Search

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

    1992-01-01

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

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

    ERIC Educational Resources Information Center

    Wagner, Julie; James, Amy

    2006-01-01

    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…

  19. A comparative study of reaction times between type II diabetics and non-diabetics

    PubMed Central

    Richerson, Samantha J; Robinson, Charles J; Shum, Judy

    2005-01-01

    Background Aging has been shown to slow reflexes and increase reaction time to varied stimuli. However, the effect of Type II diabetes on these same reaction times has not been reported. Diabetes affects peripheral nerves in the somatosensory and auditory system, slows psychomotor responses, and has cognitive effects on those individuals without proper metabolic control, all of which may affect reaction times. The additional slowing of reaction times may affect every-day tasks such as balance, increasing the probability of a slip or fall. Methods Reaction times to a plantar touch, a pure tone auditory stimulus, and rightward whole-body lateral movement of 4 mm at 100 mm/s2 on a platform upon which a subject stood, were measured in 37 adults over 50 yrs old. Thirteen (mean age = 60.6 ± 6.5 years) had a clinical diagnosis of type II diabetes and 24 (mean age = 59.4 ± 8.0 years) did not. Group averages were compared to averages obtained from nine healthy younger adult group (mean age = 22.7 ± 1.2 years). Results Average reaction times for plantar touch were significantly longer in diabetic adults than the other two groups, while auditory reaction times were not significantly different among groups. Whole body reaction times were significantly different among all three groups with diabetic adults having the longest reaction times, followed by age-matched adults, and then younger adults. Conclusion Whole body reaction time has been shown to be a sensitive indicator of differences between young adults, healthy mature adults, and mature diabetic adults. Additionally, the increased reaction time seen in this modality for subjects with diabetes may be one cause of increased slips and falls in this group. PMID:15723700

  20. [Contributions of proteomics in the study of diabetes].

    PubMed

    Jiménez-Flores, Lizbeth M; Flores-Pérez, Elsa Cristina; Mares-Álvarez, Daniela Paulina; Macías-Cervantes, Maciste Habacuc; Ramírez-Emiliano, Joel; Pérez-Vázquez, Victoriano

    2014-12-01

    The incidence of type 2 diabetes mellitus (T2D) is growing rapidly due to aging, urbanization, changes in lifestyle, and increasing prevalence of obesity. In T2D, chronic hyperglycemia leads to macro and micro vascular complications, which currently are serious problem for health systems worldwide. The complexity of T2D and its complications requires study skills of high performance that provide important information in the understanding of the pathophysiology of the disease and biological pathways involved in development of T2D and its complications. In this work we describe the recent contributions of proteomics in the study of T2D and discuss its importance in the identification of therapeutic targets and biomarkers that help to improve the diagnosis of T2D, monitor the disease progression, and the development of new drugs to improve treatment and reduce its complications. PMID:25643683

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

    Microsoft Academic Search

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

    2012-01-01

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

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

    Microsoft Academic Search

    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

    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

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

    ERIC Educational Resources Information Center

    Sarkadi, Anna; Rosenqvist, Urban

    1999-01-01

    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.…

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

    ERIC Educational Resources Information Center

    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

    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…

  5. PREVALENCE OF DIABETES MELLITUS AND CORRELATION OF URINARY TRANSFORMING GROWTH FACTOR-b1 WITH BLOOD HEMOGLOBIN A1C IN THE ATASCOSA DIABETES STUDY

    Microsoft Academic Search

    Marco A. Riojas; Rosa E. Villanueva-Vedia; Rogelio Zamilpa; Xiao Chen; Liem C. Du; Clyde F. Phelix; Richard G. LeBaron

    Introduction: This study was conducted to determine the prevalence of type 2 diabetes and prediabetes in the Atascosa Diabetes Study sample and to ascertain the relationship between urinary transforming growth factor-b1 (TGF-b1) and blood hemoglobin (Hgb) A1C. Methods: Subjects (N5526) classified as adjusted normal, at risk, prediabetes, and diabetes mellitus were given a one-hour and two-hour postprandial glucose (PPG) test.

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

    PubMed Central

    2012-01-01

    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

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

    Microsoft Academic Search

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

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

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

    PubMed

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

    2012-08-01

    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

  9. The association between diabetes and breast cancer stage at diagnosis: a population-based study.

    PubMed

    Lipscombe, Lorraine L; Fischer, Hadas D; Austin, Peter C; Fu, Longdi; Jaakkimainen, R Liisa; Ginsburg, Ophira; Rochon, Paula A; Narod, Steven; Paszat, Lawrence

    2015-04-01

    Women with diabetes have higher breast cancer incidence and mortality. The purpose of this study was to examine the impact of diabetes on stage at breast cancer diagnosis, as a possible reason for their higher mortality. Using population-based health databases from Ontario, Canada, this retrospective cohort study examined stage at diagnosis (II, III, or IV vs I) among women aged 20-105 years who were newly diagnosed with invasive breast cancer between 2007 and 2012. We compared those with diabetes to those without diabetes. Diabetes was defined based on medical records using a validated algorithm. Among 38,407 women with breast cancer, 6115 (15.9 %) women had diabetes. Breast cancer patients with diabetes were significantly more likely to present with advanced-stage breast cancer than those without diabetes. After adjustment for mammograms and other covariates, diabetes was associated with a significantly increased risk of Stage II [adjusted odds ratio (aOR) 1.14, 95 % confidence interval (CI) 1.07, 1.22], Stage III (aOR 1.21, 95 % CI 1.11, 1.33), and Stage IV (aOR 1.16, 95 % CI 1.01, 1.33) versus Stage I breast cancer. Women with diabetes had a higher risk of lymph node metastases (aOR 1.16, 95 % CI 1.06, 1.27) and tumors with size over 2 cm (aOR 1.16, 95 % CI 1.06, 1.28). Diabetes was associated with more advanced-stage breast cancer, even after accounting for differences in screening mammogram use and other factors. Our findings suggest that diabetes may predispose to more aggressive breast cancer, which may be a contributor to their higher cancer mortality. PMID:25779100

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

    PubMed

    Nash, M

    2014-10-01

    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

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

    PubMed Central

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

    2015-01-01

    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 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:24899459

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

    PubMed Central

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

    2014-01-01

    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

  13. Racial/ethnic differences in dementia risk among older type 2 diabetic patients: the diabetes and aging study.

    PubMed

    Mayeda, Elizabeth R; Karter, Andrew J; Huang, Elbert S; Moffet, Howard H; Haan, Mary N; Whitmer, Rachel A

    2014-04-01

    OBJECTIVE Although patients with type 2 diabetes have double the risk of dementia, potential racial/ethnic differences in dementia risk have not been explored in this population. We evaluated racial/ethnic differences in dementia and potential explanatory factors among older diabetic patients. RESEARCH DESIGN AND METHODS We identified 22,171 diabetic patients without preexisting dementia aged ?60 years (14,546 non-Hispanic whites, 2,484 African Americans, 2,363 Latinos, 2,262 Asians, 516 Native Americans) from the Kaiser Permanente Northern California Diabetes Registry. We abstracted prevalent medical history (1 January 1996 to 31 December 1997) and dementia incidence (1 January 1998 to 31 December 2007) from medical records and calculated age-adjusted incidence densities. We fit Cox proportional hazards models adjusted for age, sex, education, diabetes duration, and markers of clinical control. RESULTS Dementia was diagnosed in 3,796 (17.1%) patients. Age-adjusted dementia incidence densities were highest among Native Americans (34/1,000 person-years) and African Americans (27/1,000 person-years) and lowest among Asians (19/1,000 person-years). In the fully adjusted model, hazard ratios (95% CIs) (relative to Asians) were 1.64 (1.30-2.06) for Native Americans, 1.44 (1.24-1.67) for African Americans, 1.30 (1.15-1.47) for non-Hispanic whites, and 1.19 (1.02-1.40) for Latinos. Adjustment for diabetes-related complications and neighborhood deprivation index did not change the results. CONCLUSIONS Among type 2 diabetic patients followed for 10 years, African Americans and Native Americans had a 40-60% greater risk of dementia compared with Asians, and risk was intermediate for non-Hispanic whites and Latinos. Adjustment for sociodemographics, diabetes-related complications, and markers of clinical control did not explain observed differences. Future studies should investigate why these differences exist and ways to reduce them. PMID:24271192

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

    PubMed Central

    2011-01-01

    Background The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV have associated diabetes, mostly type II Diabetes Mellitus (DM). In Egypt the prevalence of DM is 25.4% among HCV patients. Therefore, it is important to identify the magnitude of the problem of diabetes in order to optimize the treatment of chronic hepatitis C. Methods The objective of this case-control study was to evaluate the prevalence of DM and other extrahepatic (EH) manifestations among patients with different HCV morbidity stages including asymptomatic, chronic hepatic and cirrhotic patients. In this study, 289 HCV patients older than 18 were selected as cases. Also, 289 healthy controls were included. Laboratory investigations including Liver Function tests (LFT) and blood glucose level were done. Also serological assays including cryoglobulin profile, rheumatoid factor, antinuclear antibody, HCV-PCR were performed. Results Out of 289 HCV cases, 40 (13.84%) were diabetic. Out of 289 healthy controls, 12 (4.15%) were diabetic. It was found that the diabetic HCV group mean age was [48.1 (± 9.2)]. Males and urbanians represented 72.5% and 85% respectively. Lower level of education was manifested in 52.5% and 87.5% were married. In the nondiabetic HCV group mean age was [40.7 (± 10.4)]. Males and urbanians represented 71.5% and 655% respectively. secondary and higher level of education was attained in 55.4% and 76.7% were married. Comparing between the diabetic HCV group and the non diabetic HCV group, age, residence and alcohol drinking were the only significant factors affecting the incidence of diabetes between the two groups. There was no significant difference regarding sonar findings although cirrhosis was more prevalent among diabetic HCV cases and the fibrosis score was higher in diabetic HCV patients than among the non diabetic HCV cases. Conclusion The diabetic patients in the HCV group were older, more likely to have a history of alcohol drinking than the non diabetic HCV cases. Age and alcohol drinking are factors that could potentially contribute to the development of type 2 diabetes. Logistic regression analyses showed that age and residence in urban regions were the predictive variables that could be associated with the presence of diabetes. Alcohol consumption was not a significant predictive factor. PMID:21791087

  15. Incidence and severity of ketoacidosis in childhood-onset diabetes in Kuwait. Kuwait Diabetes Study Group.

    PubMed

    al Khawari, M; Shaltout, A; Qabazard, M; Abdella, N; al Moemen, J; al-Mazidi, Z; Mandani, F; Moussa, M A

    1997-03-01

    In 1992, the diabetes registry was started in Kuwait, as part of DiaMond, a WHO multinational collaborative project on the incidence of childhood-onset diabetes. Children (243) aged below 15 years, were identified between 1 January 1992 and 31 December 1995. Children (203) were Kuwaiti and 40 were non-Kuwaiti children but resident of Kuwait. For the years 1992, 1993, the annual incidence of childhood onset diabetes for Kuwaiti children was 15.4 per 100,000 (95% confidence interval 12.9-19), and the degree of ascertainment was 92%. Polyuria, polydypsia, weight loss and nocturia were the most frequently reported symptoms; four children were in coma and one in shock at presentation. Nearly half of the children (49%) presented ketoacidosis (venous pH < 7.3 and/or plasma bicarbonate level < 18 mmol/l). and in 53 children (23.5%) it was severe (venous pH < 7.1 and/or plasma bicarbonate level < 10 mmol/l). In 62 children (25.5%) it was mild to moderate (venous pH 7.1-7.3 and/or plasma bicarbonate level 10.1-18 mmol/l). The incidence of severe ketoacidosis was similar in all age groups and sexes. All children recovered completely without major complications and no deaths were recorded. We conclude that diabetic ketoacidosis is a common presentation at the onset of diabetes in childhood in Kuwait and attests to the lack of awareness of general practitioners and parents to the symptoms and signs of diabetes in childhood. PMID:9179467

  16. Plasma glucose levels as predictors of diabetes: the Mexico City diabetes study

    Microsoft Academic Search

    E. Ferrannini; M. Massari; M. Nannipieri; A. Natali; R. Lopez Ridaura; C. Gonzales-Villalpando

    2009-01-01

    Aims\\/hypothesis  The value of diagnostic categories of glucose intolerance for predicting type 2 diabetes is much debated. We therefore sought\\u000a to estimate relative and population-attributable risk of different definitions based on fasting (impaired fasting glucose\\u000a [IFG]) or 2 h plasma glucose concentrations (impaired glucose tolerance [IGT]) and to describe the associated clinical phenotypes.\\u000a \\u000a \\u000a \\u000a Methods  We prospectively observed a population-based cohort of 1,963 non-diabetic

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

    PubMed Central

    2014-01-01

    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

  18. Mechanistic studies of lifestyle interventions in type 2 diabetes

    PubMed Central

    Mitra, Analava; Dewanjee, Debasis; Dey, Baishakhi

    2012-01-01

    AIM: To investigate the effect of lifestyle interventions in the non-pharmacological management of type 2 diabetes via a mechanistic approach. METHODS: A randomized controlled trial was carried out on 60 type 2 diabetic male and female volunteers that fulfilled the inclusion criteria, with their proper consent and permission of the International Electrotechnical Commission for 1 year. 30 patients were included in the test group and 30 patients in the control group. Demographic details, anthropometrical status, physical activity, food habits and blood glucose lipid profile of the volunteers were recorded at baseline, the test group was directed for lifestyle intervention and final blood glucose lipid data were collected at the end of one year of patient follow-up. RESULTS: After 1 year, the test group who had a lifestyle intervention was found to show a significant improvement in blood glucose lipid profile. The fasting plasma glucose level (FPG), postprandial plasma glucose level (PPG), glycosylated hemoglobin (HbA1c) and body mass index (BMI) values of the test group were reduced significantly, up to 145 ± 2.52, 174 ± 2.59, 6.3 ± 0.32 and 25 ± 0.41 respectively at the end of the study period, in comparison to the control group where FPG, PPG, HbA1c and BMI values were 193 ± 3.36, 249 ± 4.24, 7.2 ± 0.42 and 26 ± 0.65 respectively. Improvement in the total cholesterol (TC), triglyceride (TG), high-density lipoproteins (HDL) and low-density lipoproteins (LDL) values of the test group was also remarkable in comparison to the control group. The TC, TG, HDL and LDL values of the test group were reduced significantly, up to 149 ± 3.32, 124 ± 2.16, 58 ± 0.62 and 118 ± 2.31, respectively. CONCLUSION: The significant improvement in the blood glucose lipid profile of the test group after 1 year signifies the value of non-pharmacological management of type 2 diabetes via lifestyle intervention strategies. PMID:23301122

  19. Awareness, Treatment, and Control of Diabetes in Bangladesh: A Nationwide Population-Based Study

    PubMed Central

    Rahman, Md. Shafiur; Akter, Shamima; Abe, Sarah Krull; Islam, Md. Rafiqul; Mondal, Md. Nazrul Islam; Rahman, J. A. M. Shoquilur; Rahman, Md. Mizanur

    2015-01-01

    Objectives To examine awareness, treatment, and control of diabetes mellitus among the adult population in Bangladesh. Methods The study used data from the 2011 nationally representative Bangladesh Demographic and Health Survey (BDHS). The BDHS sample is comprised of 7,786 adults aged 35 years or older. The primary outcome variables were fasting blood glucose, diagnosis, treatment, and control of diabetes. Multilevel logistic regression models were used to identify the risk factors for diabetes awareness. Results Overall, age-standardized prevalence of diabetes was 9.2%. Among subjects with diabetes, 41.2% were aware of their condition, 36.9% were treated, and 14.2% controlled their condition. A significant inequality in diabetes management was found from poor to wealthy households: 18.2% to 63.2% (awareness), 15.8% to 56.6% (treatment), and 8.2% to 18.4% (control). Multilevel models suggested that participants who had a lower education and lower economic condition were less likely to be aware of their diabetes. Poor management was observed among non-educated, low-income groups, and those who lived in the northwestern region. Conclusions Diabetes has become a national health concern in Bangladesh; however, treatment and control are quite low. Improving detection, awareness, and treatment strategies is urgently needed to prevent the growing burden associated with diabetes. PMID:25692767

  20. The Verona diabetes study: a population-based survey on known diabetes mellitus prevalence and 5-year all-cause mortality

    Microsoft Academic Search

    M. Muggeo; G. Verlato; E. Bonora; F. Bressan; S. Girotto; M. Corbellini; M. L. Gemma; P. Moghetti; M. Zenere; V. Cacciatori; G. Zoppini; R. De Marco

    1995-01-01

    Summary  This population-based survey aimed to determine the prevalence of known diabetes mellitus on 31 December 1986, and to assess all-cause mortality in the subsequent 5 years (1987–1991) in Verona, Italy. In the study of prevalence, 5996 patients were identified by three independent sources: family physicians, diabetes clinics, and drug prescriptions for diabetes. Mortality was assessed by matching all death certificates

  1. Work, Diabetes and Obesity: A Seven Year Follow-Up Study among Danish Health Care Workers

    PubMed Central

    Poulsen, Kjeld; Cleal, Bryan; Clausen, Thomas; Andersen, Lars L.

    2014-01-01

    Objectives The rise in prevalence of diabetes is alarming and research ascribes most of the increase to lifestyle. However, little knowledge exists about the influence of occupational factors on the risk for developing diabetes. This study estimates the importance of work and lifestyle as risk factors for developing diabetes mellitus among healthcare workers and explores the association of work factors and obesity, which is a risk factor for diabetes. Methods Questionnaire-based prospective cohort study among 7,305 health care workers followed for seven years in the Danish National Diabetes Register. We used bivariate comparisons to give an unadjusted estimate of associations, followed by adjusted survival analysis and logistic regression models to estimate the influences of potential risk factors related to job, health and lifestyle on diabetes and obesity. Results During seven years of follow up, 3.5% of participants developed diabetes, associated with obesity (HR ?=? 6.53; 95% CI 4.68–9.10), overweight (HR ?=? 2.89; CI 2.11–3.96) age 50–69 y (HR ?=? 2.27; 95% CI 1.57–3.43) and high quality of leadership (HR ?=? 1.60; CI 1.19–2.16). Obesity at baseline was most common among the youngest employees, and was mainly associated with developing diabetes (OR ?=? 3.84; CI 2.85–5.17), impaired physical capacity and physical inactivity. In the occupational setting, obesity was associated with shift work, severe musculoskeletal pain, low influence, but also by good management, fewer role conflicts and a positive work-life balance. Looking only at non-smokers, removed the influence of age and pain. However, non-smokers also had higher depression scores and more role conflicts. Conclusions Confirming obesity as the strongest risk factor for developing diabetes, the present study identified few occupational risk factors. However, obesity, the key risk factor for diabetes, had a more variable relation with work than did diabetes. PMID:25068830

  2. 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

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

    E-print Network

    Brown, Lucy L.

    ), and 5 (1997-1999) and glucose tolerance tests in phases 3 and 5. Results: Participants working was related to incidence of diabetes and impaired glucose tolerance (OR, 1.25 [95% CI, 1Prospective Study of Social and Other Risk Factors for Incidence of Type 2 Diabetes

  4. [Contribution to the study of glyceraldehyde-3-phosphate dehydrogenase in patients with type 2 diabetes.

    PubMed

    Senhaji, N; Elkhalfi, B; Soukri, A

    2014-09-01

    Diabetes is recognized as a major public health problem responsible for early morbidity and mortality with a worldwide prevalence in permanent increase. The type II diabetes once called non-insulin dependent diabetes, accounts for about 90 % of all forms of diabetes and is characterized by abnormalities that affect insulin secretion and insulin action and thus, induces hyperglycemia. The aim of this work is to study the involvement of a key enzyme of glycolysis, glyceraldehyde-3-phosphate dehydrogenase in type 2 diabetes. This work includes a biochemical, kinetic studies, and the study of the expression of GAPDH in subjects with type 2 diabetes. From our study, we could classify the diabetic subjects into two categories: the first one, consisting of subjects in whom GAPDH has a specific activity and an electrophoretic profile similar to healthy subjects, and the second one, in which there is an inhibition of GAPDH. Our results suggest that, in 60 % of our patients with type 2 diabetes, a reversible inhibition of GAPDH is observed. This inhibition is probably mediated by the ionic interaction with the erythrocyte membrane protein, band 3. PMID:25189828

  5. Retinal Thickness Study with Optical Coherence Tomography in Patients with Diabetes

    Microsoft Academic Search

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

    2002-01-01

    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

  6. Predictors of early-stage left ventricular dysfunction in type 2 diabetes: results of DYDA study

    Microsoft Academic Search

    Carlo B Giorda; Giovanni Cioffi; Giovanni de Simone; Andrea Di Lenarda; Pompilio Faggiano; Roberto Latini; Donata Lucci; Aldo P Maggioni; Luigi Tarantini; Mario Velussi; Paolo Verdecchia; Marco Comaschi

    2011-01-01

    Background: Better knowledge of prevalence and early-stage determinants of subclinical left ventricular dysfunction (LVD) in type 2 diabetes would be useful to design prevention strategies. The objective of the LVD in Diabetes (DYDA) study was to assess these points in patients without established cardiac disease.Method: Baseline clinical, ECG, laboratory and echocardiographic data from 751 patients (61 ± 7 years, 59%

  7. Diabetes Mellitus and Optic Atrophy: A Study of Wolfram Syndrome in the Lebanese Population

    Microsoft Academic Search

    R. Medlej; J. WASSON; P. BAZ; S. AZAR; I. SALTI; J. LOISELET; A. PERMUTT; G. HALABY

    2004-01-01

    Wolfram syndrome (WFS) is a rare hereditary neurodegen- erative disorder also known as DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness). WFS seems to be a heterogeneous disease that has not yet been fully char- acterized in terms of clinical features and pathophysiological mechanisms because the number of patients in most series was small. In this study we describe

  8. 1 in 3 People with Type 1 Diabetes Still Produce Insulin, Study Says

    MedlinePLUS

    ... please enable JavaScript. 1 in 3 People With Type 1 Diabetes Still Produce Insulin, Study Says More likely for ... Dallas Tuesday, December 30, 2014 Related MedlinePlus Page Diabetes Type 1 MONDAY, Dec. 29, 2014 (HealthDay News) -- Although it's ...

  9. Case study: Use of vibration therapy in the treatment of diabetic peripheral small fiber neuropathy

    Microsoft Academic Search

    Junggi Hong; Meredith J. Barnes; Nathan J. Kessler

    The aim of the study was to describe a case of type II diabetic peripheral small fiber neuropathic pain treated with whole body vibration therapy after a failed trial of conventional drugs and interventional pain management. A 64-year-old male had chronic diabetic peripheral neuropathic pain in both his feet for about 2years. The patient tried multiple pain medications and various

  10. 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.

  11. Exenatide in type 2 diabetes: treatment effects in clinical studies and animal study data.

    PubMed

    Gallwitz, B

    2006-12-01

    The therapeutic options for treating type 2 diabetes have been widened by the introduction of exenatide as the first incretin mimetic. Incretins are gut hormones that contribute to the stimulation of insulin secretion after a carbohydrate rich meal. The incretin hormone glucagon-like peptide-1 (GLP-1) not only stimulates insulin secretion under hyperglycaemic conditions, but also suppresses glucagon secretion, slows gastric emptying, induces satiety and improves beta cell function in type 2 diabetes. These beneficial effects have awakened the interest to use GLP-1 for the treatment of type 2 diabetes. Because of its short biological half-life, GLP-1 itself is not practical for type 2 diabetes therapy. Exenatide is a peptide found in the lizard Heloderma suspectum and has a high similarity to GLP-1. Exenatide belongs to the novel class of incretin mimetics because of its incretin-like action. It has a much longer biological half life than GLP-1 and is a GLP-1 receptor agonist that can be used for therapeutic purposes by twice daily injection. Clinical studies and clinical experience with exenatide have shown a significant reduction in HbA1c, fasting- and postprandial glucose and a marked reduction in body weight in type 2 diabetic patients. Animal studies reveal an improvement of beta cell function and an increase in beta cell mass after exenatide treatment. This review gives an overview on exenatide, its pharmacological profile and its role and potential in the therapeutic setting of type 2 diabetes. Furthermore, future developments concerning exenatide application are highlighted. PMID:17109672

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

    Microsoft Academic Search

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

    1986-01-01

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

  13. Implementation of Ramadan-specific diabetes management recommendations: a multi-centered prospective study from Pakistan

    PubMed Central

    2014-01-01

    Background To observe the outcome of implementation of Ramadan-specific diabetes management recommendations in fasting individuals with diabetes through health care providers. Methods This multi-centered prospective study was conducted at nine diabetes specialist centers in four provinces of Pakistan. The study was carried out in two phases; pre-Ramadan recruitment interview (visit A) and post-Ramadan follow up interview (visit B) of the same patients. Pre-Ramadan individual counseling was given and educational material provided to each patient by health care providers during visit A. Results Out of 388 patients with diabetes, blood glucose level was checked by all patients with type 1 and 71.43% patients with type 2 diabetes when they developed hypoglycemic symptoms during Ramadan. Of patients with type 1 and type 2 diabetes, 33.33% and 48% discontinued their fast when they felt hypoglycemic symptoms, respectively. None of the patient with type 1, while 18.87% patients with type 2 diabetes discontinued fast on the development of hyperglycemic symptoms. Drug dosage and timing were altered in 80% patients with type 1 and 90.5% patients with type 2 diabetes during Ramadan. Majority of the patients with type 2 diabetes changed from moderate/severe levels of physical activity before Ramadan to light physical activity during Ramadan (p<0.000). None of the patients required hospitalization when they developed symptomatic hypoglycemia or hyperglycemia and none developed diabetic ketoacidosis and hyperglycemic hyperosmolar state during Ramadan. Conclusion We observed that it is practicable to implement Ramadan-specific diabetes management recommendations through health care providers. PMID:24559109

  14. [A study of the knowledge of diabetics (author's transl)].

    PubMed

    Larpent, N; Eschwege, E; Canivet, J

    1981-03-01

    One hundred and forty five diabetics regularly attending a hospital clinic were submitted to a questionnaire assessing their knowledge of diabetes. The patients had previously been instructed in urine glucose analysis, insulin injections, diet and hypoglycaemic attacks. Despite this, they appeared to be neither better controlled nor more painstaking with their disease than before education. The replies to the questionnaire revealed that the patients had poor understanding of the symptoms and of the long-term complications of diabetes, of the criteria of good control, and of the proportion of carbohydrate in common food. Moreover, they held many fallacious ideas with regard to these concepts. The results suggest that although these diabetics had acquired sufficient knowledge to avoid the acute metabolic disturbances of diabetes and to lead a day-to-day existence with a minimum of harmful effects, they were not properly aware of the long-term consequences of diabetes and of the overall strategy for the good management of their disease. An improved educational strategy appears necessary to enable diabetics to take better care of themselves. PMID:7238974

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

    PubMed

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

    2014-08-01

    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

  16. The Khatri Sikh Diabetes Study (SDS): study design, methodology, sample collection, and initial results.

    PubMed

    Sanghera, Dharambir K; Bhatti, Jaswinder S; Bhatti, Gurjit K; Ralhan, Sarju K; Wander, Gurpreet S; Singh, Jai Rup; Bunker, Clareann H; Weeks, Daniel E; Kamboh, M Ilyas; Ferrell, Robert E

    2006-02-01

    Non-insulin-dependent diabetes mellitus, or type 2 diabetes (T2DM), has become a major public health problem in India. The high prevalence, relatively young age of onset, and strong familial aggregation of T2DM in some Indian communities remains to be explained. Many of the traditional risk factors established for European populations do not appear to be present in Asian Indians. Phase I of the Sikh Diabetes Study (SDS) was launched to build the population resources required to initiate a large-scale genetic epidemiological study of diabetes in an Asian Indian population. The SDS is focused on the Khatri Sikh population of North India. In all, 1,892 subjects were enrolled to participate in the family-based study; 1,623 of these subjects belong to 324 families, each of which has at least 2 siblings affected with T2DM. The sample included 1,288 individuals affected with T2DM (siblings, parents, or relatives) and 335 unaffected siblings, parents, or relatives. The remaining 269 subjects were unrelated nondiabetic control subjects, including unaffected spouses of probands or siblings. This primarily nonvegetarian, nonsmoking endogamous caste group has presented an unusual clinical picture of uneven distribution of adiposity and a high rate of T2DM with secondary complications. Such well-characterized population isolates may offer unique advantages in mapping genes for common complex diseases. PMID:16900881

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  20. Infant feeding patterns in families with a diabetes history – observations from The Environmental Determinants of Diabetes in the Young (TEDDY) birth cohort study

    PubMed Central

    Hummel, Sandra; Vehik, Kendra; Uusitalo, Ulla; McLeod, Wendy; Aronsson, Carin Andrén; Frank, Nicole; Gesualdo, Patricia; Yang, Jimin; Norris, Jill M; Virtanen, Suvi M

    2014-01-01

    Objective To assess the association between diabetes family history and infant feeding patterns. Design Data on breast-feeding duration and age at first introduction of cow’s milk and gluten-containing cereals were collected in 3-month intervals during the first 24 months of life. Setting Data from the multicentre TEDDY (The Environmental Determinants of Diabetes in the Young) study, including centres in the USA, Sweden, Finland and Germany. Subjects A total of 7026 children, including children with a mother with type 1 diabetes (T1D; n 292), gestational diabetes mellitus (GDM; n 404) or without diabetes but with a father and/or sibling with T1D (n 464) and children without diabetes family history (n 5866). Results While exclusive breast-feeding ended earlier and cow’s milk was introduced earlier in offspring of mothers with T1D and GDM, offspring of non-diabetic mothers but a father and/or sibling with T1D were exclusively breast-fed longer and introduced to cow’s milk later compared with infants without diabetes family history. The association between maternal diabetes and shorter exclusive breast-feeding duration was attenuated after adjusting for clinical variables (delivery mode, gestational age, Apgar score and birth weight). Country-specific analyses revealed differences in these associations, with Sweden showing the strongest and Finland showing no association between maternal diabetes and breast-feeding duration. Conclusions Family history of diabetes is associated with infant feeding patterns; however, the associations clearly differ by country, indicating that cultural differences are important determinants of infant feeding behaviour. These findings need to be considered when developing strategies to improve feeding patterns in infants with a diabetes family history. PMID:24477208

  1. Comparative Study of Esterase and Hemolytic Activities in Clinically Important Candida Species, Isolated From Oral Cavity of Diabetic and Non-diabetic Individuals

    PubMed Central

    Fatahinia, Mahnaz; Poormohamadi, Farzad; Zarei Mahmoudabadi, Ali

    2015-01-01

    Background: Diabetes mellitus as a chronic metabolic disease occurs in patients with partial or complete deficiency of insulin secretion or disorder in action of insulin on tissue. The disease is known to provide conditions for overgrowth of Candida species. Candida spp. cause candidiasis by many virulence factors such as esterase, hemolysin and phospholipase. Objectives: This study aimed to compare esterase and hemolytic activity in various Candida species isolated from oral cavity of diabetic and non-diabetic individuals. Patients and Methods: Swab samples were taken from 95 patients with diabetes (35 men and 60 women) and 95 normal persons (42 men and 53 women) and cultured on Sabouraud dextrose agar. Identification of isolated yeasts was performed by germ tube test, morphology on CHROMagar Candida medium, corn meal agar and ability to grow at 45°C. Hemolysin activity was evaluated using blood plate assay and esterase activity was determined using the Tween 80 opacity test. Results: Different Candida species were isolated from 57 (60%) diabetic and 24 (25%) non-diabetic individuals. Esterase activity was detected in all Candida isolates. Only 21.6% of C. albicans from patients with diabetes had esterase activity as + 3, while it ranged from + 1 to + 2 in others. Hemolytic activity was determined in C. albicans, C. dubliniensis, C. glabrata and C. krusei as 0.79, 0.58, 0.66 and 0.74, respectively. Hemolytic activity was significantly different in the two groups of diabetics and non-diabetics. Conclusions: Oral carriage of C. albicans in the diabetic group (n = 42; 66.7%) was significantly greater than the control group (n = 16; 57.1%). Esterase activity of C. albicans in diabetic group was higher than non-diabetic group. Although C. albicans remains the most frequently pathogenic yeast for human, but other species are increasing.

  2. Glycated Hemoglobin and Incident Type 2 Diabetes in Singaporean Chinese Adults: The Singapore Chinese Health Study

    PubMed Central

    Bancks, Michael P.; Koh, Woon-Puay; Yuan, Jian-Min; Gross, Myron D.

    2015-01-01

    Background The American Diabetes Association recently included glycated hemoglobin in the diagnostic criteria for diabetes, but research on the utility of this biomarker in Southeast Asians is scant. The aim of this study was to evaluate the association between percent HbA1c and incident diabetes in an Asian population of adult men and women without reported diabetes. Methods Data analysis of 5,770 men and women enrolled in the Singapore Chinese Health Study who provided a blood sample at the follow-up I visit (1999–2004) and had no cancer and no reported history of diabetes or cardiovascular disease events. Diabetes was defined as self-report of physician diagnosis, identified at the follow-up II visit (2006–2010). Results Hazard ratios (and 95% confidence intervals) for incident diabetes by 5 categories of HbA1c were estimated with Cox regression models and continuous HbA1c with cubic spline analysis. Compared to individuals with an HbA1c ? 5.7% (?39 mmol/mol), individuals with HbA1c 5.8–5.9% (40–41 mmol/mol), 6.0–6.1% (42–43 mmol/mol), 6.2–6.4% (44–47 mmol/mol), and ? 6.5% (?48 mmol/mol) had significantly increased risk for incident diabetes during follow-up. In cubic spline analysis, levels below 5.7% HbA1c were not significantly associated with incident diabetes. Conclusions Our study found a strong and graded association with HbA1c 5.8% and above with incident diabetes in Chinese men and women. PMID:25775375

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

    Microsoft Academic Search

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

    1983-01-01

    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

  4. Yearly evolution of organ damage markers in diabetes or metabolic syndrome: data from the LOD-DIABETES study

    PubMed Central

    2011-01-01

    Background Cardiovascular disease morbidity-mortality is greater in people with type 2 diabetes mellitus or metabolic syndrome. The purpose of this study was to evaluate the yearly evolution of organ damage markers in diabetes or metabolic syndrome, and to analyze the associated factors. Methods An observational prospective study was carried out in the primary care setting, involving 112 patients: 68 diabetics and 44 subjects with metabolic syndrome, subjected to 12 months of follow-up. Measurements: traditional cardiovascular risk factors (blood pressure, blood glucose, lipids, smoking, body mass index (BMI) and) and non-traditional risk factors (waist circumference, hsC Reactive Protein and fibrinogen); subclinical vascular (carotid intima-media thickness, pulse wave velocity and ankle/brachial index), cardiac (Cornell voltage-duration product), renal organ damage (creatinine, glomerular filtration and albumin/creatinine index), and antihypertensive and lipid-lowering drugs. Results At baseline, the diabetics presented a mean age of 59.9 years, versus 55.2 years in the subjects with metabolic syndrome (p = 0.03). Diastolic blood pressure, total cholesterol and HDL-cholesterol were lower among the patients with diabetes, while blood glucose and HbA1c, as well as antihypertensive and lipid-lowering drug use, were greater. At evaluation after one year, the diabetics showed a decrease in BMI (-0.39), diastolic blood pressure (-3.59), and an increase in fibrinogen (30.23 mg/dL), ankle/brachial index (0.07) and the number of patients with ankle/brachial index pathologic decreased in 6. In turn, the patients with metabolic syndrome showed an increase in HDL-cholesterol (1-91 mg/dL), fibrinogen (25.54 mg/dL), Cornell voltage-duration product (184.22 mm/ms), ankle/brachial index (0.05) and the use of antihypertensive and lipid-lowering drugs, and a reduction in serum glucose (3.74 mg/dL), HOMA, systolic (-6.76 mmHg), diastolic blood pressure (-3.29 mmHg), and pulse wave velocity (-0.72 m/s). The variable that best predicted a decrease in pulse wave velocity in subjects with metabolic syndrome was seen to be an increase in antihypertensive drug use. Conclusions The annual assessment of cardiovascular risk factors and the decrease in pulse wave velocity was more favorable in the patients with metabolic syndrome, probably influenced by the increased percentage of subjects treated with antihypertensive and lipid lowering drugs in this group. PMID:21999369

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

    Microsoft Academic Search

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

    1999-01-01

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

  6. 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

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

    1995-01-01

    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

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

    PubMed Central

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

    2014-01-01

    Purpose We previously reported that insulin resistance, low high-density lipoprotein (HDL) cholesterol, and glycaemic exposure Index are independently associated with peripheral neuropathy in Korean patients with type 2 diabetes mellitus. We followed the patients who participated in that study in 2006 for another 6 years to determine the relationship between insulin resistance and neuropathy. Materials and Methods This study involved 48 of the original 86 Korean patients with type 2 diabetes mellitus who were referred to the Neurology clinic for the assessment of diabetic neuropathy from January 2006 to December 2006. These 48 patients received management for glycaemic control and prevention of diabetic complications in the outpatient clinic up to 2012. We reviewed blood test results and the nerve conduction study findings of these patients, taken over a 6-year period. Results Low HDL cholesterol and high triglycerides significantly influenced the development of diabetic neuropathy. Kitt value (1/insulin resistance) in the previous study affected the occurrence of neuropathy, despite adequate glycaemic control with HbA1c <7%. Insulin resistance affected the development of diabetic neuropathy after 6 years: insulin resistance in 2006 showed a positive correlation with a change in sural sensory nerve action potential in 2012. Conclusion Diabetic neuropathy can be affected by previous insulin resistance despite regular glycaemic control. Dyslipidaemia should be controlled in patients who show high insulin resistance because HDL cholesterol and triglycerides are strongly correlated with later development of diabetic neuropathy. PMID:24719137

  8. The multinational second Diabetes, Attitudes, Wishes and Needs study: results of the French survey

    PubMed Central

    Reach, Gérard; Consoli, Silla M; Halimi, Serge; Colas, Claude; Duclos, Martine; Fontaine, Pierre; Martineau, Caroline; Avril, Carole; Tourette-Turgis, Catherine; Pucheu, Sylvie; Brunet, Olivier

    2015-01-01

    Aim The second Diabetes, Attitudes, Wishes and Needs (DAWN2™) multinational cross-sectional study was aimed at generating insights to facilitate innovative efforts by people with diabetes (PWD), family members (FMs), and health care professionals (HCPs) to improve self-management and psychosocial support in diabetes. Here, the French data from the DAWN2™ study are described. Methods In France, 500 PWD (80 with type 1 diabetes [T1] and 420 with type 2 diabetes [T2]), 120 FMs, and 288 HCPs were recruited. The questionnaires assessed the impact of diabetes on quality of life and mood, self-management, attitudes/beliefs, and care/support. Results Diabetes negatively impacted the emotional well-being of 59% of people with T1 versus 45% of people with T2 (P<0.05) and about half of FMs. A high level of distress was felt by about half of PWD and FMs. About half of HCPs reported assessing depression in their patients. Sixty-two percent of FMs considered managing diabetes to be a burden. Hypoglycemia was a source of concern for 64% of people with T1 and 73% of FMs of insulin users. About two-thirds of non-insulin-medicated people with T2 agreed to start insulin if prescribed, while half of HCPs preferred to delay insulin initiation. A discrepancy between HCPs’ perceptions of their interactions with their patients and PWD’s recollection of these interactions with regard to patients’ personal needs and distress was also observed. Conclusion While distress remains under-assessed by HCPs, the negative impact of diabetes on the lives of PWD and FMs clearly induces distress on both groups. These findings provide new understanding of barriers precluding optimal management of diabetes. Developing strategies to overcome these barriers is now warranted. PMID:25709415

  9. Association between obesity and depression in patients with diabetes mellitus type 2; a study protocol

    PubMed Central

    De la Cruz-Cano, Eduardo; Tovilla-Zarate, Carlos Alfonso; Reyes-Ramos, Emilio; Gonzalez-Castro, Thelma Beatriz; Juarez-Castro, Isela; López-Narváez, Maria Lilia; Fresan, Ana

    2015-01-01

    Background: Diabetes mellitus and depression are highly prevalent conditions throughout the world and have significant impact on health outcomes. It has been estimated that diabetes mellitus type 2 affects about 246 million people in the world; nevertheless, incidence varies among countries. There is evidence that depression is associated with a poor metabolic control in patients with type 2 diabetes mellitus that present other health problems (such as hypertension and obesity). The aim of this study protocol is to determine if obesity increases the risk for depression in patient with diabetes type 2. Methods: The analysis will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).The studies suitable for inclusion will be assessed by the Newcastle-Ottawa Scale (NOS) to determine their methodological quality. To identify the studies of interest, we will search on PubMed and EBSCO databases. We will use the following keyword combinations: "Diabetes Mellitus type 2 AND obesity AND depression", "depression AND Diabetes Mellitus type 2", "Diabetes Mellitus type 2 AND body mass index cross sectional study", "depression AND obesity cross-sectional study". Causes for exclusion will be publications that studied patients diagnosed with diabetes mellitus type 1; articles that focused on the treatment and complications of diabetes mellitus type 2; publications that have studied other clinical or psychiatric conditions (for instance, seizure disorder or history of schizophrenia, bipolar disorder, psychotic symptoms or dementia). Conclusion: The results of this study will form the basis for a better understanding of the association between obesity and depression in patients with diabetes mellitus type 2, and will allow development of prediction tools and better interventions. It is evident that several modifiable and non-modifiable risk factors play an important role in the pathogenesis of diabetes among population. Currently, evidence for the deleterious effects of diabetes mellitus type 2 are based on cross-sectional or other observational designs. Therefore, this study will have important implications for future research and public health guidance. PMID:25789160

  10. Quantitative Electrocardiographic and Vectorcardiographic Study on Newly-Diagnosed Non-Insulin-Dependent Diabetic and Non-Diabetic Control Subjects

    Microsoft Academic Search

    Matti Uusitupa; Juha Mustonen; Onni Siitonen; Kalevi Pyörälä

    1988-01-01

    Quantitative electrocardiographic (ECG) and vectorcardiographic (VCG) analysis was carried out in 113 newly diagnosed, middle-aged, non-insulin-dependent diabetics (61 men, 52 women) and 125 non-diabetic control subjects (56 men, 69 women) in order to explore changes attributable to non-coronary heart disease (diabetic cardiomyopathy) in diabetics. Diabetic men had a prolonged PQ interval and women a more negative P-terminal force and a

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

    PubMed Central

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

    2010-01-01

    BACKGROUND Little is known about the frequency of significant hypoglycemic events in actual practice. Limited health literacy (HL) is common among patients with type 2 diabetes, may impede diabetes self-management, and thus HL could increase the risk of hypoglycemia. OBJECTIVE To determine the proportion of ambulatory, pharmacologically-treated patients with type 2 diabetes reporting ?1 significant hypoglycemic events in the prior 12 months, and evaluate whether HL is associated with hypoglycemia. RESEARCH DESIGN Cross-sectional analysis in an observational cohort, the Diabetes Study of Northern California (DISTANCE). SUBJECTS The subjects comprised 14,357 adults with pharmacologically-treated, type 2 diabetes who are seen at Kaiser Permanente Northern California (KPNC), a non-profit, integrated health care delivery system. MEASURES Patient-reported frequency of significant hypoglycemia (losing consciousness or requiring outside assistance); patient-reported health literacy. RESULTS At least one significant hypoglycemic episode in the prior 12 months was reported by 11% of patients, with the highest risk for those on insulin (59%). Patients commonly reported limited health literacy: 53% reported problems learning about health, 40% needed help reading health materials, and 32% were not confident filling out medical forms by themselves. After adjustment, problems learning (OR 1.4, CI 1.1-1.7), needing help reading (OR 1.3, CI 1.1-1.6), and lack of confidence with forms (OR 1.3, CI 1.1-1.6) were independently associated with significant hypoglycemia. CONCLUSIONS Significant hypoglycemia was a frequent complication in this cohort of type 2 diabetes patients using anti-hyperglycemic therapies; those reporting limited HL were especially vulnerable. Efforts to reduce hypoglycemia and promote patient safety may require self-management support that is appropriate for those with limited HL, and consider more vigilant surveillance, conservative glycemic targets or avoidance of the most hypoglycemia-inducing medications. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1389-7) contains supplementary material, which is available to authorized users. PMID:20480249

  12. Diabetes mellitus and intermittent claudication: a cross-sectional study of 920 claudicants

    PubMed Central

    2014-01-01

    Introduction Diabetes mellitus (DM) and intermittent claudication (IC) are frequently associated health conditions. Our hypothesis is that the nature, severity and quality of life (QoL) of patients with IC and DM are worse than those of claudicant patients without diabetes. Material and methods An observational, cross-sectional and multicentre study of 920 patients with IC, divided into two groups: diabetic (n?=?477) and non-diabetic (n?=?443). For each group, we examined clinical and biological characteristics (including levels of glucose and lipids), the ankle-brachial index (ABI), responses to the Walking Impairment Questionnaire (WIQ) and the European Quality of Life-5 Dimensions (EQ-5D) questionnaire. Results Compared with claudicant patients without diabetes, claudicants with diabetes were older (p?diabetes also had significantly more cardiovascular risk factors (p?diabetic-IC patients was slightly lower than IC patients without diabetes (p?=?0.016). All WIQ subdomains scores were significantly lower (p?diabetic patients with compared with those without diabetes. The mean E5-QD global scores and the mean EQ-5D visual analogue scale in the whole series were 0.58 (SD?=?0.21) and 55.04 (SD?=?21.30), respectively. Both E5-QD scores were significantly lower, indicating poorer QoL, in claudicant patients with diabetes than claudicant patients without diabetes (p?diabetes. PMID:24533798

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

    PubMed Central

    2013-01-01

    Background Worldwide, type 2 diabetes (T2DM) prevalence has more than doubled over two decades. In Australia, diabetes is the second highest contributor to the burden of disease. Lifestyle modification programs comprising diet changes, weight loss and moderate physical activity, have been proven to reduce the incidence of T2DM in high risk individuals. As part of the Council of Australia Governments, the State of Victoria committed to develop and support the diabetes prevention program ‘Life! Taking action on diabetes’ (Life!) which has direct lineage from effective clinical and implementation trials from Finland and Australia. The Melbourne Diabetes Prevention Study (MDPS) has been set up to evaluate the effectiveness and cost-effectiveness of a specific version of the Life! program. Methods/design We intend to recruit 796 participants for this open randomized clinical trial; 398 will be allocated to the intervention arm and 398 to the usual care arm. Several methods of recruitment will be used in order to maximize the number of participants. Individuals aged 50 to 75 years will be screened with a risk tool (AUSDRISK) to detect those at high risk of developing T2DM. Those with existing diabetes will be excluded. Intervention participants will undergo anthropometric and laboratory tests, and comprehensive surveys at baseline, following the fourth group session (approximately three months after the commencement of the intervention) and 12 months after commencement of the intervention, while control participants will undergo testing at baseline and 12 months only. The intervention consists of an initial individual session followed by a series of five structured-group sessions. The first four group sessions will be carried out at two week intervals and the fifth session will occur eight months after the first group session. The intervention is based on the Health Action Process Approach (HAPA) model and sessions will empower and enable the participants to follow the five goals of the Life! program. Discussion This study will determine whether the effect of this intervention is larger than the effect of usual care in reducing central obesity and cardiovascular risk factors and thus the risk of developing diabetes and cardiovascular disease. Also it will evaluate how these two options compare economically. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12609000507280 PMID:23369724

  14. A systematic review of predictive risk models for diabetes complications based on large scale clinical studies.

    PubMed

    Lagani, Vincenzo; Koumakis, Lefteris; Chiarugi, Franco; Lakasing, Edin; Tsamardinos, Ioannis

    2013-01-01

    This work presents a systematic review of long-term risk assessment models for evaluating the probability of developing complications in diabetes patients. Diabetes mellitus can cause many complications if not adequately controlled; risk assessment models can help physicians and patients in identifying the complications most likely to arise and in taking the necessary countermeasures. We identified six large medical studies related to diabetes mellitus upon which current available risk assessment models are built on; all these studies had duration over 5 years and most of them included some common demographic and clinical data strongly related to diabetic complications. The most common predictions for long term diabetes complications are related to cardiovascular diseases and diabetic retinopathy. Our analysis of the literature led us to the conclusion that researchers and medical practitioners should take in account that some limitations undermine the applicability of risk assessment models; for example, it is hard to judge whether results obtained on a specific cohort can be effectively translated to other populations. Nevertheless, all these studies have significantly contributed to identify significant risk factors associated with the major diabetes complications. PMID:23273850

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

    PubMed Central

    A. Villena, Josep; Carvalho, Andrea R.; Garcia-Arumí, José; Ramos, David; Ruberte, Jesús; Simó, Rafael; Hernández, Cristina

    2014-01-01

    Background To characterize the sequential events that are taking place in retinal neurodegeneration in a murine model of spontaneous type 2 diabetes (db/db mouse). Methods C57BLKsJ-db/db mice were used as spontaneous type 2 diabetic animal model, and C57BLKsJ-db/+ mice served as the control group. To assess the chronological sequence of the abnormalities the analysis was performed at different ages (8, 16 and 24 weeks). The retinas were evaluated in terms of morphological and functional abnormalities [electroretinography (ERG)]. Histological markers of neurodegeneration (glial activation and apoptosis) were evaluated by immunohistochemistry. In addition glutamate levels and glutamate/aspartate transporter (GLAST) expression were assessed. Furthermore, to define gene expression changes associated with early diabetic retinopathy a transcriptome analyses was performed at 8 week. Furthermore, an additional interventional study to lower blood glucose levels was performed. Results Glial activation was higher in diabetic than in non diabetic mice in all the stages (p<0.01). In addition, a progressive loss of ganglion cells and a significant reduction of neuroretinal thickness were also observed in diabetic mice. All these histological hallmarks of neurodegeneration were less pronounced at week 8 than at week 16 and 24. Significant ERG abnormalities were present in diabetic mice at weeks 16 and 24 but not at week 8. Moreover, we observed a progressive accumulation of glutamate in diabetic mice associated with an early downregulation of GLAST. Morphological and ERG abnormalities were abrogated by lowering blood glucose levels. Finally, a dysregulation of several genes related to neurotransmission and oxidative stress such as UCP2 were found at week 8. Conclusions Our results suggest that db/db mouse reproduce the features of the neurodegenerative process that occurs in the human diabetic eye. Therefore, it seems an appropriate model for investigating the underlying mechanisms of diabetes-induced retinal neurodegeneration and for testing neuroprotective drugs. PMID:24837086

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

    PubMed Central

    Tseng, Chin-Hsiao

    2014-01-01

    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

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

    Microsoft Academic Search

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

    2004-01-01

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

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

    Microsoft Academic Search

    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

    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

  19. Automated diabetic retinopathy imaging in Indian eyes: A pilot study

    PubMed Central

    Roy, Rupak; Lob, Aneesha; Pal, Bikramjeet P; Oliveira, Carlos Manta; Raman, Rajiv; Sharma, Tarun

    2014-01-01

    Aim: To evaluate the efficacy of an automated retinal image grading system in diabetic retinopathy (DR) screening. Materials and Methods: Color fundus images of patients of a DR screening project were analyzed for the purpose of the study. For each eye two set of images were acquired, one centerd on the disk and the other centerd on the macula. All images were processed by automated DR screening software (Retmarker). The results were compared to ophthalmologist grading of the same set of photographs. Results: 5780 images of 1445 patients were analyzed. Patients were screened into two categories DR or no DR. Image quality was high, medium and low in 71 (4.91%), 1117 (77.30%) and 257 (17.78%) patients respectively. Specificity and sensitivity for detecting DR in the high, medium and low group were (0.59, 0.91); (0.11, 0.95) and (0.93, 0.14). Conclusion: Automated retinal image screening system for DR had a high sensitivity in high and medium quality images. Automated DR grading software's hold promise in future screening programs. PMID:25579354

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

    E-print Network

    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

    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...

  1. Immunolocalization of CD34 Positive Progenitor Cells in Diabetic and Non Diabetic Periodontitis Patients – A Comparative Study

    PubMed Central

    Mandalapu, Narendra; DV, Sitaramaraju; Mannem, Ravikanth; Alla, Rama Krishna; Gadde, Praveen

    2014-01-01

    Background: Little research has been documented to determine the CD34 positive cells in healthy periodontium, chronic periodontitis and in chronic periodontitis with diabetes mellitus individuals. Aim: The aim of the present study was to evaluate and compare the CD34 positive progenitor cells of the gingiva in patients with healthy periodontium, chronic periodontitis and chronic periodontitis with Diabetes Mellitus. Materials and Methods: A total number of 75 patients were divided into 3 groups which included Group I (healthy periodontium), Group II (chronic periodontitis) and Group III (chronic periodontitis with diabetes mellitus). Periodontal examination included Plaque index, Gingival index, Gingival bleeding index, Probing pocket depth and Clinical attachment levels. Gingival biopsies were collected from each participant and they were fixed in formalin embedded in paraffin which was later subjected to immunohistochemical procedure with anti-CD34 (a stemness marker). T-Test and Regression analysis (R-square) was used to analyse the data. Results: The mean number of CD34 positive cells were higher in group III (5.71±1.97) compared to Group chronic periodontitis group I (4.98± 2.08) and II (4.48± 1.24). Conclusion: Although CD34 is a non specific stemness marker, results suggest that there is a significant difference in the number of CD34 positive progenitor cells between Group II and Group III but no significant difference was observed between Group I, II and Group I, III. PMID:25584328

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

    PubMed Central

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

    2012-01-01

    Aim Asthma is believed to increase the risk for several proinflammatory diseases, yet epidemiologic studies on asthma in relation to risk of developing type 2 diabetes are sparse and have reported inconsistent results. In the present study, we investigated the hypothesis that asthma is associated with an increased risk of incident type 2 diabetes in Chinese adults. Methods We used data from the Singapore Chinese Health Study, including Chinese men and women aged 45–74 years, free of cancer, heart disease, stroke, and diabetes at baseline (1993–1998) and followed through 2004 for incident physician-diagnosed diabetes. Cox regression models were used to examine the associations between self-reported history of physician-diagnosed asthma and risk of diabetes. Results During an average follow-up of 5.7 years per person, 2,234 of the 42,842 participants included in the current analyses reported diagnoses of type 2 diabetes. After adjustment for potential confounders, not including body mass index (BMI), asthma was associated with a 31% increased risk of incident diabetes (HR = 1.31; 95% CI: 1.00–1.72). The association was attenuated after adjustment for adult BMI (HR = 1.25 95% CI: 0.95–1.64). The asthma-diabetes association appeared stronger for adult- versus child-diagnosed asthma cases, and for participants who were obese compared to non-obese. Conclusions In Singaporean Chinese adults we observed a positive association between self-reported, physician-diagnosed asthma and risk of developing type 2 diabetes that was modestly attenuated upon adjustment for BMI. PMID:23260853

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

    Microsoft Academic Search

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

    2009-01-01

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

  4. Studies of renal injury III: Lipid-induced nephropathy in type II diabetes

    Microsoft Academic Search

    Jesus H Dominguez; Nianjun Tang; Wei Xu; Andrew P Evan; Aristotle N Siakotos; Rajiv Agarwal; James Walsh; Mark Deeg; Howard J Pratt; Keith L March; Vincent M Monnier; Miriam F Weiss; John W Baynes; Richard Peterson

    2000-01-01

    Studies of renal injury III: Lipid-induced nephropathy in type II diabetes.BackgroundNephrotoxicity from elevated circulating lipids occurs in experimental and clinical situations. We tested the hypothesis that lipid-induced nephropathy causes advanced renal failure in rats with type II diabetes and dyslipidemia.MethodsFirst generation (F1) hybrid rats derived from the spontaneous hypertensive heart failure rat (SHHF\\/Gmi-fa) and the LA\\/NIH-corpulent rat (LA\\/N-fa) were studied

  5. Short report: Epidemiology C-reactive protein concentration predicts mortality in type 2 diabetes: the Diabetes Heart Study

    PubMed Central

    Cox, A. J.; Agarwal, S.; Herrington, D. M; Carr, J. J.; Freedman, B. I.; Bowden, D. W.

    2015-01-01

    Aims Although current American Heart Association guidelines address C-reactive protein concentration and cardiovascular disease risk, it remains unclear whether this paradigm is consistent across populations with differing disease burdens. Individuals with Type 2 diabetes mellitus represent one group at increased risk of cardiovascular disease and subsequent mortality. This study aimed to examine the relationship between C-reactive protein concentrations and risk for all-cause mortality in European Americans with Type 2 diabetes from the Diabetes Heart Study. Methods A total of 846 European Americans with Type 2 diabetes and baseline measures of C-reactive protein were evaluated. Vital status was determined after a follow-up period of 7.3 ± 2.1 years (mean ± SD). C-reactive protein concentrations were compared between living and deceased subgroups along with other known risk factors for cardiovascular disease, including blood lipids. Logistic regression was performed to determine risk for mortality associated with increasing C-reactive protein concentrations. Results At follow-up 160 individuals (18.7%) were deceased. No significant differences in baseline serum glucose or lipid measures were observed between living and deceased subgroups. Baseline C-reactive protein concentrations were significantly higher in the deceased subgroup (9.37 ± 15.94) compared with the living subgroup (5.36 ± 7.91 mg/l; P < 0.0001). Participants with C-reactive protein concentrations of 3–10 mg/l were approximately two times more likely to be deceased at follow-up (OR 2.06; 95% CI 1.17–3.62); those with C-reactive protein >10 mg/l were more than five times more likely to be deceased (OR 5.24; CI 2.80–9.38). Conclusions This study documents the utility of C-reactive protein in predicting risk for all-cause mortality in European Americans with Type 2 diabetes and supports its use as a screening tool in risk prediction models. PMID:22211818

  6. Tight Diabetes Control

    MedlinePLUS

    ... test strips and syringes, than before. What About Type 2 Diabetes? The DCCT studied only people with type 1 ... control can also prevent complications in people with type 2 diabetes. Most people with type 2 diabetes do not ...

  7. Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study

    PubMed Central

    Pan, Q.; Barrett-Connor, E.; de Groot, M.; Zhang, P.; Percy, C.; Florez, H.; Ackermann, R.; Montez, M.; Rubin, R. R.

    2013-01-01

    Purpose The purpose of this study is to assess if diagnosis of type 2 diabetes affected health-related quality of life (HRQoL) among participants in the Diabetes Prevention Program/Diabetes Prevention Program Outcome Study and changes with treatment or diabetes duration. Methods 3,210 participants with pre-diabetes were randomized to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB). HRQoL was assessed using the SF-36 including: (1) 8 SF-36 subscales; (2) the physical component (PCS) and mental component summary (MCS) scores; and (3) the SF-6D. The sample was categorized by diabetes free versus diagnosed. For diagnosed subgroup, mean scores in the diabetes-free period, at 6 months, 2, 4 and 6 years post-diagnosis, were compared. Results PCS and SF-6D scores declined in all participants in all treatment arms (P <.001). MCS scores did not change significantly in any treatment arm regardless of diagnosis. ILS participants reported a greater decrease in PCS scores at 6 months post-diagnosis (P <.001) and a more rapid decline immediately post-diagnosis in SF-6D scores (P = .003) than the MET or PLB arms. ILS participants reported a significant decrease in the social functioning subscale at 6 months (P <.001) and two years (P <.001) post-diagnosis. Conclusions Participants reported a decline in measures of overall health state (SF-6D) and overall physical HRQoL, whether or not they were diagnosed with diabetes during the study. There was no change in overall mental HRQoL. Participants in the ILS arm with diabetes reported a more significant decline in some HRQoL measures than those in the MET and PLB arms that developed diabetes. PMID:23709097

  8. Type 2 diabetes-associated genetic variants discovered in the recent genome-wide association studies are related to gestational diabetes mellitus in the Korean population

    Microsoft Academic Search

    Y. M. Cho; T. H. Kim; S. Lim; S. H. Choi; H. D. Shin; H. K. Lee; K. S. Park; H. C. Jang

    2009-01-01

    Aims\\/hypothesis  New genetic variants associated with susceptibility to type 2 diabetes mellitus have been discovered in recent genome-wide\\u000a association (GWA) studies. The aim of the present study was to examine the association between these diabetogenic variants\\u000a and gestational diabetes mellitus (GDM).\\u000a \\u000a \\u000a \\u000a Methods  The study included 869 Korean women with GDM and 345 female and 287 male Korean non-diabetic controls. We genotyped the

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

    ERIC Educational Resources Information Center

    Reardon, A. W.; And Others

    1993-01-01

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

  10. The impact of ethnicity and sex on subclinical cardiovascular disease: the Diabetes Heart Study

    Microsoft Academic Search

    B. I. Freedman; F. C. Hsu; C. D. Langefeld; S. S. Rich; D. M. Herrington; J. J. Carr; J. Xu; D. W. Bowden; L. E. Wagenknecht

    2005-01-01

    Aims\\/hypothesis  African–Americans with type 2 diabetes and access to adequate healthcare are at lower risk of clinical coronary artery disease\\u000a than are white diabetic patients. We evaluated whether ethnic differences in subclinical cardiovascular disease, coronary\\u000a and carotid artery calcified plaque and carotid artery intima–medial thickness (IMT) were present in members of The Diabetes\\u000a Heart Study families.\\u000a \\u000a \\u000a \\u000a Subjects and Methods  In a bi–racial

  11. Abnormal phosphocreatine metabolism in perfused diabetic hearts. A 31P nuclear-magnetic-resonance study.

    PubMed Central

    Pieper, G M; Salhany, J M; Murray, W J; Wu, S T; Eliot, R S

    1983-01-01

    31P n.m.r. analysis of control and diabetic hearts perfused for 1 h with a glucose buffer showed constant and normal levels of phosphocreatine and ATP. Supplementing the buffer with 0.5, 1.2 or 2.0 mM-palmitic acid had little or no effect on high-energy-phosphate levels in control hearts. In contrast, increases in palmitate concentration produced significant decreases in ATP in diabetic hearts, despite normal and constant levels of phosphocreatine. This 31P n.m.r. study suggests a defect in phosphocreatine metabolism in the perfused diabetic heart that might be related to creatine kinase kinetics. PMID:6860306

  12. 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.

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

    Microsoft Academic Search

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

    2010-01-01

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

  14. A prospective study of dietary selenium intake and risk of type 2 diabetes

    PubMed Central

    2010-01-01

    Background Growing evidence raises concern about possible associations of high selenium exposure with diabetes in selenium-replete populations such as the US. In countries with lower selenium status, such as Italy, there is little epidemiological evidence on the association between selenium and diabetes. This study examined the prospective association between dietary selenium intake and risk of type 2 diabetes. Methods The ORDET cohort study comprised a large sample of women from Northern Italy (n = 7,182). Incident type 2 diabetes was defined as a self-report of a physician diagnosis, use of antidiabetic medication, or a hospitalization discharge. Dietary selenium intake was measured by a semi-quantitative food-frequency questionnaire at the baseline examination (1987-1992). Participants were divided in quintiles based on their baseline dietary selenium intake. Results Average selenium intake at baseline was 55.7 ?g/day. After a median follow-up of 16 years, 253 women developed diabetes. In multivariate logistic regression analyses, the odds ratio for diabetes comparing the highest to the lowest quintile of selenium intake was 2.39, (95% CI: 1.32, 4.32; P for linear trend = 0.005). The odds ratio for diabetes associated with a 10 ?g/d increase in selenium intake was 1.29 (95% CI: 1.10, 1.52). Conclusions In this population, increased dietary selenium intake was associated with an increased risk of type 2 diabetes. These findings raise additional concerns about the association of selenium intake above the Recommended Dietary Allowance (55 ?g/day) with diabetes risk. PMID:20858268

  15. 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

    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

    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

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

    PubMed Central

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

    2011-01-01

    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

  17. Impact of Ellagic Acid in Bone Formation after Tooth Extraction: An Experimental Study on Diabetic Rats

    PubMed Central

    Al-Obaidi, Mazen M. Jamil; Al-Bayaty, Fouad Hussain; Hussaini, Jamal; Khor, Goot Heah

    2014-01-01

    Objectives. To estimate the impact of ellagic acid (EA) towards healing tooth socket in diabetic animals, after tooth extraction. Methods. Twenty-four Sprague Dawley male rats weighing 250–300?g were selected for this study. All animals were intraperitoneally injected with 45?mg/kg (b.w.) of freshly prepared streptozotocin (STZ), to induce diabetic mellitus. Then, the animals were anesthetized, and the upper left central incisor was extracted and the whole extracted sockets were filled with Rosuvastatin (RSV). The rats were separated into three groups, comprising 8 rats each. The first group was considered as normal control group and orally treated with normal saline. The second group was regarded as diabetic control group and orally treated with normal saline, whereas the third group comprised diabetic rats, administrated with EA (50?mg/kg) orally. The maxilla tissue stained by eosin and hematoxylin (H&E) was used for histological examinations and immunohistochemical technique. Fibroblast growth factor (FGF-2) and alkaline phosphatase (ALP) were used to evaluate the healing process in the extracted tooth socket by immunohistochemistry test. Results. The reactions of immunohistochemistry for FGF-2 and ALP presented stronger expression, predominantly in EA treated diabetic rat, than the untreated diabetic rat. Conclusion. These findings suggest that the administration of EA combined with RSV may have accelerated the healing process of the tooth socket of diabetic rats, after tooth extraction. PMID:25485304

  18. DIABETES Industrial Health AND 2010, MEDICAL/DENTAL 48, 857–863 CARE COSTS Original Article 857 Relationships between Diabetes and Medical and Dental Care Costs: Findings from a Worksite Cohort Study in Japan

    E-print Network

    Reiko Ide; Tsutomu Hoshuyama; Donald John Wilson; Ken Takahashi; Toshiaki Higashi

    2009-01-01

    Abstract: The purpose of this study was to evaluate the relationships between diabetes and medical and dental care costs from a 5-yr prospective observation of Japanese workers. The data were derived from health and dental examinations and health insurance claims of 4,086 workers aged 40–54 yr. At baseline, the subjects were assigned to four categories: known diabetes; undiagnosed diabetes; impaired fasting glucose (IFG); and non-diabetic. The differences in health care costs among the non-diabetics, IFG and undiagnosed diabetes groups were not seen at baseline, but the costs incurred by the subjects with undiagnosed diabetes substantially increased thereafter. Over 5 yr of the study period, compared with the non-diabetic group, subjects with known diabetes incurred 3.9- and 2.9-fold higher annual inpatient and outpatient costs, respectively, while subjects in the undiagnosed diabetes group incurred 3.0- and 1.6-fold higher costs, respectively. There were no significant associations between annual dental care costs and diabetic status. The excess costs of medical care among subjects with diabetes were attributable to diabetes itself, heart disease and cerebrovascular disease, but not cancer. Among middle-aged workers, diabetics incurred significantly greater medical care costs than non-diabetics, whereas IFG was not associated with higher costs.

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

    PubMed Central

    Salinero-Fort, Miguel Á.; San Andrés-Rebollo, Francisco Javier; de Burgos-Lunar, Carmen; Arrieta-Blanco, Francisco Jesús; Gómez-Campelo, Paloma

    2013-01-01

    Objective To evaluate the incidence of diabetic retinopathy in patients with Type 2 Diabetes Mellitus, to identify the risk factors associated with the incidence of retinopathy and to develop a risk table to predict four-year retinopathy risk stratification for clinical use, from a four-year cohort study. Design The MADIABETES Study is a prospective cohort study of 3,443 outpatients with Type 2 Diabetes Mellitus, sampled from 56 primary health care centers (131 general practitioners) in Madrid (Spain). Results The cumulative incidence of retinopathy at four-year follow-up was 8.07% (95% CI?=?7.04–9.22) and the incidence density was 2.03 (95% CI?=?1.75–2.33) cases per 1000 patient-months or 2.43 (95% CI?=?2.10–2.80) cases per 100 patient-years. The highest adjusted hazard ratios of associated risk factors for incidence of diabetic retinopathy were LDL-C >190 mg/dl (HR?=?7.91; 95% CI?=?3.39–18.47), duration of diabetes longer than 22 years (HR?=?2.00; 95% CI?=?1.18–3.39), HbA1c>8% (HR?=?1.90; 95% CI?=?1.30–2.77), and aspirin use (HR?=?1.65; 95% CI?=?1.22–2.24). Microalbuminuria (HR?=?1.17; 95% CI?=?0.75–1.82) and being female (HR?=?1.12; 95% CI?=?0.84–1.49) showed a non-significant increase of diabetic retinopathy. The greatest risk is observed in females who had diabetes for more than 22 years, with microalbuminuria, HbA1c>8%, hypertension, LDL-Cholesterol >190 mg/dl and aspirin use. Conclusions After a four-year follow-up, the cumulative incidence of retinopathy was relatively low in comparison with other studies. Higher baseline HbA1c, aspirin use, higher LDL-Cholesterol levels, and longer duration of diabetes were the only statistically significant risk factors found for diabetic retinopathy incidence. This is the first study to demonstrate an association between aspirin use and diabetic retinopathy risk in a well-defined cohort of patients with Type 2 Diabetes Mellitus at low risk of cardiovascular events. However, further studies with patients at high cardiovascular and metabolic risk are needed to clarify this issue. PMID:24146865

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

    PubMed Central

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

    2014-01-01

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

  1. Nerve biopsy and conduction studies in diabetic neuropathy

    Microsoft Academic Search

    F Behse; F Buchthal; F Carlsen

    1977-01-01

    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,

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

    Microsoft Academic Search

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

    2007-01-01

    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,

  3. Transplantation of placenta-derived mesenchymal stem cells in type 2 diabetes: a pilot study

    Microsoft Academic Search

    Ranhua Jiang; Zhibo Han; Guangsheng Zhuo; Xiaodan Qu; Xue Li; Xin Wang; Yuankang Shao; Shimin Yang; Zhong Chao Han

    2011-01-01

    Mesenchymal stem cells (MSC) have been used in clinical trials for severe diabetes, a chronic disease with high morbidity\\u000a and mortality. Bone marrow is the traditional source of human MSC, but human term placenta appears to be an alternative and\\u000a more readily available source. Here, the therapeutic effect of human placenta-derived MSC (PD-MSC) was studied in type 2 diabetes\\u000a patients

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

    Microsoft Academic Search

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

    2008-01-01

    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

  5. Early mortality in childhood diabetes in Austria – a population based cohort study

    Microsoft Academic Search

    E. Schober; U. Schneider; K. Unsinn

    1996-01-01

    All Austrian patients with insulin dependent diabetes diagnosed between 1979 and 1990 and age at onset below 15 years were\\u000a followed from manifestation until death or until 31 December 1990 by cross linking the diabetes registry data with the National\\u000a Mortality database (death certificates). Out of the cohort consisting of 1185 cases, 6 had died during the study period, resulting

  6. Screening for Type 2 diabetes : lessons from the ADDITION-Europe study

    Microsoft Academic Search

    M. van den Donk; A. Sandbaek; K. Borch-Johnsen; T. Lauritzen; R. K. Simmons; N. J. Wareham; S. J. Griffin; M. J. Davies; K. Khunti; G. E. H. M. Rutten

    2011-01-01

    Aims To describe and compare attendance rates and the proportions of people identified with\\u000aType 2 diabetes mellitus in people with previously unknown diabetes who participated in\\u000ascreening programmes undertaken in general practice in the UK, Denmark and the Netherlands as\\u000apart of the ADDITION-Europe study.\\u000aMethods In Cambridge, routine computer data searches were conducted to identify individuals\\u000aaged 40–69

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

    PubMed Central

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

    2014-01-01

    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

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

    Microsoft Academic Search

    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

    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

  9. Beliefs about Racism and Health among African American Women with Diabetes: A Qualitative Study

    PubMed Central

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

    2011-01-01

    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 (AA) 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 AA 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. AA 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

  10. Adipocytokines, Hepatic and Inflammatory Biomarkers and Incidence of Type 2 Diabetes. The CoLaus Study

    PubMed Central

    Marques-Vidal, Pedro; Schmid, Rémy; Bochud, Murielle; Bastardot, François; von Känel, Roland; Paccaud, Fred; Glaus, Jennifer; Preisig, Martin; Waeber, Gérard; Vollenweider, Peter

    2012-01-01

    Context There is contradictory information regarding the prognostic importance of adipocytokines, hepatic and inflammatory biomarkers on the incidence of type 2 diabetes. The objective was to assess the prognostic relevance of adipocytokine and inflammatory markers (C-reactive protein – CRP; interleukin-1beta – IL-1?; interleukin-6– IL-6; tumour necrosis factor-? – TNF-?; leptin and adiponectin) and gamma-glutamyl transpeptidase (?GT) on the incidence of type 2 diabetes. Methods Prospective, population-based study including 3,842 non-diabetic participants (43.3% men, age range 35 to 75 years), followed for an average of 5.5 years (2003–2008). The endpoint was the occurrence of type 2 diabetes. Results 208 participants (5.4%, 66 women) developed type 2 diabetes during follow-up. On univariate analysis, participants who developed type 2 diabetes had significantly higher baseline levels of IL-6, CRP, leptin and ?GT, and lower levels of adiponectin than participants who remained free of type 2 diabetes. After adjusting for a validated type 2 diabetes risk score, only the associations with adiponectin: Odds Ratio and (95% confidence interval): 0.97 (0.64–1.47), 0.84 (0.55–1.30) and 0.64 (0.40–1.03) for the second, third and forth gender-specific quartiles respectively, remained significant (P-value for trend?=?0.05). Adding each marker to a validated type 2 diabetes risk score (including age, family history of type 2 diabetes, height, waist circumference, resting heart rate, presence of hypertension, HDL cholesterol, triglycerides, fasting glucose and serum uric acid) did not improve the area under the ROC or the net reclassification index; similar findings were obtained when the markers were combined, when the markers were used as continuous (log-transformed) variables or when gender-specific quartiles were used. Conclusion Decreased adiponectin levels are associated with an increased risk for incident type 2 diabetes, but they seem to add little information regarding the risk of developing type 2 diabetes to a validated risk score. PMID:23251619

  11. A study of sociodemographic clinical and glycemic control factors associated with co-morbid depression in type 2 diabetes mellitus

    PubMed Central

    Singh, Hritu; Raju, M. S. V. K.; Dubey, Vaibhav; Kurrey, Ravindra; Bansal, Shaifali; Malik, Mustafa

    2014-01-01

    Context: Diabetes affects 9.2% of adults in India. About 8–16% of its population also suffer from depression. Both diseases pose a serious health challenge at individual and system level. The prevalence of depression in diabetes is much higher than in the general population. Undiagnosed and untreated depression puts people at higher morbidity and mortality risk. Aim: To study the prevalence of depression in diabetes and to identify associated risk factors. Settings and Design: Case control study carried out in an outpatient setting of a tertiary hospital in central India. Materials and Methods: One hundred and nine type 2 diabetes patients and 91 healthy controls formed the subjects of the study. Sociodemographic data were obtained on seven parameters. Comprehensive clinical data were obtained by means of standard procedures. Blood sugar levels and glycosylated hemoglobin levels were measured to assess glycemic control. Data of diabetic patients and controls as well as that of depressed and nondepressed diabetics were subjected to statistical analysis. Results: About 42.2% of diabetes patients and only 4.39% of controls had depression. About 19% of diabetics had peripheral neuropathy but had much higher neuropathic symptoms. Depression was not related to any sociodemographic or clinical factors but was strongly associated with poor glycemic control. Conclusion: Depression is highly prevalent in diabetes. Physical symptoms mask depression. Special attention needs to be paid to diagnose depression in diabetes and treat it appropriately along with effective glycemic control. Diabetes patients need to be treated collaboratively by physicians and psychiatrists. PMID:25788803

  12. 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

    2013-01-01

    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

  13. 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

  14. Effects of aldose reductase inhibitor treatment in diabetic polyneuropathy - a clinical and neurophysiological study.

    PubMed Central

    Fagius, J; Jameson, S

    1981-01-01

    The efficacy of treatment with an aldose reductase inhibitor (1,3-dioxo-1 H-benz-de-isoquinoline-2(3H)-acetic acid, AY-22,284, Alrestatin) on peripheral nerve function in diabetic polyneuropathy was assessed. Thirty patients with long-standing diabetes and slight to moderate neuropathy participated in the double-blind placebo trial. Clinical examination, sensory threshold determinations for vibratory, tactile and thermal stimuli, conduction velocity measurements and studies of automatic function were performed to evaluate the treatment. Significant differences favouring Alrestatin over placebo were found for many of the measured variables, whereas no changes occurred on placebo. The apparent improvement of neuropathy occurred despite persisting hyperglycaemia. The results indicate that aldose reductase inhibitor treatment may be of value in diabetic polyneuropathy, and provide support for the sorbitol pathway hypothesis of diabetic polyneuropathy. PMID:6801211

  15. Cardiovascular complications in diabetic patients undergoing regular hemodialysis: a 5-year observational study.

    PubMed

    Al-Thani, Hassan; Shabana, Adel; Hussein, Ahmed; Sadek, Ahmed; Sharaf, Ahmed; Koshy, Valsa; El-Menyar, Ayman

    2015-03-01

    We aimed to study the vascular outcomes in hemodialysis (HD) patients based on their diabetic status. A cohort observational study was conducted among patients undergoing regular HD with a 5-year follow-up. Of the 252 consecutive HD patients, 60% were diabetic. Compared with nondiabetics, diabetics were 11 years older, 4 years lesser on HD, and more likely to have prior cerebrovascular and coronary artery disease (CAD). Overall 5-year follow-up showed that diabetic patients had higher rates of HD vascular accesses (57% vs 41%, P = .01), CAD (64% vs 33%, P = .001), major amputations (8.6% vs 0%, P = .003), and mortality (66% vs 23%, P = .001). On multivariate analysis, independent predictors of mortality included number of vascular accesses in nondiabetics and HD duration, CAD, and peripheral artery disease in diabetic patients. Diabetes mellitus is associated with a significant vascular burden and mortality among HD patients. Moreover, our finding highlights the vascular impact of renal failure and HD. PMID:24576984

  16. Sex Differences in Cardiovascular Mortality in Diabetics and Nondiabetic Subjects: A Population-Based Study (Italy)

    PubMed Central

    Ballotari, Paola; Ranieri, Sofia Chiatamone; Luberto, Ferdinando; Caroli, Stefania; Greci, Marina; Manicardi, Valeria

    2015-01-01

    The objective of this study is to assess the impact of diabetes on cardiovascular mortality, focusing on sex differences. The inhabitants of Reggio Emilia province on December 31, 2009, aged 20–84 were followed up for three years for mortality. The exposure was determined using Reggio Emilia diabetes register. The age-adjusted death rates were estimated as well as the incidence rate ratios using Poisson regression model. Interaction terms for diabetes and sex were tested by the Wald test. People with diabetes had an excess of mortality, compared with nondiabetic subjects (all cause: IRR = 1.68; 95%CI 1.60–1.78; CVD: IRR = 1.61; 95%CI 1.47–1.76; AMI: IRR = 1.59; 95%CI 1.27–1.99; renal causes: IRR = 1.71; 95%CI 1.22–2.38). The impact of diabetes is greater in females than males for all causes (P = 0.0321) and for CVD, IMA, and renal causes. Further studies are needed to investigate whether the difference in cardiovascular risk profile or in the quality of care delivered justifies the higher excess of mortality in females with diabetes compared to males. PMID:25873959

  17. Diabetic cardiomyopathy

    PubMed Central

    Asghar, Omar; Al-Sunni, Ahmed; Khavandi, Kaivan; Khavandi, Ali; Withers, Sarah; Greenstein, Adam; Heagerty, Anthony M.; Malik, Rayaz A.

    2009-01-01

    Diabetic cardiomyopathy is a distinct primary disease process, independent of coronary artery disease, which leads to heart failure in diabetic patients. Epidemiological and clinical trial data have confirmed the greater incidence and prevalence of heart failure in diabetes. Novel echocardiographic and MR (magnetic resonance) techniques have enabled a more accurate means of phenotyping diabetic cardiomyopathy. Experimental models of diabetes have provided a range of novel molecular targets for this condition, but none have been substantiated in humans. Similarly, although ultrastructural pathology of the microvessels and cardiomyocytes is well described in animal models, studies in humans are small and limited to light microscopy. With regard to treatment, recent data with thiazoledinediones has generated much controversy in terms of the cardiac safety of both these and other drugs currently in use and under development. Clinical trials are urgently required to establish the efficacy of currently available agents for heart failure, as well as novel therapies in patients specifically with diabetic cardiomyopathy. PMID:19364331

  18. Bacterial infections in patients with type 1 diabetes: a 14-year follow-up study

    PubMed Central

    Simonsen, Johan R; Harjutsalo, Valma; Järvinen, Asko; Kirveskari, Juha; Forsblom, Carol; Groop, Per-Henrik; Lehto, Markku

    2015-01-01

    Objective This study explored the annual occurrence/incidence of bacterial infections, and their association with chronic hyperglycemia and diabetic nephropathy, in patients with type 1 diabetes. Design In a register-based follow-up study, we investigated the frequency of bacterial infections in patients with type 1 diabetes (n=4748) and age-matched and sex-matched non-diabetic control (NDC) subjects (n=12?954) using nationwide register data on antibiotic drug prescription purchases and hospital discharge diagnoses, collected between 1996 and 2009. Diabetic nephropathy was classified based on the urinary albumin excretion rate (AER). Results The hospitalization rate due to bacterial infections was higher in patients with diabetes compared with NDCs (rate ratio (RR) 2.30 (95% CI 2.11 to 2.51)). The rate correlated with the severity of diabetic nephropathy: RR for microalbuminuria was 1.23 (0.94 to 1.60), 1.97 (1.49 to 2.61) for macroalbuminuria, 11.2 (8.1 to 15.5) for dialysis, and 6.72 (4.92 to 9.18) for kidney transplant as compared to patients with diabetes and normal AER. The annual number of antibiotic purchases was higher in patients with diabetes (1.00 (1.00 to 1.01)) as compared with NDCs (0.47 (0.46 to 0.47)), RR=1.71 (1.65 to 1.77). Annual antibiotic purchases were 1.18-fold more frequent in patients with microalbuminuria, 1.29-fold with macroalbuminuria, 2.43-fold with dialysis, and 2.74-fold with kidney transplant as compared to patients with normal AER. Each unit of increase in glycated hemoglobin was associated with a 6–10% increase in the number of annual antibiotic purchases. Conclusions The incidence of bacterial infections was significantly higher in patients with type 1 diabetes compared with age-matched and sex-matched NDC subjects, and correlated with the severity of diabetic nephropathy in inpatient and outpatient settings.

  19. Prediction of insulin-dependent diabetes mellitus in siblings of children with diabetes. A population-based study. The Childhood Diabetes in Finland Study Group.

    PubMed Central

    Kulmala, P; Savola, K; Petersen, J S; Vähäsalo, P; Karjalainen, J; Löppönen, T; Dyrberg, T; Akerblom, H K; Knip, M

    1998-01-01

    An unselected population of 755 siblings of children with insulin-dependent diabetes mellitus (IDDM) was studied to evaluate the predictive characteristics of islet cell antibodies (ICA), antibodies to the IA-2 protein (IA-2A), antibodies to the 65-kD isoform of glutamic acid decarboxylase (GADA), insulin autoantibodies (IAA), and combinations of these markers. We also evaluated whether the histochemical ICA test could be replaced by the combined detection of other markers. 32 siblings progressed to IDDM within 7.7 yr of the initial sample taken at or close to the diagnosis of the index case (median follow-up, 9.1 yr). The positive predictive values of ICA, IA-2A, GADA, and IAA were 43, 55, 42, and 29%, and their sensitivities 81, 69, 69, and 25%, respectively. In contrast to the other three antibody specificities, GADA levels were not related to the risk for IDDM. The risk for IDDM in siblings with four, three, two, one, or no antibodies was 40, 70, 25, 2, and 0.8%, respectively. Combined screening for IA-2A and GADA identified 70% of all ICA-positive siblings, and all of the ICA-positive progressors were also positive for at least one of the three other markers. The sensitivity of the combined analysis of IA-2A and GADA was 81%, and the positive predictive value was 41%. In conclusion, combined screening for IA-2A and GADA may replace the ICA assay, giving comparable sensitivity, specificity, and positive predictive value. Accurate assessment of the risk for IDDM in siblings is complicated, as not even all those with four antibody specificities contract the disease, and some with only one or no antibodies initially will progress to IDDM. PMID:9435304

  20. Trends in Cardiovascular Disease Risk Factors in People with and without Diabetes Mellitus: A Middle Eastern Cohort Study

    PubMed Central

    Jahangiri-Noudeh, Younes; Akbarpour, Samaneh; Lotfaliany, Mojtaba; Zafari, Neda; Khalili, Davood; Tohidi, Maryam; Mansournia, Mohammad Ali; Azizi, Fereidoun; Hadaegh, Farzad

    2014-01-01

    Aims/Hypothesis To investigate secular trends in cardiovascular disease (CVD) risk factors during a decade of follow-up in a Middle Eastern cohort, and to compare observed trends between diabetic and non-diabetic populations. Methods In a population of 6181 participants (2622 males and 3559 females), diabetes status and CVD risk factors were evaluated in 4 study phases from 1999–2011. 1045 subjects had type 2 diabetes mellitus at baseline and 5136 participants were diabetes-free. To examine the trends of CVD risk factors, generalized estimation equation models were constructed. The interaction between the diabetes status and each phase of the study was checked in a separate model. Results During the follow-up period diabetic females significantly gained better control of their blood pressure, serum low density lipoprotein cholesterol and general and central obesity measures compared to non-diabetic counterparts, although 60% of them had high BP and 64% had high serum LDL-C levels till the end of the study. Diabetic males however, experienced significantly better control on their serum LDL-C and general and central obesity measures compared to their non-diabetic controls; but 24% of them were still smoker, 63% had high BP and 60% had high serum LDL-C levels at the end of the follow-up (all Ps interaction <0.05). Use of lipid-lowering and antihypertensive medications increased consistently in both diabetic and non-diabetic populations. Conclusions/Interpretation Although CVD risk factors have been controlled to some extent among diabetic population in Iran, still high numbers of people with diabetes have uncontrolled CVD risk factors that prompt more attention. PMID:25461381

  1. New Research Methods Developed for Studying Diabetic Foot Ulceration

    NASA Technical Reports Server (NTRS)

    1998-01-01

    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.

  2. Do Public Health Clinics Reduce Rehospitalizations?: The Urban Diabetes Study

    Microsoft Academic Search

    Vivian G. Valdmanis Jessica M. Robbins; David A. Webb

    2008-01-01

    Safety-net health clinics have been shown to reduce hospitalizations for ambulatory care-sensitive conditions. Their impact on rehospitalization after hospital discharge is unknown. We hypothesized that use of publicly-funded safety-net health clinics would reduce rates of rehospitalization among patients with diabetes. We expected this effect to be most evident among the most vulnerable patients. Linking data from the Philadelphia Health Care

  3. Epidemiology of Diabetic Foot Infections in an Eastern Caribbean Population: A Prospective Study

    PubMed Central

    Islam, Shariful; Harnarayan, Patrick; Cawich, Shamir O; Budhooram, Steve; Bheem, Vinoo; Mahabir, Vijai; Ramsewak, Shiva; Aziz, Imran; Naraynsingh, Vijay

    2013-01-01

    Introduction: This study evaluates the epidemiology of diabetic foot infections in an Eastern Caribbean nation in order to direct public health preventive measures. Methods: We prospectively identified all patients with diabetic foot infections who were admitted to tertiary care hospitals across Trinidad and Tobago from July 2011 to June 2012. A questionnaire was used to collect data on demographics, patient knowledge, avoidance of risk factors for chronic diseases (a proxy to unhealthy lifestyles), and glycosylated hemoglobin measurements on admission as an index of blood glucose control. The data were analyzed with statistical software. Results: There were 446 patients with diabetic foot infections (mean age = 56.9 years, standard deviation = 12.4 years). Most patients had Type 2 diabetes (93.3%) and were of Indo-Trinidadian (49.1%) or Afro-Trinidadian (41.7%) descent. There were preexisting complications of diabetes in 82.9% of patients with Type 2 diabetes: foot infections requiring hospitalization (70.2%), ischemic heart disease (32.5%), renal impairment (13.7%), and retinopathy (22.1%). Despite most patients claiming compliance with treatment, 75% had glycosylated hemoglobin levels above 7.1% at presentation, and 49.3% continued unhealthy lifestyles. Despite the high prevalence of diabetic complications at admission, and despite 70% having had previous hospitalization for treatment of foot infections, only 57.4% of patients reported ever being counseled or taught about foot care by medical personnel. Conclusions: There is room for improvement in public health strategies to prevent diabetic foot complications in this setting. Such strategies should focus on patient education with emphasis on lifestyle modification and compliance with medical therapy. PMID:23704841

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

    PubMed Central

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

    2013-01-01

    Aims High consumption of dietary fructose has been shown to contribute to dyslipidemia and elevated blood pressure in adults, but there are few data in youth, particularly those at greater risk of cardiovascular disease (CVD). The aim of this study was to examine the association between fructose intake and CVD risk factors in a diverse population of youth with type 1diabetes (T1D). Methods This was a cross-sectional analysis of data from the SEARCH for Diabetes in Youth study, including 2085 youth ages 10–22 years with T1D, of which 22% were racial/ethnic minority and 50% were female. A semi-quantitative food frequency questionnaire was used to assess intake. Results Median daily fructose consumption was 7.9% of total calories. Fructose intake was positively associated with triglycerides (p<.01), but not with total cholesterol, LDL-cholesterol, HDL-cholesterol, or blood pressure after adjustment for physical activity and socio-demographic, clinical, and dietary covariates. An increase in fructose intake of 22 grams (equivalent to a 12 oz. can of soda) was associated with a 23% higher odds of borderline/ high versus low triglycerides (p<.005). Conclusion These data suggest that children with T1D should moderate their intake of fructose, particularly those with borderline or high triglycerides. PMID:23540682

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

    PubMed Central

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

    1998-01-01

    Objective: To explore the experience of diabetes in British Bangladeshis, since successful management of diabetes requires attention not just to observable behaviour but to the underlying attitudes and belief systems which drive that behaviour. Design: Qualitative study of subjects’ experience of diabetes using narratives, semi-structured interviews, focus groups, and pile sorting exercises. A new qualitative method, the structured vignette, was developed for validating researchers’ understanding of primary level culture. Subjects: 40 British Bangladeshi patients with diabetes, and 10 non-Bangladeshi controls, recruited from primary care. Result: Several constructs were detected in relation to body image, cause and nature of diabetes, food classification, and knowledge of complications. In some areas, the similarities between Bangladeshi and non-Bangladeshi subjects were as striking as their differences. There was little evidence of a fatalistic or deterministic attitude to prognosis, and most informants seemed highly motivated to alter their diet and comply with treatment. Structural and material barriers to behaviour change were at least as important as “cultural” ones. Conclusion: Bangladeshi culture is neither seamless nor static, but some widely held beliefs and behaviours have been identified. Some of these have a potentially beneficial effect on health and should be used as the starting point for culturally sensitive diabetes education. PMID:9550958

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

    PubMed Central

    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

    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

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

    PubMed

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

    2014-07-01

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

  8. The Ness field: An integrated field study

    SciTech Connect

    Karasek, R.M.; Kean, K.R.; Richards, M.L. (Mobil North Sea Ltd., London (England))

    1990-05-01

    The Ness oil field, located in UK Block 9/13, was discovered in May 1986 by well 9/13b-28A. The field comprises a high-quality Middle Jurassic reservoir with an average 148-ft oil column trapped in a west-dipping, fault-bounded closure. The oil is substantially undersaturated. The field was brought on production as a subsea satellite development tied back to the Beryl B Platform. Oil was first delivered on August 11, 1987, just over a year from discovery. Initial producing rates from the 9/13B-28A well averaged about 10,000 BOPD. Since this well, another producer and water injector have been completed. Based on the frequent and accurate pressure data available from permanent downhole gauges installed in all three wells of the Ness field, material balance was used to calculate initial oil in place. These calculations gave an oil in place value consistent with recent calculations of 87 {times} 166 STB after less than 3% of the oil-in-place had been produced, compared with 55 {times} 106 STB initially mapped. Pressure monitoring enabled reservoir drive mechanisms to be tracked and a high offtake rate to be maintained by balancing water injection with withdrawals. A reevaluation of the mapped structure was prompted by a revision of the geological model following the 9/13b-38/38Z appraisal wells, together with the discrepancy between the oil in place from mapping and material balance. The seismic data was reinterpreted using the additional well control, and the field remapped. This resulted in a revised volume of 129 {times} 106 STB. Additional insight into the differentiation between oil and water volumes in this low compressibility system and a resolution of the differences between material balance and volumetrics were obtained through a black-oil simulation.

  9. Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study

    Microsoft Academic Search

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

    2005-01-01

    Aims To examine patient- and provider-reported psychosocial problems and barriers to effective self-care and resources for dealing with those barriers. Methods Cross-sectional study using face-to-face or telephone interviews with diabetic patients and health-care providers in 13 countries in Asia, Australia, Europe and North America. Participants were randomly selected adults ( n = 5104) with Type 1 or Type 2 diabetes,

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

    ERIC Educational Resources Information Center

    Urteaga, Edie

    2011-01-01

    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…

  11. Vanadium and diabetes

    Microsoft Academic Search

    Patrick Poucheret; Subodh Verma; Marc D. Grynpas; John H. McNeill

    1998-01-01

    We demonstrated in 1985 that vanadium administered in the drinking water to streptozotocin (STZ) diabetic rats restored elevated blood glucose to normal. Subsequent studies have shown that vanadyl sulfate can lower elevated blood glucose, cholesterol and triglycerides in a variety of diabetic models including the STZ diabetic rat, the Zucker fatty rat and the Zucker diabetic fatty rat. Long-term studies

  12. Identification of undiagnosed diabetes and quality of diabetes care in the United States: cross-sectional study of 11.5 million primary care electronic records

    PubMed Central

    Gunnarsson, Candace L.; Cload, Paul A.; Ross, Susan D.

    2014-01-01

    Background Electronic diabetes registers promote structured care and enable identification of undiagnosed diabetes, but they require consistent coding of the diagnosis in electronic medical records. We investigated the potential of electronic medical records to identify undiagnosed diabetes and to support diabetes management in a large primary care population in the United States. Methods We conducted a cross-sectional study and retrospective observational cohort analysis of primary care electronic medical records from a nationally representative US database (GE Centricity). We tested the feasibility of identifying patients with undiagnosed diabetes by applying simple algorithms to the electronic medical record data. We compared the quality of care provided to patients in the United States who had diabetes (coded and uncoded) for at least 15 months with the quality of care provided in England using a set of 16 indicators. Results We included 11 540 454 electronic medical records from more than 9000 primary care clinics across the United States. Of the 1 110 398 records indicating diagnosed diabetes, only 61.9% contained a diagnostic code. Of the 10 430 056 records for nondiabetic patients, 0.4% (n = 40 359) had at least 2 abnormal fasting or random blood glucose values, and 0.2% (n = 23 261) of the remaining records had at least 1 documented glycated hemoglobin (HbA1c) value of 6.5% or higher. Among the 622 260 patients for whom information on quality-of-care indicators was available, those with a coded diagnosis of diabetes had a significantly higher level of quality of care than those with uncoded diabetes (p < 0.01); however, the quality of care was generally lower than that indicated in England. Interpretation We were able to identify a substantial number of patients with uncoded diabetes and probable undiagnosed diabetes using simple algorithms applied to the primary care electronic records. Electronic coding of the diagnosis was associated with improved quality of care. Electronic diabetes registers are underused in US primary care and provide opportunities to facilitate the systematic, structured approach that is established in England. PMID:25485250

  13. Insights From Twin Research: Conference at Royal Childrens Hospital, Melbourne, Australia / Twin Studies: Timing of Monozygotic Splitting and Commentary; Gestational Diabetes; ICOMBO'S Post-Partum Depression Study; Photographs of Conjoined Twins / Human Interest: Rare Quadruplets; Mistaken Identity on the Soccer Field; Prenatal Laser Surgery on Triplets; Twins Born to Prince and Princess of Monaco.

    PubMed

    Segal, Nancy L

    2015-04-01

    Highlights from a conference, 'Healthier Kids: Insights From Twin Research', held in Melbourne, Australia on December 5, 2014, are summarized. In addition to informative and exciting presentations and discussions of recent findings, three key themes emerged: (1) results from twin research have important implications for non-twins, (2) researchers from diverse disciplines should be encouraged to participate actively in twin research, and (3) investigators, twins and families need to work more collaboratively. Next, papers and studies concerning the biological bases of monozygotic (MZ) twinning, gestational diabetes and post-partum depression are reviewed. Finally, general interest reports of rare quadruplets, mistaken identity, prenatal laser surgery and a royal twin birth are provided. PMID:25740114

  14. The association between neighbourhood greenspace and type 2 diabetes in a large cross-sectional study

    PubMed Central

    Bodicoat, Danielle H; O'Donovan, Gary; Dalton, Alice M; Gray, Laura J; Yates, Thomas; Edwardson, Charlotte; Hill, Sian; Webb, David R; Khunti, Kamlesh; Davies, Melanie J; Jones, Andrew P

    2014-01-01

    Objective To investigate the relationship between neighbourhood greenspace and type 2 diabetes. Design Cross-sectional. Setting 3 diabetes screening studies conducted in Leicestershire, UK in 2004–2011. The percentage of greenspace in the participant's home neighbourhood (3?km radius around home postcode) was obtained from a Land Cover Map. Demographic and biomedical variables were measured at screening. Participants 10?476 individuals (6200 from general population; 4276 from high-risk population) aged 20–75?years (mean 59?years); 47% female; 21% non-white ethnicity. Main outcome measure Screen-detected type 2 diabetes (WHO 2011 criteria). Results Increased neighbourhood greenspace was associated with significantly lower levels of screen-detected type 2 diabetes. The ORs (95% CI) for screen-detected type 2 diabetes were 0.97 (0.80 to 1.17), 0.78 (0.62 to 0.98) and 0.67 (0.49 to 0.93) for increasing quartiles of neighbourhood greenspace compared with the lowest quartile after adjusting for ethnicity, age, sex, area social deprivation score and urban/rural status (Ptrend=0.01). This association remained on further adjustment for body mass index, physical activity, fasting glucose, 2?h glucose and cholesterol (OR (95% CI) for highest vs lowest quartile: 0.53 (0.35 to 0.82); Ptrend=0.01). Conclusions Neighbourhood greenspace was inversely associated with screen-detected type 2 diabetes, highlighting a potential area for targeted screening as well as a possible public health area for diabetes prevention. However, none of the risk factors that we considered appeared to explain this association, and thus further research is required to elicit underlying mechanisms. Trial registration number This study uses data from three studies (NCT00318032, NCT00677937, NCT00941954). PMID:25537783

  15. Daycare attendance, breastfeeding, and the development of type 1 diabetes: the diabetes autoimmunity study in the young.

    PubMed

    Hall, Katelyn; Frederiksen, Brittni; Rewers, Marian; Norris, Jill M

    2015-01-01

    Background. The hygiene hypothesis attributes the increased incidence of type 1 diabetes (T1D) to a decrease of immune system stimuli from infections. We evaluated this prospectively in the Diabetes Autoimmunity Study in the Young (DAISY) by examining daycare attendance during the first two years of life (as a proxy for infections) and the risk of T1D. Methods. DAISY is a prospective cohort of children at increased T1D risk. Analyses were limited to 1783 children with complete daycare and breastfeeding data from birth to 2 years of age; 58 children developed T1D. Daycare was defined as supervised time with at least one other child at least 3 times a week. Breastfeeding duration was evaluated as a modifier of the effect of daycare. Cox proportional hazards regression was used for analyses. Results. Attending daycare before the age of 2 years was not associated with T1D risk (HR: 0.89; CI: 0.54-1.47) after adjusting for HLA, first degree relative with T1D, ethnicity, and breastfeeding duration. Breastfeeding duration modified this association, where daycare attendance was associated with increased T1D risk in nonbreastfed children and a decreasing T1D risk with increasing breastfeeding duration (interaction P value = 0.02). Conclusions. These preliminary data suggest breastfeeding may modify the effect of daycare on T1D risk. PMID:25883944

  16. Daycare Attendance, Breastfeeding, and the Development of Type 1 Diabetes: The Diabetes Autoimmunity Study in the Young

    PubMed Central

    Norris, Jill M.

    2015-01-01

    Background. The hygiene hypothesis attributes the increased incidence of type 1 diabetes (T1D) to a decrease of immune system stimuli from infections. We evaluated this prospectively in the Diabetes Autoimmunity Study in the Young (DAISY) by examining daycare attendance during the first two years of life (as a proxy for infections) and the risk of T1D. Methods. DAISY is a prospective cohort of children at increased T1D risk. Analyses were limited to 1783 children with complete daycare and breastfeeding data from birth to 2 years of age; 58 children developed T1D. Daycare was defined as supervised time with at least one other child at least 3 times a week. Breastfeeding duration was evaluated as a modifier of the effect of daycare. Cox proportional hazards regression was used for analyses. Results. Attending daycare before the age of 2 years was not associated with T1D risk (HR: 0.89; CI: 0.54–1.47) after adjusting for HLA, first degree relative with T1D, ethnicity, and breastfeeding duration. Breastfeeding duration modified this association, where daycare attendance was associated with increased T1D risk in nonbreastfed children and a decreasing T1D risk with increasing breastfeeding duration (interaction P value = 0.02). Conclusions. These preliminary data suggest breastfeeding may modify the effect of daycare on T1D risk.

  17. Toenail selenium and risk of type 2 diabetes: the ORDET cohort study.

    PubMed

    Vinceti, Marco; Grioni, Sara; Alber, Dorothea; Consonni, Dario; Malagoli, Carlotta; Agnoli, Claudia; Malavolti, Marcella; Pala, Valeria; Krogh, Vittorio; Sieri, Sabina

    2015-01-01

    Epidemiologic studies, particularly randomized controlled trials, have shown a direct relation between dietary and environmental exposure to the metalloid selenium and risk of type 2 diabetes. We investigated the association between baseline toenail selenium levels and diabetes occurrence in a case-control study nested in ORDET, a population-based female cohort in Northern Italy. After a median follow-up of 16 years, we identified 226 cases of type 2 diabetes cases and 395 age-matched control women with available toenail samples at baseline. The multivariate odds ratios of diabetes in increasing a priori defined categories of toenail selenium exposure were 1.09 (95% confidence interval 0.61, 1.96), 0.71 (0.38, 1.34) and 1.14 (0.46, 2.80) compared with the lowest category. The results were not substantially altered when quartile distribution of toenail selenium in controls was used to define exposure categories. Spline regression analysis did not show homogeneous risk trends. Overall, we did not find an association between toenail selenium and subsequent development of diabetes. Since the diabetogenic activity of selenium is strongly supported by experimental studies and some observational investigations, our null results might be explained by the limitations of overall selenium toenail content to assess environmental exposure to selenium species of etiologic relevance in the study population. PMID:25169979

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

    Microsoft Academic Search

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

    1993-01-01

    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

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

    Microsoft Academic Search

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

    1999-01-01

    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

  20. (Studies in quantum field theory)

    SciTech Connect

    Not Available

    1990-01-01

    During the period 4/1/89--3/31/90 the theoretical physics group supported by Department of Energy Contract No. AC02-78ER04915.A015 and consisting of Professors Bender and Shrauner, Associate Professor Papanicolaou, Assistant Professor Ogilvie, and Senior Research Associate Visser has made progress in many areas of theoretical and mathematical physics. Professors Bender and Shrauner, Associate Professor Papanicolaou, Assistant Professor Ogilvie, and Research Associate Visser are currently conducting research in many areas of high energy theoretical and mathematical physics. These areas include: strong-coupling approximation; classical solutions of non-Abelian gauge theories; mean-field approximation in quantum field theory; path integral and coherent state representations in quantum field theory; lattice gauge calculations; the nature of perturbation theory in large order; quark condensation in QCD; chiral symmetry breaking; the 1/N expansion in quantum field theory; effective potential and action in quantum field theories, including OCD; studies of the early universe and inflation, and quantum gravity.

  1. Peripheral Arterial Disease among Adult Diabetic Patients Attending a Large Outpatient Diabetic Clinic at a National Referral Hospital in Uganda: A Descriptive Cross Sectional Study

    PubMed Central

    Mwebaze, Raymond Mbayo; Kibirige, Davis

    2014-01-01

    Background Peripheral arterial disease (PAD) is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, hence significant morbidity and mortality. Among African adult diabetic populations, screening and diagnosis of PAD is frequently suboptimal. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda. Methods In this descriptive cross sectional study, 146 ambulatory adult diabetic patients were studied. Information about their socio-demographic and clinical characteristics, fasting lipid profile status, blood pressure, glycated haemoglobin (HbA1c) levels and presence of albuminuria was collected using a pre tested questionnaire. Measurement of ankle brachial index (ABI) to assess for PAD, defined as a ratio less than 0.9 was performed using a portable 5–10 MHz Doppler device. Clinical factors associated with PAD were determined by comparing specific selected characteristics in patients with PAD and those without. Results The mean age/standard deviation of the study participants was 53.9/12.4 years with a male predominance (75, 51.4%). PAD was prevalent in 57 (39%) study participants. Of these, 34 (59.6%) had symptomatic PAD. The noted clinical factors associated with PAD in this study population were presence of symptoms of intermittent claudication and microalbuminuria. Conclusions This study documents a high prevalence of PAD among adult ambulatory Ugandan diabetic patients. Aggressive screening for PAD using ABI measurement in adult diabetic patients should be emphasised in Uganda especially in the presence of symptoms of intermittent claudication and microalbuminuria. PMID:25133533

  2. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies

    PubMed Central

    2013-01-01

    Objective To determine whether individual fruits are differentially associated with risk of type 2 diabetes. Design Prospective longitudinal cohort study. Setting Health professionals in the United States. Participants 66 105 women from the Nurses’ Health Study (1984-2008), 85 104 women from the Nurses’ Health Study II (1991-2009), and 36 173 men from the Health Professionals Follow-up Study (1986-2008) who were free of major chronic diseases at baseline in these studies. Main outcome measure Incident cases of type 2 diabetes, identified through self report and confirmed by supplementary questionnaires. Results During 3 464 641 person years of follow-up, 12 198 participants developed type 2 diabetes. After adjustment for personal, lifestyle, and dietary risk factors of diabetes, the pooled hazard ratio of type 2 diabetes for every three servings/week of total whole fruit consumption was 0.98 (95% confidence interval 0.96 to 0.99). With mutual adjustment of individual fruits, the pooled hazard ratios of type 2 diabetes for every three servings/week were 0.74 (0.66 to 0.83) for blueberries, 0.88 (0.83 to 0.93) for grapes and raisins, 0.89 (0.79 to 1.01) for prunes, 0.93 (0.90 to 0.96) for apples and pears, 0.95 (0.91 to 0.98) for bananas, 0.95 (0.91 to 0.99) for grapefruit, 0.97 (0.92 to 1.02) for peaches, plums, and apricots, 0.99 (0.95 to 1.03) for oranges, 1.03 (0.96 to 1.10) for strawberries, and 1.10 (1.02 to 1.18) for cantaloupe. The pooled hazard ratio for the same increment in fruit juice consumption was 1.08 (1.05 to 1.11). The associations with risk of type 2 diabetes differed significantly among individual fruits (P<0.001 in all cohorts). Conclusion Our findings suggest the presence of heterogeneity in the associations between individual fruit consumption and risk of type 2 diabetes. Greater consumption of specific whole fruits, particularly blueberries, grapes, and apples, is significantly associated with a lower risk of type 2 diabetes, whereas greater consumption of fruit juice is associated with a higher risk. PMID:23990623

  3. Genome-Wide Association Study of Retinopathy in Individuals without Diabetes

    PubMed Central

    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

    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

  4. Fracture Risk in Diabetic Elderly Men: The MrOS Study

    PubMed Central

    Napoli, Nicola; Strotmeyer, Elsa S.; Ensrud, Kristine E.; Sellmeyer, Deborah E.; Bauer, Douglas C.; Hoffman, Andrew R.; Dam, Thuy-Tien L.; Barrett-Connor, Elizabeth; Palermo, Lisa; Orwoll, Eric S.; Cummings, Steven R.; Black, Dennis M; Schwartz, Ann V.

    2015-01-01

    Objective Diabetes mellitus is associated with increased fracture risk in women but few studies are available in men. To evaluate the relationship between diabetes and prospective non-vertebral fractures in elderly men, we used data from the Osteoporotic Fractures in Men (MrOS) study. Research Design and Methods MrOS enrolled 5,994 men (?65 years). Diabetes (ascertained by self-report, use of diabetes medication or elevated fasting glucose) was reported in 881 subjects of whom 80 used insulin. Hip and spine bone mineral density (BMD) were measured with dual x-ray absorptiometry. After recruitment, men were followed for incident nonvertebral fracture with a tri-annual questionnaire for an average of 9.1 (SD 2.7) years. The Cox proportional hazards model was used to assess incident risk of fractures. Results In models adjusted for age, race, clinic site and total hip BMD, the risk of non-vertebral fracture was higher in men with diabetes, compared with normoglycemic men, [hazard ratio (HR) 1.30 (95% CI: 1.09–1.54)] and was elevated in men using insulin (HR 2.46; 95% CI 1.69–3.59). Men with impaired fasting glucose did not have a higher risk of fracture compared to normoglycemic men (HR 1.04; 95% CI 0.89–1.21). After multivariable adjustment, the risk of non-vertebral fracture remained higher only among men with diabetes who were using insulin (HR 1.74; 95% CI 1.13–2.69). Conclusions Men with diabetes who are using insulin have an increased risk of non-vertebral fracture for a given age and BMD. PMID:24908567

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

    2014-01-01

    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

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

    PubMed Central

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

    2011-01-01

    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

  8. Prevention of Type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in FinlandStudy design and 1-year interim report on the feasibility of the lifestyle intervention programme

    Microsoft Academic Search

    J. Eriksson; J. Lindström; T. Valle; S. Aunola; H. Hämäläinen; P. Ilanne-Parikka; S. Keinänen-Kiukaanniemi; M. Laakso; M. Lauhkonen; P. Lehto; A. Lehtonen; A. Louheranta; M. Mannelin; V. Martikkala; M. Rastas; J. Sundvall; A. Turpeinen; T. Viljanen; M. Uusitupa; J. Tuomilehto

    1999-01-01

    Aims\\/hypothesis. The aim of the Diabetes Prevention Study is to assess the efficacy of an intensive diet-exercise programme in preventing\\u000a or delaying Type II (non-insulin-dependent) diabetes mellitus in subjects with impaired glucose tolerance, to evaluate the\\u000a effects of the intervention programme on cardiovascular risk factors and to assess the determinants for the progression to\\u000a diabetes in persons with impaired glucose

  9. Diabetes Text-Message Self-Management Support Program (SMS4BG): A Pilot Study

    PubMed Central

    Carter, Karen; Cutfield, Richard; Hulme, Ashley; Hulme, Richard; McNamara, Catherine; Maddison, Ralph; Murphy, Rinki; Shepherd, Matthew; Strydom, Johan; Whittaker, Robyn

    2015-01-01

    Background The increasing prevalence of diabetes and costly long-term complications associated with poor glycemic control are issues facing health services worldwide. Diabetes self-management, with the support of health care providers, is critical for successful outcomes, however, frequent clinical contact is costly. Text messages via short message service (SMS) have the advantage of instant transmission at low cost and, given the ubiquity of mobile phones, may be the ideal platform for the delivery of diabetes self-management support. A tailored text message-based diabetes support intervention called Self-Management Support for Blood Glucose (SMS4BG) was developed. The intervention incorporates prompts around diabetes education, management, and lifestyle factors (healthy eating, exercise, and stress management), as well as blood glucose monitoring reminders, and is tailored to patient preferences and clinical characteristics. Objective To determine the usability and acceptability of SMS4BG among adults with poorly controlled diabetes. Methods Adults (aged 17 to 69 years) with type 1 (n=12) or type 2 diabetes (n=30), a hemoglobin A1c (HbA1c) over 70 mmol/mol (8.6%), and who owned a mobile phone (n=42) were recruited to take part in a 3-month pilot study of SMS4BG. At registration, participants selected the modules they would like to receive and, where appropriate, the frequency and timing of blood glucose monitoring reminders. Patient satisfaction and perceptions of the usability of the program were obtained via semistructured phone interviews conducted at completion of the pilot study. HbA1c was obtained from patient records at baseline and completion of the pilot study. Results Participants received on average 109 messages during the 3-month program with 2 participants withdrawing early from the study. Follow-up interviews were completed with 93% of participants with all reporting SMS4BG to be useful and appropriate to their age and culture. Participants reported a range of perceived positive impacts of SMS4BG on their diabetes and health behaviors. HbA1c results indicated a positive impact of the program on glycemic control with a significant decrease in HbA1c from baseline to follow-up. Conclusions A tailored text message-based intervention is both acceptable and useful in supporting self-management in people with poorly controlled diabetes. A randomized controlled trial of longer duration is needed to assess the efficacy and sustainability of SMS4BG. PMID:25830952

  10. Title: Determinants of Quality of Life in Older Adults with Diabetes: The Diabetes & Aging Study (3483/3500 CHARACTERS)

    E-print Network

    Mateo, Jill M.

    [myocardial infarction (MI), stroke, heart failure (HF), amputation, foot ulcer, neuropathy, end-stage renal, marital status, education, income, smoking, alcohol use, physical activity, diabetes medications

  11. A Community-Based Epidemiologic Study of Gender Differences in the Relationship between Insulin Resistance\\/?-Cell Dysfunction and Diabetic Retinopathy among Type 2 Diabetic Patients in Kinmen, Taiwan

    Microsoft Academic Search

    Jorn-Hon Liu; Tao-Hsin Tung; Shih-Tzer Tsai; Pesus Chou; Shao-Yuan Chuang; Shih-Jen Chen; Fenq-Lih Lee; Hui-Chuan Shih; Wen-Ling Li

    2006-01-01

    Purpose: The purpose of this study was to explore whether there were gender differences in the relation of insulin resistance and ?-cell dysfunction to diabetic retinopathy among type 2 diabetic patients. Methods: From 1999 to 2002, a screening regimen for diabetic retinopathy was performed by a panel of ophthalmologists using ophthalmoscopy and 45-degree color fundus photography to examine the fundus

  12. An observational study of cutaneous manifestations in diabetes mellitus in a tertiary care Hospital of Eastern India

    PubMed Central

    Chatterjee, Nandini; Chattopadhyay, Chandan; Sengupta, Nilanjan; Das, Chanchal; Sarma, Nilendu; Pal, Salil K

    2014-01-01

    Background: Diabetes mellitus and its impact on the human body have been extensively dissected over the years. However, skin which is the largest organ in the body, has received minimum attention. Therefore, this study was designed to analyze the prevalence and pattern of skin disorders among diabetic patients from Eastern region of India. Materials and Methods: This is an observational study, conducted in the General Medicine and Endocrinology departments of a Medical College and Hospital in Eastern India. The data were collected prospectively and systematically in a pre-established proforma designed by us, where clinical findings along with investigations were recorded. Results: Six hundred and eighty (680) diabetic patients were examined, there were (64.8%) male and (35.1%) were female, of them 95.3% were Type 2 diabetics while 4.7% were Type 1. Five hundred and three patients (503) out of six hundred and eighty. i.e. 73.9% were found to have skin lesions. Thirteen (13) (41%) Type1 diabetics demonstrated skin lesions commonest being diabetic xerosis, infections and diabetic hand. Among Type2 diabetics 490(75.61%) showed skin lesions. Here infections, xerosis, hair loss beneath the knees, diabetic dermopathy were the most frequent. Majority of patients (67%) had combination of more than one type of skin lesion. There was statistically significant correlation of skin lesions with duration of diabetes, however similar correlation could not be demonstrated regarding metabolic control. Conclusion: Involvement of skin is inevitable and multifarious in diabetes mellitus. Higher prevalence is seen in Type 2 diabetic population. The duration of diabetes is positively correlated with lesions and infective dermatologic manifestations were associated with higher HbA1C values. PMID:24741520

  13. Cell-Based Regenerative Strategies for Treatment of Diabetic Skin Wounds, a Comparative Study between Human Umbilical Cord Blood-Mononuclear Cells and Calves' Blood Haemodialysate

    PubMed Central

    El-Mesallamy, Hala O.; Diab, Mohamed R.; Hamdy, Nadia M.; Dardir, Sarah M.

    2014-01-01

    Background Diabetes-related foot problems are bound to increase. However, medical therapies for wound care are limited; therefore, the need for development of new treatment modalities to improve wound healing in diabetic patients is essential and constitutes an emerging field of investigation. Methods Animals were randomly divided into 8 groups (I–VIII) (32 rats/group), all were streptozotocin (STZ)-induced diabetics except groups III and VIII were non-diabetic controls. The study comprised two experiments; the first included 3 groups. Group I injected with mononuclear cells (MNCs) derived from human umbilical cord blood (HUCB), group II a diabetic control group (PBS i.v). The second experiment included 5 groups, groups IV, V, and VI received topical HUCB-haemodialysate (HD), calves' blood HD, and solcoseryl, respectively. Group VII was the diabetic control group (topical saline). Standard circular wounds were created on the back of rats. A sample of each type of HD was analyzed using the high performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS) system. Wound area measurement and photography were carried out every 4 days. Plasma glucose, catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and platelets count were assessed. Wound samples were excised for hydroxyproline (HP) and histopathological study. Results Treatment with HUCB MNCs or HUCB-HD resulted in wound contraction, increased CAT, NO, platelets count, body weights, and HP content, and decreased MDA and glucose. Conclusion Systemic administration of HUCB MNCs and topical application of the newly prepared HUCB-HD or calves' blood HD significantly accelerated the rate of diabetic wound healing and would open the possibility of their future use in regenerative medicine. PMID:24643010

  14. Symptoms of depression and diabetes-specific emotional distress are associated with a negative appraisal of insulin therapy in insulin-naive patients with Type 2 diabetes mellitus. A study from the European Depression in Diabetes [EDID] research consortium

    Microsoft Academic Search

    C. Makine; C. Karsidag; P. Kadioglu; H. Ilkova; K. Karsidag; S. E. Skovlund; F. J. Snoek; F. Pouwer

    2009-01-01

    Aims: A meta-analysis concluded that depression is associated with poor glycaemic control in Type 2 diabetes (DM2). In DM2 patients with deteriorating glycaemic control, the initiation of insulin therapy is often postponed. The aim of the present study was to determine whether symptoms of depression and diabetes-specific emotional distress are associated with a more negative appraisal of insulin therapy. METHODS:

  15. An open label study on the supplementation of Gymnema sylvestre in type 2 diabetics.

    PubMed

    Kumar, Smriti Nanda; Mani, Uliyar Vitaldas; Mani, Indirani

    2010-09-01

    Diabetes mellitus is a complex metabolic disorder characterized by chronic hyperglycemia, and associated with long-term damage and dysfunction of various organs. Management of diabetes is therefore vital and involves maintaining euglycemia as much as possible by reducing blood glucose and by increasing insulin sensitivity and peripheral glucose uptake. Ayurveda has promoted the management of diabetes by regulating carbohydrate metabolism using several medicinal herbs, one of which is Gymnema sylvestre (GS). GS has been used in parts of India as a hypoglycemic agent and the results have been encouraging. Accordingly, we planned a quasi-experimental study to investigate the efficacy of the herb among type 2 diabetics. Patients enrolled from free-living population were purposively assigned to experimental or control groups, based on their willingness to participate in the study. The experimental group was supplemented with 500 mg of the herb per day for a period of 3 months, and the efficacy of the herb was assessed through a battery of clinical and biochemical tests. Supplementation of the diet with GS reduced polyphagia, fatigue, blood glucose (fasting and post-prandial), and glycated hemoglobin and there was a favorable shift in lipid profiles and in other clinico-biochemical tests. These findings suggest a beneficial effect of GS in the management of diabetes mellitus. PMID:22432517

  16. Risk of Type 2 Diabetes among Osteoarthritis Patients in a Prospective Longitudinal Study.

    PubMed

    Rahman, M Mushfiqur; Cibere, Jolanda; Anis, Aslam H; Goldsmith, Charlie H; Kopec, Jacek A

    2014-01-01

    Objectives. Our aim was to determine the risk of diabetes among osteoarthritis (OA) cases in a prospective longitudinal study. Methods. Administrative health records of 577,601 randomly selected individuals from British Columbia, Canada, from 1991 to 2009, were analyzed. OA and diabetes cases were identified by checking physician's visits and hospital records. From 1991 to 1996 we documented 19,143 existing OA cases and selected one non-OA individual matched by age, sex, and year of administrative records. Poisson regression and Cox proportional hazards models were fitted to estimate the effects after adjusting for available sociodemographic and medical factors. Results. At baseline, the mean age of OA cases was 61 years and 60.5% were women. Over 12 years of mean follow-up, the incidence rate (95% CI) of diabetes was 11.2 (10.90-11.50) per 1000 person years. Adjusted RRs (95% CI) for diabetes were 1.27 (1.15-1.41), 1.21 (1.08-1.35), 1.16 (1.04-1.28), and 0.99 (0.86-1.14) for younger women (age 20-64 years), older women (age ? 65 years), younger men, and older men, respectively. Conclusion. Younger adults and older women with OA have increased risks of developing diabetes compared to their age-sex matched non-OA counterparts. Further studies are needed to confirm these results and to elucidate the potential mechanisms. PMID:25538769

  17. ‘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

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

    2014-01-01

    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

  18. Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) post-natal intervention: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Gestational diabetes mellitus (GDM) is defined as glucose intolerance with its onset or first recognition during pregnancy. Post-GDM women have a life-time risk exceeding 70% of developing type 2 diabetes mellitus (T2DM). Lifestyle modifications reduce the incidence of T2DM by up to 58% for high-risk individuals. Methods/Design The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) is a randomized controlled trial aiming to assess the effectiveness of a structured diabetes prevention intervention for post-GDM women. This trial has an intervention group participating in a diabetes prevention program (DPP), and a control group receiving usual care from their general practitioners during the same time period. The 12-month intervention comprises an individual session followed by five group sessions at two-week intervals, and two follow-up telephone calls. A total of 574 women will be recruited, with 287 in each arm. The women will undergo blood tests, anthropometric measurements, and self-reported health status, diet, physical activity, quality of life, depression, risk perception and healthcare service usage, at baseline and 12 months. At completion, primary outcome (changes in diabetes risk) and secondary outcome (changes in psychosocial and quality of life measurements and in cardiovascular disease risk factors) will be assessed in both groups. Discussion This study aims to show whether MAGDA-DPP leads to a reduction in diabetes risk for post-GDM women. The characteristics that predict intervention completion and improvement in clinical and behavioral measures will be useful for further development of DPPs for this population. Trial registration Australian New Zealand Clinical Trials Registry ANZCTRN 12610000338066 PMID:24135085

  19. [The French diabetic population. Results of a study using a representative sample].

    PubMed

    Blazy, D; Nguyen, M

    1993-12-01

    The aim of this study was to assess the prevalence of diabetes mellitus in France, the existing treatment used and the effect of this chronic disease on everyday life patterns of the diabetic population. A survey was undertaken by Lilly laboratories and SOFRES medical institute from November to December 1992, which involved randomly screening 20,000 french families. After the screening questionnaire was sent at to the 20,000 families, the following feedback was obtained: 996 patients have been identified. More than 80% of the patients (that is, 122 were insulin treated and a further 674 were identified as NIDDM) replied to the second self assessment questionnaire. It was possible to make an estimation of the prevalence of diabetes mellitus in France that is to say: 1.9% of the general population. The general practitioner makes the primary diagnosis in more than 80% of the cases, and treats 97% of the NIDDM patients and 74% of the insulin treated diabetic patients. The diabetic patients have an average of 8 consultations per year with their general practitioners and 3-4 consultations per year with the endocrinologist. Therapeutic management of the NIDDM patients is based mainly on diet (82%) alone or in association with drugs. 32% of patients primary treated by drugs and secondary by insulin are not satisfied with their glycemic control (vs 22% of IDDM patients and 15% of NIDDM patients). Less than 35% of diabetic women are current users of contraception. More than one third of children who were born from a diabetic mother had a birth weight above 4 kgs. PMID:8206183

  20. Differential white cell count and incident type 2 diabetes: the Insulin Resistance Atherosclerosis Study

    PubMed Central

    Lorenzo, Carlos; Hanley, Anthony J.; Haffner, Steven M.

    2014-01-01

    Aims/hypothesis White cell count has been shown to predict incident type 2 diabetes, but differential white cell count has received scant attention. We examined the risk of developing diabetes associated with differential white cell count and neutrophil:lymphocyte ratio and the effect of insulin sensitivity and subclinical inflammation on white cell associations. Methods Incident diabetes was ascertained in 866 participants aged 40–69 years in the Insulin Resistance Atherosclerosis Study after a 5 year follow-up period. The insulin sensitivity index (SI) was measured by the frequently sampled IVGTT. Results C-reactive protein was directly and independently associated with neutrophil (p<0.001) and monocyte counts (p<0.01) and neutrophil:lymphocyte ratio (p<0.001), whereas SI was inversely and independently related to lymphocyte count (p<0.05). There were 138 (15.9%) incident cases of diabetes. Demographically adjusted ORs for incident diabetes, comparing the top and bottom tertiles of white cell (1.80 [95% CI 1.10, 2.92]), neutrophil (1.67 [1.04, 2.71]) and lymphocyte counts (2.30 [1.41, 3.76]), were statistically significant. No association was demonstrated for monocyte count (1.18 [0.73, 1.90]) or neutrophil:lymphocyte ratio (0.89 [0.55, 1.45]). White cell and neutrophil associations were no longer significant after further adjusting for family history of diabetes, fasting glucose and smoking, but the OR comparing the top and bottom tertiles of lymphocyte count remained significant (1.92 [1.12, 3.29]). This last relationship was better explained by SI rather than C-reactive protein. Conclusions/interpretation A lymphocyte association with incident diabetes, which was the strongest association among the major white cell types, was partially explained by insulin sensitivity rather than subclinical inflammation. PMID:24141640

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

    PubMed Central

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

    2014-01-01

    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

  2. The Diabetes Care Project: an Australian multicentre, cluster randomised controlled trial [study protocol

    PubMed Central

    2013-01-01

    Background Diabetes mellitus is an increasingly prevalent metabolic disorder that is associated with substantial disease burden. Australia has an opportunity to improve ways of caring for the growing number of people with diabetes, but this may require changes to the way care is funded, organised and delivered. To inform how best to care for people with diabetes, and to identify the extent of change that is required to achieve this, the Diabetes Care Project (DCP) will evaluate the impact of two different, evidence-based models of care (compared to usual care) on clinical quality, patient and provider experience, and cost. Methods/Design The DCP uses a pragmatic, cluster randomised controlled trial design. Accredited general practices that are situated within any of the seven Australian Medicare Locals/Divisions of General Practice that have agreed to take part in the study were invited to participate. Consenting practices will be randomly assigned to one of three treatment groups for approximately 18 to 22 months: (a) control group (usual care); (b) Intervention 1 (which tests improvements that could be made within the current funding model, facilitated through the use of an online chronic disease management network); or (c) Intervention 2 (which includes the same components as Intervention 1, as well as altered funding to support voluntary patient registration with their practice, incentive payments and a care facilitator). Adult patients who attend the enrolled practices and have established (?12 month’s duration) type 1 diabetes mellitus or newly diagnosed or established type 2 diabetes mellitus are invited to participate. Multiple outcomes will be studied, including changes in glycosylated haemoglobin (primary outcome), changes in other biochemical and clinical metrics, incidence of diabetes-related complications, quality of life, clinical depression, success of tailored care, patient and practitioner satisfaction, and budget sustainability. Discussion This project responds to a need for robust evidence of the clinical and economic effectiveness of coordinated care for the management of diabetes in the Australian primary care setting. The outcomes of the study will have implications not only for diabetes management, but also for the management of other chronic diseases, both in Australia and overseas. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12612000363886); World Health Organisation (U1111-1128-0481). PMID:24359432

  3. Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study.

    PubMed Central

    Gall, M. A.; Hougaard, P.; Borch-Johnsen, K.; Parving, H. H.

    1997-01-01

    OBJECTIVE: To evaluate putative risk factors for the development of incipient diabetic nephropathy (persistent microalbuminuria) and overt diabetic nephropathy (persistent macroalbuminuria) in patients with non-insulin dependent diabetes. DESIGN: Prospective, observational study of a cohort of white, non-insulin dependent diabetic patients followed for a median period of 5.8 years. SETTING: Outpatient clinic in tertiary referral centre. SUBJECTS: 191 patients aged under 66 years with non-insulin dependent diabetes and normoalbuminuria (urinary albumin excretion rate < 30 mg/24 h) who attended the clinic during 1987. MAIN OUTCOME MEASURES: Incipient and overt diabetic nephropathy. RESULTS: Fifteen patients were lost to follow up. Thirty six of the 176 remaining developed persistent microalbuminuria (30-299 mg/24 h in two out of three consecutive 24 hour urine collections) and five developed persistent macroalbuminuria (> or = mg/24 h in two out of three consecutive collections) during follow up. The five year cumulative incidence of incipient diabetic nephropathy was 23% (95% confidence interval 17% to 30%). Cox's multiple stepwise regression analysis revealed the following risk factors for the development of incipient or overt diabetic nephropathy: increased baseline log urinary albumin excretion rate (relative risk 11.1 (3.4 to 35.9); P < 0.0001); male sex (2.6 (1.2 to 5.4); P < 0.02); presence of retinopathy (2.4 (1.3 to 4.7); P < 0.01); increased serum cholesterol concentration (1.4 (1.1 to 1.7); P < 0.01); haemoglobin A1c concentration (1.2 (1.0 to 1.4); P < 0.05); and age (1.07 (1.02 to 1.12); P < 0.01). Known duration of diabetes, body mass index, arterial blood pressure, serum creatinine concentration, pre-existing coronary heart disease, and history of smoking were not risk factors. CONCLUSION: Several potentially modifiable risk factors predict the development of incipient and overt diabetic nephropathy in normoalbuminuric patients with non-insulin dependent diabetes. PMID:9080995

  4. Creative Expression as a Way of Knowing in Diabetes Adult Health Education: An Action Research Study

    ERIC Educational Resources Information Center

    Stuckey, Heather L.

    2009-01-01

    This action research study explores the meaning-making process using forms of creative expression for eight women with insulin-dependent diabetes. The study is theoretically informed by arts-based ways of knowing and aspects of feminist poststructuralism, and explains the process of creativity used in the action research process. The findings…

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

    Microsoft Academic Search

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

    1982-01-01

    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

  6. Diabetes, glaucoma, sex, and cataract: analysis of combined data from two case control studies

    Microsoft Academic Search

    J J Harding; M Egerton; R van Heyningen; R S Harding

    1993-01-01

    Data from two case control studies in Oxfordshire were combined and analysed. The combined study covered 1940 subjects, 723 cases, and 1217 controls, between the ages of 50 and 79 with a response rate of 97% for cases and 94% for controls. Diabetes was shown to be a powerful and highly significant risk factor for cataract with a relative risk

  7. Improvement of visual acuity in patients suffering from diabetic retinopathy after membrane differential filtration: a pilot study

    Microsoft Academic Search

    Randolf A Widder; Richard Brunner; Peter Walter; Christoph Lüke; Karl Ulrich Bartz-Schmidt; Klaus Heimann; Helmut Borberg

    1999-01-01

    Background: Membrane differential filtration is an extracorporeal treatment procedure which eliminates high molecular weight proteins and lipids from the blood. This pilot study was initiated to investigate the short-term effects on blood rheology and visual function in patients suffering from diabetic retinopathy.Methods: Six patients with non-proliferative diabetic retinopathy, clinically significant macular edema (five patients, nine eyes) and inactive proliferative diabetic

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

    Microsoft Academic Search

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

    2004-01-01

    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

  9. Participants' perspective on maintaining behaviour change: a qualitative study within the European Diabetes Prevention Study

    PubMed Central

    Penn, Linda; Moffatt, Suzanne M; White, Martin

    2008-01-01

    Background The European Diabetes Prevention Study (EDIPS) is an RCT of diet and exercise interventions in people with impaired glucose tolerance. We undertook a qualitative study, nested within the EDIPS in Newcastle-upon-Tyne, UK, aiming to understand the experience of participants who maintained behaviour change, in order to inform future interventions. Methods Participants were purposively sampled, according to success criteria for diet and physical activity change maintenance, and invited to attend individual semi-structured interviews. Fifteen participants completed an interview and reflected on their experience over three to five years. We used the Framework method to analyse the transcribed data. Results Main themes were identified as factors that help (props) and those that hinder (burdens) behaviour change maintenance at different organisational levels: individual (both physical and psychological), social and environmental. Pre-existing physical conditions (such as arthritis) and social demands (such as caring for an ageing relative) hindered, whereas the benefits of becoming fitter and of having social and professional support helped, participants in maintaining behaviour change. Participants' long term experiences highlighted the salience of the continuous change in their physical, social and environmental conditions over time. Conclusion The construct of props and burdens facilitates a holistic view of participants' behaviour. Efforts to encourage behaviour change maintenance should take account of context and the way this changes over time, and should include strategies to address these issues. The experience of participants who maintain behaviour change highlights the challenges for the wider implementation of diabetes prevention strategies. Trial Registration (ISRCTN 15670600) PMID:18616797

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

    Microsoft Academic Search

    George Steiner

    2009-01-01

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

  11. Diffuse reflectance spectroscopy for monitoring diabetic foot ulcer - A pilot study

    NASA Astrophysics Data System (ADS)

    Anand, Suresh; Sujatha, N.; Narayanamurthy, V. B.; Seshadri, V.; Poddar, Richa

    2014-02-01

    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.

  12. Biventricular function and glycemic load in type 1 diabetic children: Doppler tissue-imaging study.

    PubMed

    Khattab, Ahmed Anwer; Soliman, Mahmoud Ali

    2015-02-01

    To assess right- and left-ventricular function in children with type 1 diabetes mellitus (DM) as well as correlate cardiac function with diabetes duration and state of metabolic control. The present study included 30 patients with type 1 DM (group 1) and 20 apparently normal children with comparable age and sex as controls (group 2). All children were subjected to detailed history, clinical examination, and routine laboratory investigations, including glycated hemoglobin, as well as conventional echocardiographic and tissue Doppler examination. Children with type 1 DM have impaired diastolic function in both left and right ventricles before the development of systolic dysfunction when assessed with either conventional or tissue Doppler echocardiography. Resting heart rate in diabetic patients showed a significant positive correlation with mitral A flow velocity and a significant negative correlation with mitral and tricuspid E/A ratio. Regarding morphological parameters of the left ventricle, all dimensions and volumes were comparable between diabetic patients and controls; however, a significant positive correlation was found between interventricular septal thickness at diastole (IVSd), interventricular septal thickness at systole (IVSs), and left ventricular posterior wall at systole (LVPWs) and the duration of diabetes. Children with type 1 DM have impaired diastolic function in both left and right ventricles with normal systolic function when assessed with either conventional or tissue Doppler echocardiography. PMID:25304244

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

    PubMed Central

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

    2011-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  15. Genetic testing of newborns for type 1 diabetes susceptibility: a prospective cohort study on effects on maternal mental health

    Microsoft Academic Search

    Kaja K Aas; Kristian Tambs; Marit S Kise; Per Magnus; Kjersti S Rønningen

    2010-01-01

    BACKGROUND: Concerns about the general psychological impact of genetic testing have been raised. In the Environmental Triggers of Type 1 Diabetes (MIDIA) study, genetic testing was performed for HLA-conferred type 1 diabetes susceptibility among Norwegian newborns. The present study assessed whether mothers of children who test positively suffer from poorer mental health and well-being after receiving genetic risk information about

  16. A multicentre study of registration on renal transplantation waiting list of the elderly and patients with type 2 diabetes

    Microsoft Academic Search

    Emmanuel Villar; Muriel Rabilloud; Francois Berthoux; Paul Vialtel; Michel Labeeuw; Claire Pouteil-Noble

    Background. Studies in the USA have shown that some patients (African-Americans, women, the elderly and diabetics) were less likely to receive renal trans- plants. In order to identify patient characteristics modifying the likelihood of being wait-listed, we studied registration on renal transplantation waiting list (WLR) focusing on elderly (age ? 60 years) and on patients with type 2 diabetes (D2)

  17. Thiazolidinediones and the risk of asthma exacerbation among patients with diabetes: a cohort study

    PubMed Central

    2014-01-01

    Background Thiazolidinediones are oral diabetes medications that selectively activate peroxisome proliferator-activated receptor gamma and have potent anti-inflammatory properties. While a few studies have found improvements in pulmonary function with exposure to thiazolidinediones, there are no studies of their impact on asthma exacerbations. Our objective was to assess whether exposure to thiazolidinediones was associated with a decreased risk of asthma exacerbation. Methods We performed a cohort study of diabetic Veterans who had a diagnosis of asthma and were taking oral diabetes medications during the period of 10/1/2005 – 9/30/2006. The risk of asthma exacerbations and oral steroid use during 10/1/2006 – 9/30/2007 was compared between patients who were prescribed thiazolidinediones and patients who were on alternative oral diabetes medications. Multivariable logistic regression and negative binomial regression analyses were used to characterize this risk. A sensitivity analysis was performed, restricting our evaluation to patients who were adherent to diabetes therapy. Results We identified 2,178 patients who were on thiazolidinediones and 10,700 who were not. Exposure to thiazolidinediones was associated with significant reductions in the risk of asthma exacerbation (OR?=?0.79, 95% CI, 0.62 – 0.99) and oral steroid prescription (OR?=?0.73, 95% CI 0.63 – 0.84). Among patients who were adherent to diabetes medications, there were more substantial reductions in the risks for asthma exacerbation (OR?=?0.64, 95% CI 0.47 – 0.85) and oral steroid prescription (OR?=?0.68, 95% CI 0.57 – 0.81). Conclusions Thiazolidinediones may provide a novel anti-inflammatory approach to asthma management by preventing exacerbations and decreasing the use of oral steroids. PMID:25024717

  18. Pesticide use and incident diabetes among wives of farmers in the Agricultural Health Study

    PubMed Central

    Starling, Anne P.; Umbach, David M.; Kamel, Freya; Long, Stuart; Sandler, Dale P.; Hoppin, Jane A.

    2014-01-01

    Objective To estimate associations between use of specific agricultural pesticides and incident diabetes in women. Methods We used data from the Agricultural Health Study, a large prospective cohort of pesticide applicators and their spouses in Iowa and North Carolina. For comparability with previous studies of farmers, we limited analysis to 13,637 farmers’ wives who reported ever personally mixing or applying pesticides at enrollment (1993-1997), who provided complete data on required covariates and diabetes diagnosis, and who reported no previous diagnosis of diabetes at enrollment. Participants reported ever-use of 50 specific pesticides at enrollment and incident diabetes at one of two follow-up interviews within an average of 12 years of enrollment. We fit Cox proportional hazards models with age as the time scale and adjusting for state and body mass index to estimate hazard ratios (HR) and 95% confidence intervals (CI) for each of 45 pesticides with sufficient users. Results Five pesticides were positively associated with incident diabetes (n=688; 5%): three organophosphates, fonofos (HR=1.56, 95% CI=1.11, 2.19), phorate (HR=1.57, 95% CI=1.14, 2.16), and parathion (HR=1.61, 95% CI=1.05, 2.46); the organochlorine dieldrin (HR=1.99, 95% CI=1.12, 3.54); and the herbicide 2,4,5-T/2,4,5-TP (HR=1.59, 95% CI=1.00, 2.51). With phorate and fonofos together in one model to account for their correlation, risks for both remained elevated, though attenuated compared to separate models. Conclusions Results are consistent with previous studies reporting an association between specific organochlorines and diabetes and add to growing evidence that certain organophosphates also may increase risk. PMID:24727735

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

    PubMed Central

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2013-01-01

    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

  2. Post-transplantation diabetes mellitus; frequency and related risk factors: a single center study.

    PubMed

    Ghafari, Ali; PourAli, Reza; Sepehrvand, Nariman; Hatami, Sanaz; Modarres, Vanooshe

    2010-09-01

    Post-transplantation diabetes mellitus (PTDM) is a serious complication after organ transplantation, which could lead to cardiovascular morbidity and mortality. The rate of PTDM increased in recent years, probably due to new immunosuppressive drugs such as Tacrolimus. In this study, we retrospectively evaluated the frequency of PTDM and related risk factors in 644 non diabetic patients who underwent renal transplantation. Data was analyzed by chi-square and Fisher's exact test in SPSS software ver11.5. Among 644 patients PTDM developed in 10.2% similar to literature. PTDM was significantly correlated to age (P value = 0.000), positive familial history (P= 0.003) and HBV infection (P= 0.046). In conclusion, PTDM is not uncommon in Iranian patients and a positive family history of diabetes, HBV infection and older age increases the likelihood to develop PTDM. PMID:20814117

  3. High Incidence of Diabetes after Stroke in Young Adults and Risk of Recurrent Vascular Events: The FUTURE Study

    PubMed Central

    Arntz, Renate M.; Maaijwee, Noortje A. M.; Schoonderwaldt, Henny C.; Dorresteijn, Lucille D.; van der Vlugt, Maureen J.; van Dijk, Ewoud J.; de Leeuw, Frank-Erik

    2014-01-01

    Background Diabetes diagnosed prior to stroke in young adults is strongly associated with recurrent vascular events. The relevance of impaired fasting glucose (IFG) and incidence of diabetes after young stroke is unknown. We investigated the long-term incidence of diabetes after young stroke and evaluated the association of diabetes and impaired fasting glucose with recurrent vascular events. Methods This study was part of the FUTURE study. All consecutive patients between January 1, 1980, and November 1, 2010 with TIA or ischemic stroke, aged 18–50, were recruited. A follow-up assessment was performed in survivors between November 1, 2009 and January 1, 2012 and included an evaluation for diabetes, fasting venous plasma glucose and recurrent vascular events. The association of diabetes and IFG with recurrent vascular events was assessed by logistic regression analysis, adjusted for age, sex and follow-up duration. Results 427 survivors without a medical history of diabetes were included in the present analysis (mean follow-up of 10.1 (SD 8.4) years; age 40.3 (SD 7.9) years). The incidence rate of diabetes was 7.9 per 1000 person-years and the prevalence of IFG was 21.1%. Patients with diabetes and IFG were more likely to have experienced any vascular event than those with normal fasting glucose values (OR 3.5 (95%CI 1.5–8.4) for diabetes and OR 2.5 (95%CI 1.3–4.8) for IFG). Conclusions Diabetes or IFG in young stroke survivors is frequent and is associated with recurrent vascular events. Regular screening for IFG and diabetes in this population, yields potential for secondary prevention. PMID:24466339

  4. Resistance Exercise in Already-Active Diabetic Individuals (READI): Study rationale, design and methods for a randomized controlled trial of resistance and aerobic exercise in type 1 diabetes.

    PubMed

    Yardley, Jane E; Kenny, Glen P; Perkins, Bruce A; Riddell, Michael C; Goldfield, Gary S; Donovan, Lois; Hadjiyannakis, Stasia; Wells, George A; Phillips, Penny; Sigal, Ronald J

    2015-03-01

    The Resistance Exercise in Already Active Diabetic Individuals (READI) trial aimed to examine whether adding a 6-month resistance training program would improve glycemic control (as reflected in reduced HbA1c) in individuals with type 1 diabetes who were already engaged in aerobic exercise compared to aerobic training alone. After a 5-week run-in period including optimization of diabetes care and low-intensity exercise, 131 physically active adults with type 1 diabetes were randomized to two groups for 22weeks: resistance training three times weekly, or waiting-list control. Both groups maintained the same volume, duration and intensity of aerobic exercise throughout the study as they did at baseline. HbA1c, body composition, frequency of hypoglycemia, lipids, blood pressure, apolipoproteins B and A-1 (ApoB and ApoA1), the ApoB-ApoA1 ratio, urinary albumin excretion, serum C-reactive protein, free fatty acids, total daily insulin dose, health-related quality of life, cardiorespiratory fitness and musculoskeletal fitness were recorded at baseline, 3 (for some variables), and 6months. To our knowledge, READI is the only trial to date assessing the incremental health-related impact of adding resistance training for individuals with type 1 diabetes who are already aerobically active. Few exercise trials have been completed in this population, and even fewer have assessed resistance exercise. With recent improvements in the quality of diabetes care, the READI study will provide conclusive evidence to support or refute a major clinically relevant effect of exercise type in the recommendations for physical activity in patients with type 1 diabetes. PMID:25559915

  5. Polymorphisms associated with type 2 diabetes in familial longevity: The Leiden Longevity Study.

    PubMed

    Mooijaart, Simon P; van Heemst, Diana; Noordam, Raymond; Rozing, Maarten P; Wijsman, Carolien A; de Craen, Anton J M; Westendorp, Rudi G J; Beekman, Marian; Slagboom, P Eline

    2011-01-01

    Human longevity is in part genetically determined, and the insulin/IGF-1 signal transduction (IIS) pathway has consistently been implicated. In humans, type 2 diabetes is a frequent disease that results from loss of glucose homeostasis and for which new candidate polymorphisms now rapidly emerge from genome wide association studies. In the Leiden Longevity Study (n=2415), the offspring of long lived siblings ("offspring") who are genetically enriched for longevity were shown to have a more beneficial metabolic profile compared to their environmentally matched partners ("controls"), including better glucose tolerance. We tested whether the "offspring" carry a lower burden of diabetes risk alleles. Fifteen polymorphisms derived from genome wide association (GWA) scans in type 2 diabetes were tested for association with parameters of glucose metabolism in offspring and controls, and burden of risk alleles was compared between offspring and controls. Among all participants, a higher number of type 2 diabetes risk alleles associated with a higher prevalence of diabetes (P=0.011) and higher serum concentration of glucose (P<0.016) but not insulin (P=0.450). None of the polymorphisms differed in frequency between the offspring and controls (all P>0.05), nor did the mean total number of risk alleles (P=0.977). The association between polymorphisms and glucose levels did not differ between controls and offspring (Pinteraction=0.523). The better glucose tolerance of the "offspring" is not explained by a lower burden of type 2 diabetes risk alleles, suggesting that specific mechanisms determining longevity exist. PMID:21191145

  6. Patient Characteristics Associated with Measurement of Routine Diabetes Care: An Observational Study

    PubMed Central

    Van Doorn-Klomberg, Arna L.; Braspenning, Jozé C. C.; Atsma, Femke; Jansen, Birgit; Bouma, Margriet; Wolters, René J.; Wensing, Michel

    2015-01-01

    Background Non-modifiable patient characteristics, including age, gender, ethnicity as well as the occurrence of multi-morbidities, are associated with processes and outcomes of diabetes care. Information on these factors can be used in case mix adjustment of performance measures. However, the practical relevance of such adjustment is not clear. The aim of this study was to assess the strength of associations between patient factors and diabetes care processes and outcomes. Methods We performed an observational study based on routinely collected data of 12,498 diabetes patients in 59 Dutch primary care practices. Data were collected on patient age, gender, whether the patient lived in a deprived area, body mass index and the co-occurrence of cardiovascular disease, chronic obstructive pulmonary disease, depression or anxiety. Outcomes included 6 dichotomous measures (3 process and 3 outcome related) regarding glycosylated hemoglobin, systolic blood pressure and low density lipoprotein-cholesterol. We performed separate hierarchical logistic mixed model regression models for each of the outcome measures. Results Each of the process measure models showed moderate effect sizes, with pooled areas under the curve that varied between 0.66 and 0.76. The frequency of diabetes related consultations as a measure of patient compliance to treatment showed the strongest association with all process measures (odds ratios between 5.6 and 14.5). The effect sizes of the outcome measure models were considerably smaller than the process measure models, with pooled areas under the curve varying from 0.57 to 0.61. Conclusions Several non-modifiable patient factors could be associated with processes and outcomes of diabetes care. However, associations were small. These results suggest that case-mix correction or stratification in assessing diabetes care has limited practical relevance. PMID:25822978

  7. Incidence of Type 2 Diabetes in Pre-Diabetic Japanese Individuals Categorized by HbA1c Levels: A Historical Cohort Study

    PubMed Central

    Kawahara, Tetsuya; Imawatari, Ryuichiro; Kawahara, Chie; Inazu, Tetsuya; Suzuki, Gen

    2015-01-01

    Objective Reported incidence of type 2 diabetes estimated at the pre-diabetic stage differs widely (2.3–18.1% per year). Because clinicians need to know the risk of incident diabetes after a diagnosis of pre-diabetes, our objective was to estimate precise incidence of diabetes using baseline HbA1c levels. Methods A historical cohort study using electronic medical record data obtained between January 2008 and December 2013. A total of 52,781 individuals with HbA1c < 6.5% were assigned to one of six groups categorized by baseline HbA1c level: ? 5.5% (n=34,616), 5.6–5.7% (n=9,388), 5.8–5.9% (n=4,664), 6.0–6.1% (n= 2,338), 6.2–6.3% (n=1,257), and 6.4% (n=518). Participants were tracked until a subsequent diagnosis of diabetes or end of follow-up during a period of 5 years. Results During the follow-up period (mean 3.7 years), 4,369 participants developed diabetes. The incidence of diabetes in the first year was 0.7, 1.5, 2.9, 9.2, 30.4, and 44.0% in the six HbA1c groups, respectively. At five years the incidence was 3.6, 8.9, 13.8, 27.5, 51.6, and 67.8%, respectively (p < 0.0001 comparing the HbA1c ?5.5% group to the other groups). After adjustment for confounding factors, the hazard ratios compared with the HbA1c ?5.5% group were significantly elevated: 2.3 (95%CI 2.0–2.5), 3.4 (95%CI 2.9–3.7), 8.8 (95%CI 8.0–10.1), 26.3 (95%CI 23.3–30.1), and 48.7 (95%CI 40.8–58.1) in the five HbA1c groups (p < 0.0001). Conclusion By fractionating baseline HbA1c levels into narrower HbA1c range groups, accuracy of estimating the incidence of type 2 diabetes in subsequent years was increased. The risk of developing diabetes increased with increasing HbA1c levels, especially with the HbA1c level ? 6.2% in the first follow-up year. PMID:25853519

  8. NIH Researchers Find Resveratrol Helps Protect Against Diabetes in Animal Study

    MedlinePLUS

    NIH researchers find resveratrol helps protect against diabetes in animal study August 8, 2013 Resveratrol, a compound in nuts, grapes, and wine, has ... of non-human primates, researchers have found that resveratrol counters some of the negative effects of a ...

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

    Microsoft Academic Search

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

    2008-01-01

    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,

  10. Prevalence of Obesity and Diabetes in Patients With Cryptogenic Cirrhosis: A Case-Control Study

    Microsoft Academic Search

    Asma Poonawala; Satheesh P Nair; Paul J Thuluvath

    2000-01-01

    It has recently been suggested that nonalcoholic steatohepatitis (NASH) is an under-recognized cause of cryptogenic cirrhosis (CC) on the basis of higher prevalence of obesity and type II diabetes among these patients. To test this hypothesis, we studied 65 consecutive patients with advanced cirrhosis (Child-Pugh Score ? 7) of undetermined etiology (CC) from our active waiting list for liver transplantation

  11. Cognitive-Behavioral Group Therapy for Depression in Adolescents with Diabetes: A Pilot Study

    Microsoft Academic Search

    Jeannette M. Rosselló; María I. Jiménez-Chafey

    The purpose of this study is to adapt and pilot test a group Cognitive-Behavioral Therapy (CBT) model which has been proven to be effective in treating depression in Puerto Rican adolescents, to treat depressive symptoms and improve glycemic control in adolescents with diabetes. Eleven adolescents aged 13-16 participated in a 12 session group CBT intervention. Indicators of outcome effects (depressive

  12. Predicted 25-hydroxyvitamin D score and incident type 2 diabetes in the Framingham Offspring Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Accumulating evidence suggests that vitamin D is involved in the development of type 2 diabetes (T2D). Our objective was to examine the relation between vitamin D status and incidence of T2D. We used a subsample of 1972 Framingham Offspring Study participants to develop a regression model to predict...

  13. Xerostomia, Hyposalivation, and Oral Microbiota in Type 2 Diabetic Patients: A Preliminary Study

    Microsoft Academic Search

    Tongchat Suwantuntula DDS; Soisiri Thaweboon DDS; Somsak Mitrirattanakul DDS; Weerapan Khovidhunkit

    Background and Objective: Mouth dryness is one of the major problems that can lead to several oral diseases such as dental caries, periodontitis and oral infection. Mouth dryness has also been associated with type 2 diabetes mellitus (DM). The objective of the present study was to investigate the prevalence of xerostomia (feeling of mouth dryness), hyposalivation (the reduction of saliva),

  14. Early Malnutrition and Child Neurobehavioral Development: Insights from the Study of Children of Diabetic Mothers.

    ERIC Educational Resources Information Center

    Rizzo, Thomas A.; And Others

    1997-01-01

    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…

  15. Predicted 25-hydroxyvitamin D Score and incident type 2 diabetes in the Framingham Offspring Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Accumulating evidence suggests that vitamin D is involved in the development of type 2 diabetes (T2D). Our objective was to examine the relation between vitamin D status and incidence of T2D. We used a subsample of 1972 Framingham Offspring Study participants to develop a regression model to predict...

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

    PubMed

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

    2014-10-01

    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

  17. Symptoms of depression but not anxiety are associated with central obesity and cardiovascular disease in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study

    Microsoft Academic Search

    J. Labad; J. F. Price; M. W. J. Strachan; F. G. R. Fowkes; J. Ding; I. J. Deary; A. J. Lee; B. M. Frier; J. R. Seckl; B. R. Walker; R. M. Reynolds

    2010-01-01

    Aims\\/hypothesis  The aim of the study was to identify risk factors for depression and anxiety in a well-characterised cohort of individuals\\u000a with type 2 diabetes mellitus.\\u000a \\u000a \\u000a \\u000a Methods  We used baseline data from participants (n?=?1,066, 48.7% women, aged 67.9?±?4.2 years) from the Edinburgh Type 2 Diabetes Study. Symptoms of anxiety and depression\\u000a were assessed using the Hospital Anxiety and Depression Scale (HADS). Obesity was

  18. Diabetes Insipidus

    MedlinePLUS

    ... but not thirst and fluid intake. This fluid overload can lead to water intoxi cation, a condition ... current studies, visit www.ClinicalTrials.gov. For More Information The Diabetes Insipidus and Related Disorders Network 535 ...

  19. Lesser than diabetes hyperglycemia in pregnancy is related to perinatal mortality: a cohort study in Brazil

    PubMed Central

    2011-01-01

    Background Gestational diabetes related morbidity increases along the continuum of the glycemic spectrum. Perinatal mortality, as a complication of gestational diabetes, has been little investigated. In early studies, an association was found, but in more recent ones it has not been confirmed. The Brazilian Study of Gestational Diabetes, a cohort of untreated pregnant women enrolled in the early 1990's, offers a unique opportunity to investigate this question. Thus, our objective is to evaluate whether perinatal mortality increases in a continuum across the maternal glycemic spectrum. Methods We prospectively enrolled and followed 4401 pregnant women attending general prenatal care clinics in six Brazilian state capitals, without history of diabetes outside of pregnancy, through to birth, and their offspring through the early neonatal period. Women answered a structured questionnaire and underwent a standardized 2-hour 75-g oral glucose tolerance test (OGTT). Obstetric care was maintained according to local protocols. We obtained antenatal, delivery and neonatal data from hospital records. Odds ratios (OR) were estimated using logistic regression. Results We ascertained 97 perinatal deaths (67 fetal and 31 early neonatal). Odds of dying increased according to glucose levels, statistically significantly so only for women delivering at gestational age ?34 weeks (p < 0.05 for glycemia-gestational age interaction). ORs for a 1 standard deviation difference in glucose, when analyzed continuously, were for fasting 1.47 (95% CI 1.12, 1.92); 1-h 1.55 (95% CI 1.15, 2.07); and 2-h 1.53 (95% CI 1.15, 2.02). The adjusted OR for IADPSG criteria gestational diabetes was 2.21 (95% CI 1.15, 4.27); and for WHO criteria gestational diabetes, 3.10 (95% CI 1.39, 6.88). Conclusions In settings of limited detection and treatment of gestational diabetes mellitus, women across a spectrum of lesser than diabetes hyperglycemia, experienced a continuous rise in perinatal death with increasing levels of glycemia after 34 weeks of pregnancy. Current GDM diagnostic criteria identified this increased risk of mortality. PMID:22078268

  20. Reticuloendothelial hyperphagocytosis occurs in streptozotocin-diabetic rats. Studies with colloidal carbon, albumin microaggregates, and soluble fibrin monomers

    SciTech Connect

    Cornell, R.P.

    1982-02-01

    In contrast to previous studies of diabetic humans and animals, which reported unchanged or depressed function, reticuloendothelial system (RES) hyperphagocytosis of colloidal carbon, /sup 125/I-albumin microaggregates, and /sup 125/I-fibrin monomers were observed in rats as early as 14 days after the induction of diabetes with streptozotocin (STZ). The fact that enhanced phagocytosis by RE macrophages was prevented by chronic insulin replacement therapy indicates that the diabetic internal environment of hyperglycemia and hypoinsulinemia was perhaps responsible for the observed changes. Experiments involving organ localization of intravenously administered particles, perfusion of isolated livers, and microscopic examination of the liver all suggested that increased Kupffer cell activity was the primary event in RES hyperphagocytosis by STZ-diabetic rats. Both hypertrophy and hyperplasia of Kupffer cells were apparent in livers of STZ-diabetic animals as evidenced by photomicrographs and hepatic cell quantification. Plasma fibronectin, which binds fibrin monomers to RE macrophages before phagocytosis, was significantly decreased in the circulation of STZ-diabetic rats, but the level of cell-associated fibronectin was not measured. Renal localization of urea-soluble /sup 125/I-fibrin monomers exceeded splenic and pulmonary uptake in normal control rats and was enhanced in animals with STZ-diabetes. Changes in fibronectin levels, fibrin monomer localization, and Kupffer cell size and numbers in experimental diabetes in rats may have implications for the pathogenesis of vascular disease involving phagocytic mesangial and foam cells in diabetic humans.

  1. Television viewing time and risk of incident diabetes mellitus: the English Longitudinal Study of Ageing

    PubMed Central

    Smith, L; Hamer, M

    2014-01-01

    Aim To investigate the longitudinal association between television viewing time and risk of incident diabetes mellitus in an elderly sample of adults in England. Methods Analyses of data from the English Longitudinal Study of Ageing. At baseline (2008), participants reported their television viewing time and physical activity level. Diabetes mellitus was recorded from self-reported physician diagnosis at 2-year follow-up. Associations between television viewing time and combined television viewing time and physical activity level with risk of incident diabetes mellitus at follow-up were examined using adjusted logistic regression models. Results A total of 5964 participants (mean ± sd age 65 ± 9 years at baseline, 44% male) were included in the analyses. There was an association between baseline television viewing time and risk of incident diabetes mellitus at 2-year follow-up (? 6 h/day compared with <2 h/day; odds ratio 4.27, 95% CI 1.69, 10.77), although the association was attenuated to the null in final adjusted models that included BMI. Participants who were inactive/had high television viewing time at baseline were almost twice as likely to have diabetes mellitus at 2-year follow-up than those who were active/had low television viewing time (fully adjusted odds ratio 1.94, 95% CI 1.02, 3.68), although active participants reporting high television viewing were not at risk. Conclusion Interventions to reduce the incidence of diabetes in the elderly that focus on both increasing physical activity and reducing television viewing time might prove useful. PMID:24975987

  2. Higher potency statins and the risk of new diabetes: multicentre, observational study of administrative databases

    PubMed Central

    2014-01-01

    Objective To evaluate the incremental increase in new onset diabetes from higher potency statins compared with lower potency statins when used for secondary prevention. Design Eight population based cohort studies and a meta-analysis. Setting Six Canadian provinces and two international databases from the UK and US. Participants 136 966 patients aged ?40 years newly treated with statins between 1 January 1997 and 31 March 2011. Methods Within each cohort of patients newly prescribed a statin after hospitalisation for a major cardiovascular event or procedure, we performed as-treated, nested case-control analyses to compare diabetes incidence in users of higher potency statins with incidence in users of lower potency statins. Rate ratios of new diabetes events were estimated using conditional logistic regression on different lengths of exposure to higher potency versus lower potency statins; adjustment for confounding was achieved using high dimensional propensity scores. Meta-analytic methods were used to estimate overall effects across sites. Main outcome measures Hospitalisation for new onset diabetes, or a prescription for insulin or an oral antidiabetic drug. Results In the first two years of regular statin use, we observed a significant increase in the risk of new onset diabetes with higher potency statins compared with lower potency agents (rate ratio 1.15, 95% confidence interval 1.05 to 1.26). The risk increase seemed to be highest in the first four months of use (rate ratio 1.26, 1.07 to 1.47). Conclusions Higher potency statin use is associated with a moderate increase in the risk of new onset diabetes compared with lower potency statins in patients treated for secondary prevention of cardiovascular disease. Clinicians should consider this risk when prescribing higher potency statins in secondary prevention patients. PMID:24874977

  3. Sense of coherence in people with and without type 2 diabetes mellitus: an observational study from Greece

    PubMed Central

    2013-01-01

    Background Antonovsky's concept of sense of coherence (SOC) has been suggested to relate to health, especially mental health and preventive health behaviours. Psychological distress has been identified as a risk factor for pre-diabetes and type 2 diabetes mellitus. The study of SOC and diabetes has not received much attention in Greece. This study aims to explore the extent to which type 2 diabetes mellitus can affect the SOC score. Methods An observational design was used to test the study hypothesis that individuals with type 2 diabetes mellitus would have a lower SOC than those without diabetes mellitus. A total of 202 individuals were studied, consisting of 100 people with diabetes mellitus (the study group) and 102 people with non-chronic orthopaedic conditions (the control group). All of the participants were patients of the Diabetic Clinic or the Orthopaedic Clinic of Livadia Hospital in Central Greece. SOC was assessed using a 29-item SOC questionnaire that had been translated into Greek and validated. Results Patients without type 2 diabetes mellitus had 2.4 times higher odds of having a high SOC score than patients with type 2 diabetes mellitus (P = 0.036; odds ratio [OR] = 2.35, 95% confidence interval [CI] = 1.06–5.23). Male patients had 3.9 times higher odds of having a high SOC score (P < 0.001; OR = 3.85, 95% CI = 1.71–8.67) than female patients. With regard to education, patients with a lower level of education had almost three times higher odds of having a high SOC score than patients with a higher level of education (P = 0.024; OR = 2.97, 95% CI = 1.15–7.67). Conclusions This study adds to the existing literature and indicates that SOC is a health asset. A study with an experimental design would clarify the interesting hypothesis of this study. PMID:24381649

  4. Diabetes mellitus and echocardiographic left ventricular function in free-living elderly men and women: The Cardiovascular Health Study

    Microsoft Academic Search

    Marshall Lee; Julius M. Gardin; James C. Lynch; Vivienne-Elizabeth Smith; Russell P. Tracy; Peter J. Savage; Moyses Szklo; Beverly J. Ward

    1997-01-01

    This report describes the relation among diabetes, blood pressure, and prevalent cardiovascular disease, and echocardiographically measured left ventricular mass and filling (transmitral valve flow) velocities in the Cardiovascular Health Study, a cohort of 5201 men and women ?65 years of age. Ventricular septal and left posterior wall thicknesses were greater in diabetic than in nondiabetic subjects, showing a significant linear

  5. Risk of complications of pregnancy in women with type 1 diabetes: nationwide prospective study in the Netherlands

    Microsoft Academic Search

    I. M. Evers; H. W. de Valk; G. H. A. Visser

    2004-01-01

    Objective To investigate maternal, perinatal, and neonatal outcomes of pregnancies in women with type 1 diabetes in the Netherlands. Design Nationwide prospective cohort study. Setting All 118 hospitals in the Netherlands. Participants 323 women with type 1 diabetes who became pregnant between 1 April 1999 and 1 April 2000. Main outcome measures Maternal, perinatal, and neonatal outcomes of pregnancy. Results

  6. Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study

    Microsoft Academic Search

    Nadia Abdulhadi; Mohammed Al Shafaee; Solveig Freudenthal; Claes-Göran Östenson; Rolf Wahlström

    2007-01-01

    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

  7. Utilization of 3-month Yoga Program for Adults at High Risk for Type 2 Diabetes: A Pilot Study

    Microsoft Academic Search

    Kyeongra Yang; Lisa M. Bernardo; Susan M. Sereika; Molly B. Conroy; Judy Balk; Lora E. Burke

    Various modes of physical activity, combined with dieting, have been widely recommended to prevent or delay type 2 diabetes. Among these, yoga holds promise for reducing risk factors for type 2 diabetes by promoting weight loss, improving glucose levels and reducing blood pressure and lipid levels. This pilot study aimed to assess the feasibility of implementing a 12-week yoga program

  8. Vasopressin Contributes to Hyperfiltration, Albuminuria, and Renal Hypertrophy in Diabetes Mellitus: Study in Vasopressin-Deficient Brattleboro Rats

    Microsoft Academic Search

    Pascale Bardoux; Helene Martin; Mina Ahloulay; Francois Schmitt; Nadine Bouby; Marie-Marcelle Trinh-Trang-Tan; Lise Bankir

    1999-01-01

    Diabetic nephropathy represents a major complication of diabetes mellitus (DM), and the origin of this complication is poorly understood. Vasopressin (VP), which is elevated in type I and type II DM, has been shown to increase glomerular filtration rate in normal rats and to contribute to progression of chronic renal failure in 5\\/6 nephrectomized rats. The present study was thus

  9. Genome-wide association studies in type 1 diabetes, inflammatory bowel disease and other immune-mediated disorders

    Microsoft Academic Search

    Hakon Hakonarson; Struan F. A. Grant

    2009-01-01

    Genome-wide association studies have delivered on the promise of uncovering genetic determinants of complex disease. In this review, we provide a summary of recent advances in the identification of multiple variants associated with autoimmune-mediated disorders; specifically type 1 diabetes and inflammatory bowel disease. Sixteen loci, all replicated in independent samples, have now been uncovered for type 1 diabetes and in

  10. Acceptance Factors of Mobile Apps for Diabetes by Patients Aged 50 or Older: A Qualitative Study

    PubMed Central

    Reichelt, Julius; Bellmann, Maike; Kirch, Wilhelm

    2015-01-01

    Background Mobile apps for people with diabetes offer great potential to support therapy management, increase therapy adherence, and reduce the probability of the occurrence of accompanying and secondary diseases. However, they are rarely used by elderly patients due to a lack of acceptance. Objective We investigated the question “Which factors influence the acceptance of diabetes apps among patients aged 50 or older?” Particular emphasis was placed on the current use of mobile devices/apps, acceptance-promoting/-inhibiting factors, features of a helpful diabetes app, and contact persons for technical questions. This qualitative study was the third of three substudies investigating factors influencing acceptance of diabetes apps among patients aged 50 or older. Methods Guided interviews were chosen in order to get a comprehensive insight into the subjective perspective of elderly diabetes patients. At the end of each interview, the patients tested two existing diabetes apps to reveal obstacles in (first) use. Results Altogether, 32 patients with diabetes were interviewed. The mean age was 68.8 years (SD 8.2). Of 32 participants, 15 (47%) knew apps, however only 2 (6%) had already used a diabetes app within their therapy. The reasons reported for being against the use of apps were a lack of additional benefits (4/8, 50%) compared to current therapy management, a lack of interoperability with other devices/apps (1/8, 12%), and no joy of use (1/8, 12%). The app test revealed the following main difficulties in use: nonintuitive understanding of the functionality of the apps (26/29, 90%), nonintuitive understanding of the menu navigation/labeling (19/29, 66%), font sizes and representations that were too small (14/29, 48%), and difficulties in recognizing and pressing touch-sensitive areas (14/29, 48%). Furthermore, the patients felt the apps lacked individually important functions (11/29, 38%), or felt the functions that were offered were unnecessary for their own therapy needs (10/29, 34%). The most important contents of a helpful diabetes app were reported as the ability to add remarks to measured values (9/28, 32%), the definition of thresholds for blood glucose values and highlighting deviating values (7/28, 25%), and a reminder feature for measurement/medication (7/28, 25%). The most important contact persons for technical questions were family members (19/31, 61%). Conclusions A lack of additional benefits and ease of use emerged as the key factors for the acceptance of diabetes apps among patients aged 50 or older. Furthermore, it has been shown that the needs of the investigated target group are highly heterogeneous due to varying previous knowledge, age, type of diabetes, and therapy. Therefore, a helpful diabetes app should be individually adaptable. Personal contact persons, especially during the initial phase of use, are of utmost importance to reduce the fear of data loss or erroneous data input, and to raise acceptance among this target group. PMID:25733033

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

    PubMed Central

    Shen, Zhoujun; Zhong, Shan; Wang, Xianjin; Lu, Yingli; Xu, Chen

    2013-01-01

    Background Increasing evidence suggests that diabetes mellitus (DM) may be associated with an increased risk of bladder cancer. To provide a quantitative assessment of this association, we evaluated the relation between DM and incidence and mortality of bladder cancer in an updated meta-analysis of cohort studies. Methods We identified cohort studies by searching the EMBASE and MEDLINE databases, through 31 March 2012. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated with random-effects models. Results A total of 29 cohort studies (27 articles) were included in this meta-analysis. DM was associated with an increased incidence of bladder cancer (RR 1.29, 95% CI: 1.08–1.54), with significant evidence of heterogeneity among these studies (p<0.001, I2?=?94.9%). In stratified analysis, the RRs of bladder cancer were 1.36 (1.05–1.77) for diabetic men and 1.28 (0.75–2.19) for diabetic women, respectively. DM was also positively associated with bladder cancer mortality (RR 1.33, 95% CI: 1.14–1.55), with evident heterogeneity between studies (p?=?0.002, I2?=?63.3%). The positive association was observed for both men (RR 1.54, 95% CI: 1.30–1.82) and women (RR 1.50, 95% CI: 1.05–2.14). Conclusion These findings suggest that compared to non-diabetic individuals, diabetic individuals have an increased incidence and mortality of bladder cancer. PMID:23437204

  12. Randomised controlled trial of an automated, interactive telephone intervention to improve type 2 diabetes self-management (Telephone-Linked Care Diabetes Project): study protocol

    PubMed Central

    2010-01-01

    Background An estimated 285 million people worldwide have diabetes and its prevalence is predicted to increase to 439 million by 2030. For the year 2010, it is estimated that 3.96 million excess deaths in the age group 20-79 years are attributable to diabetes around the world. Self-management is recognised as an integral part of diabetes care. This paper describes the protocol of a randomised controlled trial of an automated interactive telephone system aiming to improve the uptake and maintenance of essential diabetes self-management behaviours. Methods/Design A total of 340 individuals with type 2 diabetes will be randomised, either to the routine care arm, or to the intervention arm in which participants receive the Telephone-Linked Care (TLC) Diabetes program in addition to their routine care. The intervention requires the participants to telephone the TLC Diabetes phone system weekly for 6 months. They receive the study handbook and a glucose meter linked to a data uploading device. The TLC system consists of a computer with software designed to provide monitoring, tailored feedback and education on key aspects of diabetes self-management, based on answers voiced or entered during the current or previous conversations. Data collection is conducted at baseline (Time 1), 6-month follow-up (Time 2), and 12-month follow-up (Time 3). The primary outcomes are glycaemic control (HbA1c) and quality of life (Short Form-36 Health Survey version 2). Secondary outcomes include anthropometric measures, blood pressure, blood lipid profile, psychosocial measures as well as measures of diet, physical activity, blood glucose monitoring, foot care and medication taking. Information on utilisation of healthcare services including hospital admissions, medication use and costs is collected. An economic evaluation is also planned. Discussion Outcomes will provide evidence concerning the efficacy of a telephone-linked care intervention for self-management of diabetes. Furthermore, the study will provide insight into the potential for more widespread uptake of automated telehealth interventions, globally. Trial Registration Number ACTRN12607000594426 PMID:20937148

  13. Zinc supplementation in pre-diabetes: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background The number of people with diabetes is increasing worldwide, especially in developing South Asian countries. Therefore, preventing diabetes at the early stages has become an important issue. Recent clinical trials, systematic reviews, and meta-analysis have shown that zinc has beneficial effects on glycemic and metabolic control in those with diabetes. The present study is designed to evaluate the effects of zinc supplementation on glycemic control and other metabolic parameters in those with pre-diabetes. Methods/design The study will be conducted as a randomized, double-blind, placebo-controlled clinical trial for a period of 12 months at the Faculty of Medicine, University of Colombo, Sri Lanka. The study has been approved by the Ethics Review Committee of Faculty of Medicine, University of Colombo (EC/11/189). A total of 200 adults (age 18–60 years) with pre-diabetes will be recruited for the study. They will be stratified according to age, gender, and body mass index and randomly assigned into the test and placebo groups on a 1:1 ratio. The zinc capsules, each weighing 456 mg, will contain the following ingredients:zinc sulfate monohydrate 55.096 mg (elemental zinc 20 mg), lactose monohydrate 399.504 mg, and stearic acid 1.400 mg. The placebo capsule with the same weight will be comprised of lactose monohydrate 454.600 mg and stearic acid 1.400 mg. The subjects will receive either zinc 20 mg capsules or placebo daily for a period of 12 months. The study drugs will be double blinded to both investigators and subjects. The visits and the evaluations will be done as follows: screening (visit 0), 1 month (visit 1), 3 month (visit 2), 6 month (visit 3), and 12 month (visit 4). The following primary outcome measures will be evaluated:fasting plasma glucose (FPG), post oral glucose tolerance test (OGTT), serum insulin, HbA1c, total/low-density lipoprotein (LDL)/high-density lipoprotein (HDL) cholesterol, triglycerides, serum zinc, and appetite using a visual analog scale. Secondary outcome measures include: blood pressure, anthropometry, and dietary assessment using a validated food frequency questionnaire. Data will be analyzed using SPSS v16. Discussion The present protocol will aim to establish the beneficial effects of zinc supplementation on disease progression in those with pre-diabetes and also establish its effectiveness in the prevention of diabetes mellitus. Trial registration Sri Lanka Clinical Trial Registry: SLCTR/2012/010 PMID:23421759

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

    2009-01-01

    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

  16. Study on Total Antioxidant Status in Relation to Oxidative Stress in Type 2 Diabetes Mellitus

    PubMed Central

    Rani, A. Jamuna; Mythili, S.V

    2014-01-01

    Background: Diabetes Mellitus is a condition of increased oxidative stress and requiries antioxidants. The sum of endogenous and food derived antioxidants represents the total antioxidant activity of the system. The cooperation among different antioxidants provides greater protection against damage caused by reactive oxygen species or reactive nitrogen species, than any single compound alone. Thus the overall antioxidant capacity may provide more relevant biological information compared to that obtained by the measurement of individual components, as it considers the cumulative effect of all antioxidants present in plasma and body fluids and hence the study. Materials and Methods: The study population included healthy volunteers from staff of Sree Balaji Medical College & Hospital (SBMC&H) and Type 2 Diabetic patients attending SBMC&H, Chennai, India. Malondialdehyde levels and total antioxidant status of the case and controls was assessed. Results: A significant decrease in the total antioxidant status among Diabetic patients and significant increase in their malondialdehyde levels in comparison to healthy controls was observed. Conclusion: Type 2 Diabetes Mellitus is a condition in which there is increased oxidative stress as evident by increased Malondialdehyde levels and the condition calls for utilization of antioxidants to combat the oxidants thereby resulting in decreased total antioxidants status. PMID:24783095

  17. Meta-Analysis of 23 Type 2 Diabetes Linkage Studies from the International Type 2 Diabetes Linkage Analysis Consortium

    Microsoft Academic Search

    Weihua Guan; Anna Pluzhnikov; Nancy J. Cox; Michael Boehnke

    2008-01-01

    Background: The International Type 2 Diabetes Linkage Analysis Consortium was formed to localize type 2 diabetes predisposing variants based on 23 autosomal linkage scans. Methods: We carried out meta-analysis using the genome scan meta-analysis (GSMA) method which divides the genome into bins of ?30 cM, ranks the best linkage results in each bin for each sample, and then sums the

  18. Mastication and Risk for Diabetes in a Japanese Population: A Cross-Sectional Study

    PubMed Central

    Yamazaki, Toru; Yamori, Masashi; Asai, Keita; Nakano-Araki, Ikuko; Yamaguchi, Akihiko; Takahashi, Katsu; Sekine, Akihiro; Matsuda, Fumihiko; Kosugi, Shinji; Nakayama, Takeo; Inagaki, Nobuya; Bessho, Kazuhisa

    2013-01-01

    Background Associations between mastication and insufficient nutrient intake, obesity, and glucose metabolism have been shown in previous studies. However, the association between mastication and diabetes has not been clarified. Our objective was to examine the association between mastication, namely masticatory performance or rate of eating, and diabetes in a population-based cohort. Methods We conducted a cross-sectional study of the association between mastication and diabetes in the Nagahama Prospective Cohort Study, an ongoing study which recruits citizens of Nagahama City in Shiga Prefecture, central Japan. 2,283 male and 4,544 female residents aged 40–74 years were enrolled from July 2009 to November 2010. Masticatory performance was evaluated by spectrophotometric measurement of color changes after masticating color-changeable chewing gum. Categorical rate of eating (fast, intermediate or slow) was self-assessed using a questionnaire. Results 177 males (7.7%) and 112 (2.4%) females were diagnosed with diabetes. We divided participants into four groups by quartile of masticatory performance, namely Q1 (lowest), 2, and 3 and 4 (highest). Compared to the lowest performance group, the multivariable adjusted odds ratio (OR) of diabetes was 0.91 (95% confidence interval (CI), 0.58–1.4) in Q2, 0.77 (95% CI, 0.48–1.2) in Q3, and 0.53 (95% CI, 0.31–0.90) in the highest group in males, and 1.2 (95% CI, 0.73–2.0), 0.95 (95% CI, 0.54–1.6) and 0.56 (95% CI, 0.30–1.0) in females. We also estimated ORs of diabetes by rate of eating. Compared to the fast eating group, ORs in males were 0.87 (95% CI, 0.61–1.2) in the intermediate group and 0.38 (95% CI, 0.16–0.91) in the slow group, and ORs in females were 0.92 (95% CI, 0.59–1.4) and 1.5 (95% CI, 0.73–3.0). Conclusions These findings support the hypothesis that higher masticatory performance and slow eating prevent the occurrence of diabetes. PMID:23755114

  19. 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 ...

  20. Costs of Diabetes Mellitus in Korea

    E-print Network

    Diabetes Metab J; Kwan Woo Lee

    Outcome research focusing on the economics of the medical field began in the mid-1990s and has included studies about costs, cost effectiveness, and policies. According to the American Diabetes Association, the total estimated cost of diabetes in 2007 was $174 billion. The economic burden of patients with diabetes in Canada is expected to be about $12.2 billion in 2010. Recent Korean studies have analyzed the expenses associated with type 2 diabetes for patients in selected general hospitals. Type 2 diabetic patients without complications cost approximately 1,184,563 won (the equivalent of US $1,184) per patient for healthcare annually. In contrast, patients with microvascular disease due to diabetic complications cost up to 4.7 times that amount, and patients with macrovascular disease incur up to 10.7 times the annual costs for patients without diabetic complications. Diabetic complications ultimately impact the quality of life for patients and patient mortality, and are associated with higher direct medical expenses for patients. To avoid increased medical costs, appropriate management techniques must be implemented to ensure timely care for patients with diabetes.

  1. Factors Associated With Maternal-Reported Actions to Prevent Type 1 Diabetes in the First Year of the TEDDY Study

    PubMed Central

    Smith, Laura B.; Lynch, Kristian F.; Baxter, Judith; Lernmark, Barbro; Roth, Roswith; Simell, Tuula; Johnson, Suzanne Bennett

    2014-01-01

    OBJECTIVE Mothers of children at risk for type 1 diabetes report engaging in preventive behaviors. The purpose of this study is to further document these actions in an international, longitudinal sample and examine variables that predict whether mothers engage in these behaviors. RESEARCH DESIGN AND METHODS This study examined an international sample (from Finland, Germany, Sweden, and the U.S.) from the naturalistic, longitudinal The Environmental Determinants of Diabetes in the Young (TEDDY) study, which tracked children genetically at risk for type 1 diabetes from birth to age 15 years. Mothers of 7,613 infants aged 6 months and 6,503 infants aged 15 months completed questionnaires assessing psychosocial factors and actions intended to prevent diabetes. RESULTS Many mothers (29.9% at 6 months and 42.8% at 15 months) reported engaging in a behavior intended to prevent type 1 diabetes, with the largest percentages (20.9–29.2%) reporting making changes to their child’s diet (e.g., reducing the consumption of sweets and carbohydrates). Factors related to engaging in preventive behaviors include older maternal age; higher maternal education; minority status; having only one child; having a first-degree relative with type 1 diabetes; being from a country other than Sweden; having an accurate perception of the child’s increased risk for developing diabetes; having postpartum depression, maternal anxiety, and worry about the risk of diabetes; and believing that diabetes can be prevented. CONCLUSIONS The findings of this study suggest that many mothers engage in actions to prevent diabetes and highlight the importance of tracking these behaviors to ensure the validity of naturalistic observational studies. PMID:24041684

  2. Oral glucose tolerance test and HbA 1c for diagnosis of diabetes in patients undergoing coronary angiography the Silent Diabetes Study

    Microsoft Academic Search

    R. Doerr; U. Hoffmann; W. Otter; L. Heinemann; W. Hunger-Battefeld; B. Kulzer; A. Klinge; V. Lodwig; I. Amann-Zalan; D. Sturm; D. Tschoepe; S. G. Spitzer; J. Stumpf; T. Lohmann; O. Schnell

    Aims\\/hypothesis  The primary aim of this study was to compare the results of HbA1c measurements with those of an OGTT for early diagnosis of ‘silent diabetes’ in patients with coronary artery disease (CAD)\\u000a undergoing angiography without prediagnosed diabetes. A secondary aim was to investigate the correlation between the extent\\u000a of CAD and the glycaemic status of the patient.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Data from 1,015

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

    PubMed Central

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

    2014-01-01

    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

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

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

    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.

  5. PS2-01: Factors Influencing Completion in the IDEA Diabetes Education Study

    PubMed Central

    Adams, Kenneth; Beaton, Sarah; Parker, Emily; Lavin-Tompkins, Jodi; Sperl-Hillen, JoAnn; Hanson, Ann; Davis, Herbert; Fernandes, Omar; Von Worley, Ann; Glasrud, Patricia; Parsons, William; Spain, Vic

    2011-01-01

    Background/Aims Participant non-adherence to study protocols can adversely affect clinical trials by reducing statistical power. Similarly non-adherence is an important issue in clinical practice. Ceasing to participate is one form of non-adherence. Subject characteristics appear to influence adherence. We evaluated relationships between subject characteristics and completion of educational sessions in IDEA, a clinical trial testing 2 modes of diabetes education in patients with sub-optimal diabetes control. Methods IDEA eligibility criteria included Type 2 diabetes, A1c =7%, and no recent diabetes education. Subjects (n=623) were randomly allocated to one of 3 diabetes education treatment arms; individual education, group education, or a comparison group with no active intervention. Individual education consisted of three 1-hour sessions, following an AADE program. Group education was delivered in four 2-hour group sessions that emphasized patient interaction. Subjects were considered adherent if they completed all assigned sessions. At the end of the study, tracking data indicated completion rates of 72.0% (175/243) in the group education intervention and 86.1% (211/245) in the individual treatment intervention. We sought to identify demographic, psychosocial and clinical characteristics that might explain non-completion. We hypothesized that, within each arm, baseline health status (SF-12 mental composite and physical composite scores), depression (PHQ9), personality type (TIPI Big 5; extraversion, agreeability, emotional stability, conscientiousness, and openness), and Hb A1c level were associated with completion. Results In the group education arm, subjects scoring higher on the emotional stability scale were more likely to complete (p<0.05). Generally, demographic factors were more strongly associated with completion of group education than were psychosocial or clinical factors: women and older subjects were more likely to complete than men and younger subjects (gender, p=0.008; age, p=<0.0005). Within the individual education arm, completion was predicted by higher physical health score (SF12-PCS; p=0.005), higher mental health scales (SF12-MCS, p=0.008), lower depression score (PHQ9, p=0.002), and lower Hb A1c (p<0.05). However, neither gender nor age was associated with completion. Conclusions Factors related to study completion appear to differ between the 2 diabetes educational interventions. These results may be relevant to diabetes educational programs considering strategies to improve “no show” and lack of completion rates.

  6. 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

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

    1989-01-01

    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

  7. Associations between Depression and Diabetes in the Community: Do Symptom Dimensions Matter? Results from the Gutenberg Health Study

    PubMed Central

    Wiltink, Jörg; Michal, Matthias; Wild, Philipp S.; Schneider, Astrid; König, Jochem; Blettner, Maria; Münzel, Thomas; Schulz, Andreas; Weber, Matthias; Fottner, Christian; Pfeiffer, Norbert; Lackner, Karl; Beutel, Manfred E.

    2014-01-01

    Objectives While a bidirectional relationship between diabetes and depression has been established, there is little knowledge if the associations are due to somatic-affective or cognitive-affective dimensions of depression. Research Design and Methods In a population-based, representative survey of 15.010 participants we therefore studied the associations of the two dimensions of depression with diabetes and health care utilization among depressed and diabetic participants. Depression was assessed by the Patient Health Questionnaire PHQ-9. Results We found a linear and consistent association between the intensity of depression and the presence of diabetes increasing from 6.9% in no or minimal depression to 7.6% in mild, 9% in moderate and 10.5% in severe depression. There was a strong positive association between somatic-affective symptoms but not with cognitive-affective symptoms and diabetes. Depression and diabetes were both independently related to somatic health care utilisation. Conclusions Diabetes and depression are associated, and the association is primarily driven by the somatic-affective component of depression. The main limitation of our study pertains to the cross-sectional data acquisition. Further longitudinal work on the relationship of obesity and diabetes should differentiate the somatic and the cognitive symptoms of depression. PMID:25127227

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

    PubMed

    Rose, Vanessa K; Harris, Mark F

    2015-01-01

    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

  9. The Effect of Intensive Glycemic Treatment on Coronary Artery Calcification in Type 1 Diabetic Participants of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study

    PubMed Central

    Cleary, Patricia A.; Orchard, Trevor J.; Genuth, Saul; Wong, Nathan D.; Detrano, Robert; Backlund, Jye-Yu C.; Zinman, Bernard; Jacobson, Alan; Sun, Wanjie; Lachin, John M.; Nathan, David M.

    2008-01-01

    The Epidemiology of Diabetes Interventions and Complications (EDIC) study, an observational follow-up of the Diabetes Control and Complications Trial (DCCT) type 1 diabetes cohort, measured coronary artery calcification (CAC), an index of atherosclerosis, with computed tomography (CT) in 1,205 EDIC patients at ~7–9 years after the end of the DCCT. We examined the influence of the 6.5 years of prior conventional versus intensive diabetes treatment during the DCCT, as well as the effects of cardiovascular disease risk factors, on CAC. The prevalences of CAC >0 and >200 Agatston units were 31.0 and 8.5%, respectively. Compared with the conventional treatment group, the intensive group had significantly lower geometric mean CAC scores and a lower prevalence of CAC >0 in the primary retinopathy prevention cohort, but not in the secondary intervention cohort, and a lower prevalence of CAC >200 in the combined cohorts. Waist-to-hip ratio, smoking, hypertension, and hypercholesterolemia, before or at the time of CT, were significantly associated with CAC in univariate and multivariate analyses. CAC was associated with mean HbA1c (A1C) levels before enrollment, during the DCCT, and during the EDIC study. Prior intensive diabetes treatment during the DCCT was associated with less atherosclerosis, largely because of reduced levels of A1C during the DCCT. PMID:17130504

  10. Biomechanical characteristics of bone in streptozotocin-induced diabetic rats: An in-vivo randomized controlled experimental study

    PubMed Central

    Korres, Nektarios; Tsiridis, Eleftherios; Pavlou, George; Mitsoudis, Athanasios; Perrea, Despina N; Zoumbos, Aristedes B

    2013-01-01

    AIM: To investigate the in vivo effects of type?I?diabetes on the mechanical strength of tibial bone in a rodent model. METHODS: The biomechanical effect of diabetes on the structural integrity of the tibia in streptozotocin induced diabetic Wistar rats was analysed. Induction of diabetes was achieved by an intra-peritoneal injection and confirmed by measuring serial blood glucose levels (> 150 mg/dL). After 8 wk the tibiae were harvested and compared to a control group. Biomechanical analysis of harvested tibiae was performed using a three-point bending technique on a servo hydraulic MTS 858 MiniBionix frame. Maximum force applied to failure (N), stiffness (N × mm) and energy absorbed (N/mm) were recorded and plotted on load displacement curves. A displacement control loading mode of 1 mm/min was selected to simulate quasi-static loading conditions. Measurements from load-displacement curves were directly compared between groups. RESULTS: Fourteen streptozotocin induced diabetic Wistar rats were compared against nineteen non-diabetic controls. An average increase of 155.2 g in body weight was observed in the control group compared with only 5 g in the diabetic group during the experimental study period. Levels of blood glucose increased to 440.25 mg/dL in the diabetic group compared to 116.62 mg/dL in the control group.The biomechanical results demonstrate a highly significant reduction in the maximum load to failure from 69.5 N to 58 N in diabetic group compared to control (P = 0.011). Energy absorption to fracture was reduced from 28.2 N in the control group to 23.5 N in the diabetic group (P = 0.082). No significant differences were observed between the groups for bending stiffness. CONCLUSION: Streptozotocin-induced diabetes in rodents reduces the maximum force and energy absorption to failure of bone, suggesting a predisposition for fracture risk. PMID:23878780

  11. The Costs of Diabetes

    E-print Network

    Tseng Chin-hsiao

    The increasing number of diabetic patients has reached a level of epidemic globally. The mortality from diabetes mellitus is also increasing and has been ranked as one of the ten major causes of death in many countries. Diabetes is becoming one of the major public health problems because a great proportion of the healthcare expenditure has been spent on the treatment of its associated morbidity and mortality. In Taiwan, diabetes has been ranked as the fifth leading cause of death since 1987 and the number of mortality from diabetes keeps on increasing. The prevalence of diabetes is also increasing in Taiwan over the past decades. Chronic diabetic complications are common and glycemic control status has been poor. There are about 540 thousand drug-treated diabetic patients in Taiwan and they used up about 11.5 % of the total healthcare expenditure reimbursed by the National Health Insurance. Most of the diabetic complications are preventable by controlling blood glucose and the associated atherosclerotic risk factors. A recent study also showed that even diabetes itself could be prevented by regular exercise and dietary control. In the war against diabetes, preventing the occurrence of chronic diabetic complications or diabetes itself seems to be the most efficient and effective way to reduce the great burden of diabetes. Key words: Diabetes mellitus, healthcare cost, preventive medicine 1

  12. Women and Diabetes -- Diabetes Medicines

    MedlinePLUS

    ... Audience For Women Women's Health Topics Women and Diabetes - Diabetes Medicines Print and Share (PDF 372 KB) Diabetes ... 1-800-332-1088 to request a form. Diabetes Medicines The different kinds of diabetes medicines are ...

  13. Field-structured composite studies.

    SciTech Connect

    Martin, James Ellis; Williamson, Rodney L.

    2004-04-01

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

  14. Mortality in Pharmacologically Treated Older Adults with Diabetes: The Cardiovascular Health Study, 1989–2001

    Microsoft Academic Search

    Richard A Kronmal; Joshua I Barzilay; Nicholas L Smith; Bruce M Psaty; Lewis H Kuller; Gregory L Burke; Curt Furberg

    2006-01-01

    BackgroundDiabetes mellitus (DM) confers an increased risk of mortality in young and middle-aged individuals and in women. It is uncertain, however, whether excess DM mortality continues beyond age 75 years, is related to type of hypoglycemic therapy, and whether women continue to be disproportionately affected by DM into older age.Methods and FindingsFrom the Cardiovascular Health Study, a prospective study of

  15. Sex Differences in Step Count-Blood Pressure Association: A Preliminary Study in Type 2 Diabetes

    Microsoft Academic Search

    Priya Manjoo; Lawrence Joseph; Louise Pilote; Kaberi Dasgupta; Conrad P. Earnest

    2010-01-01

    BackgroundWalking and cardiovascular mortality are inversely associated in type 2 diabetes, but few studies have objectively measured associations of walking with individual cardiovascular risk factors. Such information would be useful for “dosing” daily steps in clinical practice. This study aimed to quantify decrements in blood pressure and glycated hemoglobin (A1C) per 1,000 daily step increments.Methodology\\/Principal FindingsTwo hundred and one subjects

  16. Diabetes and Progression of Carotid Atherosclerosis The Insulin Resistance Atherosclerosis Study

    Microsoft Academic Search

    Lynne E. Wagenknecht; Daniel Zaccaro; Mark A. Espeland; Andrew J. Karter; Daniel H. O'Leary; Steven M. Haffner

    2010-01-01

    Objective—We sought to determine the rate of progression of carotid atherosclerosis in persons with normal glucose tolerance, impaired glucose tolerance, and undiagnosed and diagnosed type 2 diabetes. Methods and Results—The Insulin Resistance Atherosclerosis Study (IRAS) is an observational cohort study in which 1192 men and women were examined at a 5-year interval. Participants of 3 ethnic groups (non-Hispanic white, African

  17. A Case-Control Study of Physical Activity and Non-Insulin Dependent Diabetes Mellitus (NIDDM)

    Microsoft Academic Search

    Deborah Fulton-Kehoe; Richard F Hamman; Judith Baxter; Julie Marshall

    2001-01-01

    PURPOSE: The purpose of this study was to examine the association between physical activity and non-insulin dependent diabetes mellitus (NIDDM).METHODS: We conducted a population-based case-control study in Hispanic and non-Hispanic white men and women, ages 20–74. A total of 167 cases with NIDDM and 1100 controls with normal glucose tolerance were included. All subjects completed an oral glucose tolerance test.RESULTS:

  18. Blood glucose concentrations and progression of diabetic retinopathy: the seven year results of the Oslo study

    Microsoft Academic Search

    O. Brinchmann-Hansen; K. Dahl-Jørgensen; L. Sandvik; K. F. Hanssen

    1992-01-01

    OBJECTIVE--To study insulin dependent diabetic patients for change in non-proliferative retinopathy and its relation to glycaemic control and to various clinical background data. DESIGN--Prospective study with follow up for seven years. SETTING--Outpatient departments of university hospitals. MAIN OUTCOME MEASURES--Glycated haemoglobin concentration; degree of retinopathy. RESULTS--Retinopathy worsened by an overall increase in counts of microaneurysms and haemorrhages from 17 (SD 25)

  19. Glycemic control, growth and complications in children with insulin-dependent diabetes mellitus — a study of children enrolled in a Summer camp program for diabetics in Kinki district, Japan

    Microsoft Academic Search

    Kanji Izumi; Mitsuru Hoshi; Shotaro Kuno; Giichi Okuno; Yoshimitsu Yamazaki; Gen Isshiki; Akira Sasaki

    1995-01-01

    The influence of glycemic control on growth and on the development of complications in diabetic children was studied. The subjects of the study were 107 children with insulin-dependent diabetes mellitus (IDDM), who were enrolled in a Summer camp program for diabetic children in Kinki District, Japan from 1972 to 1990, and who had at least three determinations of HbA1 during

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

    PubMed Central

    Castañeda, José Alberto; Sanz, Silvia; Henseler, Jörg

    2012-01-01

    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

  1. A COMPARATIVE STUDY OF SERUM ELECTROLYTE AND UREA IN TYPE II DIABETES AND MYCOBACTERIUM TUBERCULOSIS PATIENTS IN OWERRI NIGERIA

    E-print Network

    Nnodim Johnkennedy; Ihim Augustin; Nwobodo Emmanuel Ikechukwu

    Objective; Type II diabetes and Mycobacterium tuberclosis patients suffer electrolyte disturbances. The serum level of electrolyte and urea, levels were estimated in type II diabetes and Mycobacterium tuberclosis patients. Methods: Eighty type II diabetes, eighty Mycobacterium tuberclosis and eighty apparently health volunteers who were free from diabetes and Mycobacterium tuberclosis attending General Hospital Owerri were used in this study. Results: The serum levels of some electrolytes were significantly lower in type II diabetes and Mycobacterium tuberclosis patients (P Mycobacterium tuberclosis patients. While the level of urea in type II diabetes and Mycohacterium tuberclosis were significantly increased than in controls. Conclusion: These observations suggests that type II diabetes patients exhibit greater electrolyte disturbances than people with Mycobacterium tuberclosis. Also, patients with type II diabetes and Mycobacterium tuberclosis could be probably are prone to renal impairment. Hence monitoring of serum electrolyte and urea levels in the two conditions is very necessary as early detection and treatment of these abnormalities will enhance the quality of life of patients.

  2. Comparison of the Effectiveness of Four Bariatric Surgery Procedures in Obese Patients with Type 2 Diabetes: A Retrospective Study

    PubMed Central

    Pham, Sylvie; Gancel, Antoine; Scotte, Michel; Houivet, Estelle; Huet, Emmanuel; Lefebvre, Hervé; Kuhn, Jean-Marc; Prevost, Gaetan

    2014-01-01

    Aim. The aim of the present retrospective study was to evaluate the efficacy of four bariatric surgical procedures to induce diabetes remission and lower cardiovascular risk factors in diabetic obese patients. Moreover, the influence of surgery on weight evolution in the diabetic population was compared with that observed in a nondiabetic matched population. Methods. Among 970 patients who were operated on in our center since 2001, 81 patients were identified as type 2 diabetes. Laparoscopic adjustable gastric banding (GB), intervention type Mason (MA), gastric bypass (RYGB), and sleeve gastrectomy (SG) were performed, respectively, in 25%, 17%, 28%, and 30% of this diabetic population. Results. The resolution rate of diabetes one year after surgery was significantly higher after SG than GB (62.5% versus 20%, P < 0.01), but not significantly different between SG and RYGB. In terms of LDL-cholesterol reduction, RYGB was equivalent to SG and superior to CGMA or GB. Considering the other cardiovascular risk factors, there was no significant difference according to surgical procedures. The weight loss was not statistically different between diabetic and nondiabetic matched patients regardless of the surgical procedures used. Conclusion. Our data confirm that the efficacy of surgery to treat diabetes is variable among the diverse procedures and SG might be an interesting option in this context. PMID:24967099

  3. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2

    PubMed Central

    Tonstad, S.; Stewart, K.; Oda, K.; Batech, M.; Herring, R.P.; Fraser, G.E.

    2012-01-01

    Aim To evaluate the relationship of diet to incident diabetes among non-Black and Black participants in the Adventist Health Study-2. Methods and Results Participants were 15,200 men and 26,187 women (17.3% Blacks) across the U.S. and Canada who were free of diabetes and who provided demographic, anthropometric, lifestyle and dietary data. Participants were grouped as vegan, lacto ovo vegetarian, pesco vegetarian, semi-vegetarian or non-vegetarian (reference group). A follow-up questionnaire after two years elicited information on the development of diabetes. Cases of diabetes developed in 0.54% of vegans, 1.08% of lacto ovo vegetarians, 1.29% of pesco vegetarians, 0.92% of semi-vegetarians and 2.12% of non-vegetarians. Blacks had an increased risk compared to non-Blacks (odds ratio [OR] 1.364; 95% confidence interval [CI], 1.093–1.702). In multiple logistic regression analysis controlling for age, gender, education, income, television watching, physical activity, sleep, alcohol use, smoking and BMI, vegans (OR 0.381; 95% CI 0.236–0.617), lacto ovo vegetarians (OR 0.618; 95% CI 0.503–0.760) and semi-vegetarians (OR 0.486, 95% CI 0.312–0.755) had a lower risk of diabetes than non-vegetarians. In non-Blacks vegan, lacto ovo and semi-vegetarian diets were protective against diabetes (OR 0.429, 95% CI 0.249–0.740; OR 0.684, 95% CI 0.542–0.862; OR 0.501, 95% CI 0.303–0.827); among Blacks vegan and lacto ovo vegetarian diets were protective (OR 0.304, 95% CI 0.110–0.842; OR 0.472, 95% CI 0.270–0.825). These associations were strengthened when BMI was removed from the analyses. Conclusion Vegetarian diets (vegan, lacto ovo, semi-) were associated with a substantial and independent reduction in diabetes incidence. In Blacks the dimension of the protection associated with vegetarian diets was as great as the excess risk associated with Black ethnicity. PMID:21983060

  4. Diabetic neuropathy

    PubMed Central

    Bansal, V; Kalita, J; Misra, U K

    2006-01-01

    Diabetic neuropathy (DN) refers to symptoms and signs of neuropathy in a patient with diabetes in whom other causes of neuropathy have been excluded. Distal symmetrical neuropathy is the commonest accounting for 75% DN. Asymmetrical neuropathies may involve cranial nerves, thoracic or limb nerves; are of acute onset resulting from ischaemic infarction of vasa nervosa. Asymmetric neuropathies in diabetic patients should be investigated for entrapment neuropathy. Diabetic amyotrophy, initially considered to result from metabolic changes, and later ischaemia, is now attributed to immunological changes. For diagnosis of DN, symptoms, signs, quantitative sensory testing, nerve conduction study, and autonomic testing are used; and two of these five are recommended for clinical diagnosis. Management of DN includes control of hyperglycaemia, other cardiovascular risk factors; ? lipoic acid and L carnitine. For neuropathic pain, analgesics, non?steroidal anti?inflammatory drugs, antidepressants, and anticonvulsants are recommended. The treatment of autonomic neuropathy is symptomatic. PMID:16461471

  5. A Five-Year Prospective Study of Diabetic Retinopathy Progression in Chinese Type 2 Diabetes Patients with “Well-Controlled” Blood Glucose

    PubMed Central

    Jin, Peiyao; Peng, Jinjuan; Zou, Haidong; Wang, Weiwei; Fu, Jiong; Shen, Binjie; Bai, Xuelin; Xu, Xun; Zhang, Xi

    2015-01-01

    Purpose To determine the progression rate and risk factors for diabetic retinopathy (DR) in Chinese type 2 diabetic patients who have reached the target hemoglobin A1c (HbA1c) level recommended by the American Diabetes Association. Methods This was a 5-year community-based prospective study. The study population consisted of patients with type 2 diabetes with HbA1c less than 7.0%. Demographic information, systemic examination results and ophthalmological test results for each participant were collected. The outcome of this study was the progression of DR, which was defined as an increase in DR grade in one or both eyes at the final visit in comparison to the baseline status. The association between each potential risk factor and DR progression was studied. Results A total of 453 patients with HbA1c less than 7.0% were included in the study group. In 146 patients (32.22%), DR developed or progressed during the five-year follow-up. Baseline HbA1c level was the only independent risk factor for DR progression (p<0.01, OR = 2.84, 95%CI: 2.11~3.82). The logistic regression function suggested that the possibility of DR progression increased fastest when baseline HbA1c increased from 5.2% to 6.4%. The 5-year DR progression rate in patients with baseline HbA1c less than 5.2%, between 5.2% and 6.4%, and over 6.4% were 19.62%, 24.41%, and 76.83%, respectively. Conclusions To slow the progression of DR in Chinese patients with type 2 diabetes, more intensive glucose control is recommended. PMID:25849536

  6. Comparison of type 2 diabetes prevalence estimates in Saudi Arabia from a validated Markov model against the International Diabetes Federation and other modelling studies

    PubMed Central

    Al-Quwaidhi, Abdulkareem J.; Pearce, Mark S.; Sobngwi, Eugene; Critchley, Julia A.; O’Flaherty, Martin

    2014-01-01

    Aims To compare the estimates and projections of type 2 diabetes mellitus (T2DM) prevalence in Saudi Arabia from a validated Markov model against other modelling estimates, such as those produced by the International Diabetes Federation (IDF) Diabetes Atlas and the Global Burden of Disease (GBD) project. Methods A discrete-state Markov model was developed and validated that integrates data on population, obesity and smoking prevalence trends in adult Saudis aged ?25 years to estimate the trends in T2DM prevalence (annually from 1992 to 2022). The model was validated by comparing the age- and sex-specific prevalence estimates against a national survey conducted in 2005. Results Prevalence estimates from this new Markov model were consistent with the 2005 national survey and very similar to the GBD study estimates. Prevalence in men and women in 2000 was estimated by the GBD model respectively at 17.5% and 17.7%, compared to 17.7% and 16.4% in this study. The IDF estimates of the total diabetes prevalence were considerably lower at 16.7% in 2011 and 20.8% in 2030, compared with 29.2% in 2011 and 44.1% in 2022 in this study. Conclusion In contrast to other modelling studies, both the Saudi IMPACT Diabetes Forecast Model and the GBD model directly incorporated the trends in obesity prevalence and/or body mass index (BMI) to inform T2DM prevalence estimates. It appears that such a direct incorporation of obesity trends in modelling studies results in higher estimates of the future prevalence of T2DM, at least in countries where obesity has been rapidly increasing. PMID:24447810

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

    PubMed Central

    2008-01-01

    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

  8. Type 2 Diabetes Risk in Persons with Dysglycemia: The Framingham Offspring Study

    PubMed Central

    Wilson, Peter W. F.; D'Agostino, Ralph B.; Fox, Caroline S.; Sullivan, Lisa M.; Meigs, James B.

    2011-01-01

    Aims Detection of risk of type 2 diabetes mellitus (T2DM) among adults with dysglycemia. Methods We used a nested case-cohort prospective design to estimate risk of new diabetes (diabetes treatment or FPG ?7.0 mmol/l) among 1004 Framingham Heart Study Offspring with baseline dysglycemia [fasting plasma glucose (FPG) 5.4-6.9 mmol/l and/or 2-hour post glucose load level 7.8-11.0 mmol/l)]. Using clinical characteristics previously shown to predict incident T2DM, we used logistic regression to estimate odds ratios (OR), p-values for predictors, and assessment of model discrimination. Results At the end of 7 yrs follow-up there were 118 incident T2DM cases. In a model that included age, sex, elevated blood pressure or blood pressure treatment, lipid-lowering treatment and elevated triglycerides, we found the following additional characteristics to be independently associated with new T2DM: parental history of diabetes (OR 2.28, p=0.004); excess adiposity (BMI ?30 kg/m2 or waist circumference ?101.6 cm) (OR 2.04, p=0.0005), and low HDL-C [<1.0 (men) or <1.3 mmol/L (women)] (OR 2.77, p<0.0001). The multivariable c-statistic for this model was 0.701, and with glycemic category information included, c=0.751. Conclusions The key non-glycemic traits that predicted later T2DM in adults with dysglycemia were parental history of diabetes, excess adiposity and low HDL-C. PMID:21242014

  9. Sputum Glucose and Glycemic Control in Cystic Fibrosis-Related Diabetes: A Cross-Sectional Study

    PubMed Central

    Van Sambeek, Lindsey; Cowley, Elise S.; Newman, Dianne K.; Kato, Roberta

    2015-01-01

    Cystic fibrosis-related diabetes affects up to half of cystic fibrosis patients and is associated with increased mortality and more frequent pulmonary exacerbations. However, it is unclear to what degree good glycemic control might mitigate these risks and clinical outcomes have not previously been studied in relation to glucose from the lower airways, the site of infection and CF disease progression. We initially hypothesized that diabetic cystic fibrosis patients with glycosylated hemoglobin (HbA1c) > 6.5% have worse pulmonary function, longer and more frequent exacerbations and also higher sputum glucose levels than patients with HbA1c ? 6.5% or cystic fibrosis patients without diabetes. To test this, we analyzed spontaneously expectorated sputum samples from 88 cystic fibrosis patients. The median sputum glucose concentration was 0.70 mM (mean, 4.75 mM; range, 0-64.6 mM). Sputum glucose was not correlated with age, sex, body mass index, diabetes diagnosis, glycemic control, exacerbation frequency or length, or pulmonary function. Surprisingly, sputum glucose was highest in subjects with normal glucose tolerance, suggesting the dynamics of glycemic control, sputum glucose and pulmonary infections are more complex than previously thought. Two-year mean HbA1c was positively correlated with the length of exacerbation admission (p < 0.01), and negatively correlated with measures of pulmonary function (p < 0.01). While total number of hospitalizations for exacerbations were not significantly different, subjects with an HbA1c > 6.5% were hospitalized on average 6 days longer than those with HbA1c ? 6.5% (p < 0.01). Current clinical care guidelines for cystic fibrosis-related diabetes target HbA1c ? 7% to limit long-term microvascular damage, but more stringent glycemic control (HbA1c ? 6.5%) may further reduce the short-term pulmonary complications. PMID:25803537

  10. Fractures are increased and bisphosphonate use decreased in individuals with insulin-dependent diabetes: a 10 year cohort study

    PubMed Central

    2014-01-01

    Background Individuals with diabetes have been found previously to be at increased risk of non-traumatic fracture. However, it is unclear if these individuals are being identified and treated for osteoporosis. Methods 7753 Canadians over 50 years of age were followed prospectively for 10 years. 606/7753 (7.8%) of had diabetes; 98 were insulin-dependent and 508 were not. Using a cox proportional hazards model, we assessed the association between diabetes status and incident non-traumatic fracture. Using logistic regression we identified factors associated with bisphosphonate use over the 10 year period of study. Results Mean (SD) age of participants was 66.7(9.4) years and 72% were female. Those with diabetes had higher BMD T-scores at baseline, with a mean (SD) femoral neck T-Score of -0.97 (1.06), compared to -1.24 (0.99) in the general cohort. The adjusted hazard ratio (HR) for incident non-traumatic fracture in individuals with insulin-dependent diabetes over the 10 year study period was 2.50 (95% confidence interval [CI] 1.60, 3.90; p?diabetes (insulin-dependent or non-insulin-dependent) were less likely to be on bisphosphonate therapy at any point over 10 years of prospective follow up compared to other CaMos subjects (odds ratio [OR]: 0.59; 95% CI 0.46-0.75, p?diabetes, we that found individuals with diabetes are less likely to be treated with a bisphosphonate than those without diabetes. These findings point to a possible care gap in the treatment of non-traumatic fractures in individuals with diabetes in Canada. PMID:24919660

  11. History of Medically Treated Diabetes and Risk of Alzheimer Disease in a Nationwide Case-Control Study

    PubMed Central

    Tolppanen, Anna-Maija; Lavikainen, Piia; Solomon, Alina; Kivipelto, Miia; Uusitupa, Matti; Soininen, Hilkka; Hartikainen, Sirpa

    2013-01-01

    OBJECTIVE Type 2 diabetes in midlife or late life increases the risk of Alzheimer disease (AD), and type 1 diabetes has been associated with a higher risk of detrimental cognitive outcomes, although studies from older adults are lacking. We investigated whether individuals with AD were more likely to have a history of diabetes than matched controls from the general aged population. RESEARCH DESIGN AND METHODS Information on reimbursed diabetes medication (including both type 1 and 2 diabetes) of all Finnish individuals with reimbursed AD medication in 2005 (n = 28,093) and their AD-free control subjects during 1972–2005 was obtained from a special reimbursement register maintained by the Social Insurance Institute of Finland. RESULTS The prevalence of diabetes was 11.4% in the whole study population, 10.7% (n = 3,012) among control subjects, and 12.0% (n = 3,372) among AD case subjects. People with AD were more likely to have diabetes than matched control subjects (unadjusted OR 1.14 [95% CI 1.08–1.20]), even after adjusting for cardiovascular diseases (OR 1.31 [1.22–1.41]). The associations were stronger with diabetes diagnosed at midlife (adjusted OR 1.60 [1.34–1.84] and 1.25 [1.16–1.36] for midlife and late-life diabetes, respectively). CONCLUSIONS Individuals with clinically verified AD are more likely to have a history of clinically verified and medically treated diabetes than the general aged population, although the difference is small. PMID:23340883

  12. Randomized study of glibenclamide versus traditional Chinese treatment in type 2 diabetic patients. Chinese-French Scientific Committee for the Study of Diabetes.

    PubMed

    Vray, M; Attali, J R

    1995-12-01

    The purpose of this study was to evaluate the efficacy of a traditional Chinese treatment (TCT) based on three plants in association with a sulfonylurea, glibenclamide (2.5 mg X 3/d). A 2 X 2 factorial design was adopted for this multicentre randomized double-blind trial involving 4 groups [A = placebo (P) TCT + P glibenclamide; B = P TCT + verum glibenclamide; C = verum TCT + P glibenclamide; D = verum TCT + verum glibenclamide]. Patients included were type 2 diabetic outpatients, 40-70 years of age, treated by diet alone or oral anti-diabetic drugs. Endpoint criteria evaluated were HbA1, blood glucose and plasma insulin (at fasting, and 1 and 2 h after a test meal). At each visit, a clinical examination was performed, and a questionnaire on side effects and associated symptoms was completed. The dose was reduced by half in the case of hypoglycaemia. The 216 patients were recruited in 5 centres [Shanghai (1) = 48, Shanghai (2) = 40, Beijing = 40, Canton = 42, Chengdu = 46 and randomized into treatment groups A, B, C, D (56, 56, 50 and 54 respectively). Eleven patients were withdrawn for administrative reasons. In patients treated with glibenclamide, a significant increase in weight and insulinaemia was observed, together with a significant decrease in blood glucose values; in those receiving TCT, blood glucose values were significantly decreased only 2 h after the test meal. A synergistic effect on blood glucose was observed when both treatments were given. Hypoglycaemia occurred in 19 patients (all in the two verum glibenclamide groups). This first multicentre controlled trial showed that the 3 Chinese plants tested were well-tolerated and effective in Type 2 diabetes as indicated by a significant synergistic effect in association with a sulfonylurea. PMID:8593925

  13. Comparison of Optomap ultrawide-field imaging versus slit-lamp biomicroscopy for assessment of diabetic retinopathy in a real-life clinic

    PubMed Central

    Purbrick, Robert M J; Izadi, Shahrnaz; Gupta, Ankur; Chong, N Victor

    2014-01-01

    Purpose We aimed to assess the agreement between clinical assessment of diabetic retinopathy and Optomap ultrawide-field imaging (UWFI) in a real-life clinic setting. Methods Structured examination findings, from diabetic patients attending routine medical retina clinics in July 2011, were retrospectively compared with the grade obtained from Optomap UWFI images, graded independently by two ophthalmologists, taken at the same visit. Results A total of 84 eyes (42 patients) were examined, and 74 eyes (37 patients) were suitable for analysis. The hospital Eye Service slit-lamp biomicroscopy grades for retinopathy were: no diabetic retinopathy in zero eyes; background retinopathy in 21 eyes; preproliferative retinopathy in 34 eyes; and proliferative retinopathy in 19 eyes. For retinopathy, the agreement between the Optomap UWFI and clinical grading was moderate for both graders (?=0.57 and ?=0.63), and there was almost perfect agreement between the two graders (?=0.92). The clinical grades for the presence of photocoagulation scars were: no photocoagulation scars in 46 eyes and photocoagulation scars visible in 28 eyes, indicating substantial agreement between the Optomap UWFI and clinical grading for both graders (?=0.73 and ?=0.64). There were two instances where proliferative retinopathy was documented clinically but graded as preproliferative by both graders of Optomap UWFI. These were investigated, and neither patient required treatment, ie, the difference in retinopathy grade would not have affected the patient outcomes. Conclusion This study demonstrated moderate agreement between Optomap UWFI and hospital slit-lamp biomicroscopy grading of patients’ retinopathy in a real-life medical retina clinic setting. The authors believe that Optomap UWFI is, not only a very useful adjunct to clinical examination in terms of detection and recording of retinopathy, but also, could have a role in standalone “virtual” clinics. PMID:25114501

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

    Microsoft Academic Search

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

    2006-01-01

    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

  15. The study of hypoglycemic effects of the Morus alba L. leave extract and histology of the pancreatic islet cells in diabetic and normal rats

    Microsoft Academic Search

    Suphaket Saenthaweesuk; Amornnat Thuppia; Pornrut Rabintossaporn; Kornkanok Ingkaninan; Seewaboon Sireeratawong

    The objectives of this study were to evaluate the hypoglycemic effects and histological changes of pancreatic islets after receiving Morus alba leave extract in normal and diabetic rats. Diabetes was induced by injection of streptozotocin (STZ, 45 mg\\/kg) intraperitoneally. All diabetic rats were divided into 5 groups, each of which was orally received one of the following; vehicle, glibenclamide and

  16. Using Rasch Measurement To Investigate the Cross-form Equivalence and Clinical Utility of Spanish and English Versions of a Diabetes Questionnaire: A Pilot Study.

    ERIC Educational Resources Information Center

    Gerber, Ben; Smith, Everett V., Jr.; Girotti, Mariela; Pelaez, Lourdes; Lawless, Kimberly; Smolin, Louanne; Brodsky, Irwin; Eiser, Arnold

    2002-01-01

    Used Rasch measurement to study the psychometric properties of data obtained from a newly developed Diabetes Questionnaire designed to measure diabetes knowledge, attitudes, and self-care. Responses of 26 diabetes patients to the English version of the questionnaire and 24 patients to the Spanish version support the cross-form equivalence and…

  17. The First Signs of  Cell Autoimmunity Appear in Infancy in Genetically Susceptible Children from the General Population: The Finnish Type 1 Diabetes Prediction and Prevention Study

    Microsoft Academic Search

    T. Kimpimaki; A. KUPILA; A.-M. HAMALAINEN; M. KUKKO; P. KULMALA; K. SAVOLA; T. SIMELL

    2001-01-01

    Little is known about the timing of the etiological events and the preclinical process of type 1 diabetes during the first years of life in the general population. In this popula- tion-based prospective birth cohort study, the appearance of diabetes-associated autoantibodies as a sign of -cell au- toimmunity and the development of type 1 diabetes were monitored from birth. Of

  18. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy

    Microsoft Academic Search

    Hertzel C Gerstein

    Summary Background Diabetes mellitus is a strong risk factor for cardiovascular and renal disease. We investigated whether the angiotensin-converting-enzyme (ACE) inhibitor ramipril can lower these risks in patients with diabetes. Methods 3577 people with diabetes included in the Heart Outcomes Prevention Evaluation study, aged 55 years or older, who had a previous cardiovascular event or at least one other cardiovascular

  19. 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

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

    2012-01-01

    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…

  20. Renal glucose excretion as a function of blood glucose concentration in subjects with type 2 diabetes—results of a hyperglycaemic glucose clamp study

    Microsoft Academic Search

    Klaus Rave; Leszek Nosek; John Posner; Tim Heise; Kerstin Roggen; Ewoud-Jan van Hoogdalem

    Background. The purpose of this study was to investi- gate renal glucose excretion as a function of blood glucose concentration and to evaluate the within- subject variability and between-subject variability in subjects with type 2 diabetes. Methods. Twenty-two subjects with type 2 diabetes (age 58 (12) years, diabetes duration 7 (6) years, endogenous creatinine clearance 117 (38) ml min? 1

  1. Estudio bacteriológico de pacientes con pie diabético infectado en el Hospital Arzobispo Loayza Bacteriologic study of diabetic foot infected at Arzobispo Loayza Hospital

    Microsoft Academic Search

    Federico Elguera Falcón; José Solís Villanueva; Luis Neyra Arizmendiz

    Objectives: To determine the frequency of diabetic foot's infections and the antibiotic sensibility at Arzobispo Loayza Hospital. Methods: A descriptive study on diabetic foot was carried out at Arzobispo Loayza Hospital. Aerobic bacteria were isolated and the Kirby-Bauer method was used. Results: 95 diabetic patients had infected ulcerations in lower limb. 132 bacteria were isolated. Gram positive aerobic bacteria predominated

  2. Relationship between Carotid Intima-Media Thickness and Left Ventricular Mass in Type 1 Diabetes: results from the Epidemiology of Diabetes Interventions and Complications (EDIC) Study

    PubMed Central

    Chahal, Harjit; Backlund, Jye-Yu C.; Cleary, Patricia A.; Lachin, John M.; Polak, Joseph; Lima, Joao A.C.; Bluemke, David A.

    2012-01-01

    Introduction Type 1 diabetes mellitus is associated with early atherosclerosis and enhanced cardiovascular mortality. The relationship between carotid IMT (cIMT), a marker of subclinical atherosclerosis and left ventricular (LV) mass, an independent predictor of cardiovascular morbidity has not been previously studied in type 1 diabetics. Methods The Epidemiology of Diabetes Interventions and Complications (EDIC) study is a multicenter observational study designed to follow up the Diabetes Control and Complications Trial (DCCT) cohort. LV mass was measured with cardiac MRI at EDIC year 15 and common cIMT was assessed using B-mode ultrasound at EDIC year 12. Multivariable linear regression models were used to assess the relationship between cIMT at year 12 and LV mass at year 15. Results A total of 889 participants had both cardiac MRI and cIMT measures available for these analyses. At EDIC year 15, the mean age of the participants was 49 (±7) years; mean diabetes duration was 28 (±5) years and 52% were males. Spearman correlation coefficient (r) between LV mass and cIMT was 0.33 (p<0.0001). After adjusting for basic covariates (machine, reader, age and gender), a significant association between LV mass and cIMT (estimate 2.0 g/m2 per 0.1 mm cIMT increment, p < 0.0001) was observed. This association was diminished by the addition of systolic blood pressure in particular 1.15 g/m2 per 0.1 mm cIMT increment, p<0.0001) and to a lessor extent other cardiovascular disease (CVD) risk factors. The relationship observed between LV mass and cIMT was stronger (HOW MUCH) in patients with shorter diabetes duration. Conclusion In a well characterized population with type 1 diabetes, cIMT was an independent predictor of higher LV mass. These findings suggest a common pathway, possibly mediated by blood pressure dependent mechanisms, for vascular and myocardial structural change in T1DM. PMID:22884107

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

    PubMed Central

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

    2013-01-01

    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

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

    PubMed Central

    2014-01-01

    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

  5. One Hour versus Two Hours Postprandial Glucose Measurement in Gestational Diabetes: A Prospective Study

    Microsoft Academic Search

    Boaz Weisz; Alon Shrim; Carol J Homko; Eyal Schiff; Gil S Epstein; Eyal Sivan

    2005-01-01

    OBJECTIVE:To compare the rate of adverse perinatal outcomes among women with gestational diabetes mellitus (GDM), monitored by 1 versus 2 hour-postprandial glucose (PPG) measurements.METHODS:A total of 112 women diagnosed with GDM, by the criteria of Carpenter–Coustan, were included in the study population. Women were recruited from two different treatment settings, but were managed by the same team of health-care professionals

  6. A genome-wide association study identifies KIAA0350 as a type 1 diabetes gene

    Microsoft Academic Search

    Hakon Hakonarson; Struan F. A. Grant; Jonathan P. Bradfield; Luc Marchand; Cecilia E. Kim; Joseph T. Glessner; Rosemarie Grabs; Tracy Casalunovo; Shayne P. Taback; Edward C. Frackelton; Margaret L. Lawson; Luke J. Robinson; Robert Skraban; Yang Lu; Rosetta M. Chiavacci; Charles A. Stanley; Susan E. Kirsch; Eric F. Rappaport; Jordan S. Orange; Dimitri S. Monos; Marcella Devoto; Hui-Qi Qu; Constantin Polychronakos

    2007-01-01

    Type 1 diabetes (T1D) in children results from autoimmune destruction of pancreatic beta cells, leading to insufficient production of insulin. A number of genetic determinants of T1D have already been established through candidate gene studies, primarily within the major histocompatibility complex but also within other loci. To identify new genetic factors that increase the risk of T1D, we performed a

  7. Potential hippocampal region atrophy in diabetes mellitus type 2: a voxel-based morphometry VSRAD study

    Microsoft Academic Search

    Kazutoshi Kamiyama; Akihiko Wada; Masaki Sugihara; Souichi Kurioka; Kumi Hayashi; Takafumi Hayashi; Takeshi Yoshisako; Nobuko Yamamoto; Youji Tsuchie; Syuhei Yamaguchi; Toshitsugu Sugimoto; Hajime Kitagaki

    2010-01-01

    Purpose  Among diabetes mellitus type 2 (DM2) patients, the frequency of cognitive dysfunction is higher and the relative risk of Alzheimer’s\\u000a disease (AD) is approximately twice that of nondiabetics. Cognitive impairment symptoms of AD are induced by limbic system\\u000a dysfunction, and an early-stage AD brain without dementia has the potential for atrophy in the hippocampal region. In this\\u000a study, we estimated

  8. Longitudinal studies on the development of diabetes in individual Macaca nigra

    Microsoft Academic Search

    Charles F. Howard

    1986-01-01

    Summary  Development of spontaneous diabetes has been monitored in individual Macaca nigra. In this study, pancreatic biopsies were taken, islets were assessed morphologically, and results were related to the metabolic\\/clinical status. A biopsy or autopsy sample was obtained 4 to 10 years later, and the islet morphological state was again related to the metabolic\\/clinical status. Metabolic deterioration was correlated to the

  9. The risk of myocardial infarction in rheumatoid arthritis and diabetes mellitus: a Danish nationwide cohort study

    Microsoft Academic Search

    Jesper Lindhardsen; Ole Ahlehoff; Gunnar Hilmar Gislason; Ole Rintek Madsen; Jonas Bjerring Olesen; Christian Torp-Pedersen; Peter Riis Hansen

    2011-01-01

    ObjectivesTo examine in a nationwide cohort whether the risk of myocardial infarction (MI) in patients with rheumatoid arthritis (RA) is comparable to the risk in patients with diabetes mellitus (DM).MethodsThe study included the entire Danish population followed from 1 January 1997 until 31 December 2006. Through individual level-linkage of nationwide administrative registers, the authors identified subjects who developed RA and

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

    E-print Network

    Mann, Eleanor; Kellar, Ian; Sutton, Stephen; Kinmonth, Ann Louise; Hankins, Matthew; Griffin, Simon J; Marteau, Theresa M

    2010-12-17

    ’ contributions EM conducted statistical analysis and drafted the manuscript; IK is the study coordinator; MH provided statistical analysis support; TMM, ALK, SG and SS are Principal Investigators; TMM is the paper guarantor. All authors read and approved... health imperative or matter for informed choice. British Medical Journal 2002, 325:78-80. 8. Norris S, Kansagara D, Bougatsos C, Fu R: Screening adults for type 2 diabetes: a review of the evidence for the US Preventive Services Task Force. Annals...

  11. Noninvasive blood glucose monitoring using the optical signal of pulsatile microcirculation: a pilot study in subjects with diabetes

    Microsoft Academic Search

    Chung-Sen Chen; Kuang-Kuo Wang; Ming-Yie Jan; Wei-Chen Hsu; Sai-Ping Li; Yuh-Ying Wang-Lin; Jian-Guo Bau

    2008-01-01

    ObjectiveThe objective of this study was to determine the conditions for optimizing measurements obtained with a noninvasive blood glucose monitor using the optical signal of pulsatile microcirculation (OSPM) in both prediabetic and diabetic subjects receiving medication.

  12. 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

    Klas Malmberg; Anna Norhammar; Hans Wedel; Lars Ryden

    2010-01-01

    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,

  13. Serum Resistin and Kidney Function: A Family-Based Study in Non-Diabetic, Untreated Individuals

    PubMed Central

    Menzaghi, Claudia; Salvemini, Lucia; Fini, Grazia; Thompson, Ryan; Mangiacotti, Davide; Di Paola, Rosa; Morini, Eleonora; Giorelli, Maddalena; De Bonis, Concetta; De Cosmo, Salvatore; Doria, Alessandro; Trischitta, Vincenzo

    2012-01-01

    Background High serum resistin levels have been associated with kidney dysfunction. Most of these studies have been carried out in individuals with severe kidney impairment, diabetes, cardiovascular disease and related treatments. Thus, the observed association might have been influenced by these confounders. Our aim was to study the relationship between serum resistin, urinary albumin/creatinine ratio (ACR) and glomerular filtration rate (GFR) in a family-based sample, the Gargano Family Study (GFS) of 635 non diabetic, untreated Whites. Methods A linear mixed effects model and bivariate analyses were used to evaluate the phenotypic and genetic relations between serum resistin and both ACR and eGFR. All analyses were adjusted for sex, age, age squared, BMI, systolic blood pressure, smoking habits and physical exercise. Results After adjustments, resistin levels were slightly positively associated with ACR (?±SE?=?0.049±0.023, p?=?0.035) and inversely related to eGFR (?±SE?=??1.43±0.61, p?=?0.018) levels. These associations remained significant when either eGFR or ACR were, reciprocally, added as covariates. A genetic correlation (?g?=??0.31±0.12; adjusted p?=?0.013) was observed between resistin and eGFR (but not ACR) levels. Conclusion Serum resistin levels are independently associated with ACR and eGFR in untreated non-diabetic individuals. Serum resistin and eGFR share also some common genetic background. Our data strongly suggest that resistin plays a role in modulating kidney function. PMID:22701635

  14. Comparative study of Vamana and Virechanakarma in controlling blood sugar levels in diabetes mellitus

    PubMed Central

    Jindal, Nitin; Joshi, Nayan P.

    2013-01-01

    Diabetes mellitus (DM) with its devastating consequences is a global health problem of this era. Presently India is having the largest diabetic population of 50.8 million. The characteristic features of DM have close resemblance with Prameha (obstinate urinary disorders including diabetes) in Ayurveda. Madhumeha is a Vatika subtype of Prameha that is most close to DM. One variety of this Madhumeha (DM) is Aavaranjanya (due to occlusion) in which Vayu aggravates due to occlusion by Pitta or Kapha. This type of Madhumeha (DM) can be managed if Samshodhana (bio-cleansing) is used in early stages of disease followed by palliative treatment. Vamana (emetic therapy) and Virechana (purgation therapy) are the Samsodhana Karma (bio-cleansing therapies) that are compatible to overcome this Aavarana (occlusion). A comparative study was planned to compare their efficacy in controlling blood sugar levels in patients with DM. Although none of them were completely able to control blood sugar in the long-term but the study yields some very interesting results in reducing the blood sugar levels which could be useful in the future studies related to DM. PMID:24501520

  15. Correlation between Plantar Foot Temperature and Diabetic Neuropathy: A Case Study by Using an Infrared Thermal Imaging Technique

    PubMed Central

    Bagavathiappan, Subramnaiam; Philip, John; Jayakumar, Tammana; Raj, Baldev; Rao, Pallela Narayana Someshwar; Varalakshmi, Muthukrishnan; Mohan, Viswanathan

    2010-01-01

    Background Diabetic neuropathy consists of multiple clinical manifestations of which loss of sensation is most prominent. High temperatures under the foot coupled with reduced or complete loss of sensation can predispose the patient to foot ulceration. The aim of this study was to look at the correlation between plantar foot temperature and diabetic neuropathy using a noninvasive infrared thermal imaging technique. Methods Infrared thermal imaging, a remote and noncontact experimental tool, was used to study the plantar foot temperatures of 112 subjects with type 2 diabetes selected from a tertiary diabetes centre in South India. Results Patients with diabetic neuropathy (defined as vibration perception threshold (VPT) values on biothesiometry greater than 20 V) had a higher foot temperature (32–35 °C) compared to patients without neuropathy (27–30 °C). Diabetic subjects with neuropathy also had higher mean foot temperature (MFT) (p = .001) compared to non-neuropathic subjects. MFT also showed a positive correlation with right great toe (r = 0.301, p = .001) and left great toe VPT values (r = 0.292, p = .002). However, there was no correlation between glycated hemoglobin and MFT. Conclusion Infrared thermal imaging may be used as an additional tool for evaluation of high risk diabetic feet. PMID:21129334

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

    PubMed Central

    Kumar, Senthil

    2014-01-01

    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

  17. The clinical implications of recent studies on the structure and function of the retinal microvasculature in diabetes.

    PubMed

    Cheung, Carol Yimlui; Ikram, M Kamran; Klein, Ronald; Wong, Tien Yin

    2015-05-01

    The retinal blood vessels provide the opportunity to study early structural and functional changes in the microvasculature prior to clinically significant microvascular and macrovascular complications of diabetes. Advances in digital retinal photography and computerised assessment of the retinal vasculature have provided more objective and precise measurements of retinal vascular changes. Clinic- and population-based studies have reported that these quantitatively measured retinal vascular changes (e.g. retinal arteriolar narrowing and venular widening) are associated with preclinical structural changes in other microvascular systems (e.g. infarct in the cerebral microcirculation), as well as diabetes and diabetic complications, suggesting that they are markers of early microvascular dysfunction. In addition, there are new retinal imaging techniques to further assess alterations in retinal vascular function (e.g. flicker-induced vasodilatory response, blood flow and oxygen saturation) in diabetes and complications that result from the effects of chronic hyperglycaemia, inflammation and endothelial dysfunction. In this review, we summarise the latest findings on the relationships between quantitatively measured structural and functional retinal vascular changes with diabetes and diabetic complications. We also discuss clinical implications and future research to evaluate whether detection of retinal vascular changes has additional value beyond that achieved with methods currently used to stratify the risk of diabetes and its complications. PMID:25669631

  18. The burden of physical activity on type 2 diabetes public healthcare expenditures among adults: a retrospective study

    PubMed Central

    2011-01-01

    Background Determinants of public healthcare expenditures in type 2 diabetics are not well investigated in developing nations and, therefore, it is not clear if higher physical activity decreases healthcare costs. The purpose of this study was to analyze the relationship between physical activity and the expenditures in public healthcare on type 2 diabetes mellitus treatment. Methods Cross-sectional study carried out in Brazil. A total of 121 type 2 diabetics attended to in two Basic Healthcare Units were evaluated. Public healthcare expenditures in the last year were estimated using a specific standard table. Also evaluated were: socio-demographic variables; chronological age; exogenous insulin use; smoking habits; fasting glucose test; diabetic neuropathy and anthropometric measures. Habitual physical activity was assessed by questionnaire. Results Age (r = 0.20; p = 0.023), body mass index (r = 0.33; p = 0.001) and waist-to-hip ratio (r = 0.20; p = 0.025) were positively related to expenditures on medication for the treatment of diseases other than diabetes. Insulin use was associated with increased expenditures. Higher physical activity was associated with lower expenditure, provided medication for treatment of diseases other than diabetes (OR = 0.19; p = 0.007) and medical consultations (OR = 0.26; p = 0.029). Conclusions Type 2 diabetics with higher enrollment in physical activity presented consistently lower healthcare expenditures for the public healthcare system. PMID:21542924

  19. Dietary education must fit into everyday life: a qualitative study of people with a Pakistani background and type 2 diabetes

    PubMed Central

    Hempler, Nana F; Nicic, Sara; Ewers, Bettina; Willaing, Ingrid

    2015-01-01

    Background The high prevalence of diabetes among South Asian populations in European countries partially derives from unhealthy changes in dietary patterns. Limited studies address perspectives of South Asian populations with respect to utility of diabetes education in everyday life. This study explores perspectives on dietary diabetes education and healthy food choices of people living in Denmark who have a Pakistani background and type 2 diabetes. Methods In-depth interviews were conducted between October 2012 and December 2013 with 12 participants with type 2 diabetes who had received dietary diabetes education. Data analysis was systematic and was based on grounded theory principles. Results Participants described the process of integrating and utilizing dietary education in everyday life as challenging. Perceived barriers of the integration and utilization included a lack of a connection between the content of the education and life conditions, a lack of support from their social networks for dietary change, difficulty integrating the education into everyday life, and failure to include the participants’ taste preferences in the educational setting. Conclusion Dietary education that is sensitive to the attitudes, wishes, and preferences of the participants and that aims at establishing a connection to the everyday life of the participants might facilitate successful changes in dietary practices among people with a Pakistani background and type 2 diabetes. The findings suggest that more focus should be placed on collaborative processes in the dietary educational setting in order to achieve appropriate education and to improve communication between this population and health care professionals.

  20. Comparison of shoe-length fit between people with and without diabetic peripheral neuropathy: a case–control study

    PubMed Central

    2012-01-01

    Background Amongst the many identified mechanisms leading to diabetic foot ulceration, ill-fitting footwear is one. There is anecdotal evidence that people with diabetic peripheral neuropathy wear shoes that are too small in order to increase the sensation of fit. The aim of this study was to determine whether people with diabetic sensory neuropathy wear appropriate length footwear. Methods A case–control design was used to compare internal shoe length and foot length differences between a group of people with diabetes and peripheral sensory neuropathy and a group of people without diabetes and no peripheral sensory neuropathy. Shoe and foot length measurements were taken using a calibrated Internal Shoe Size Gauge® and a Brannock Device®, respectively. Results Data was collected from 85 participants with diabetes and 118 participants without diabetes. The mean difference between shoe and foot length was not significantly different between the two groups. However, a significant number of participants within both groups had a shoe to foot length difference that lay outside a previously suggested 10 to 15?mm range. From the diabetic and non-diabetic groups 82% (70/85) and 66% (78/118), respectively had a foot to shoe length difference outside this same range. Conclusions This study shows that although there is no significant difference in shoe-length fit between participants with and without neuropathy, a significant proportion of these populations wear shoes that are either too long or too short for their foot length according to the 10 to 15?mm value used for comparison. The study has highlighted the need for standardised approaches when considering the allowance required between foot and internal shoe length and for the measurement and comparison of foot and shoe dimensions. PMID:22507446

  1. Studying fringe field effect of a field emitter array

    NASA Astrophysics Data System (ADS)

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

    2014-10-01

    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.

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

    Microsoft Academic Search

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

    2000-01-01

    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

  3. Relationship between risk factors and mortality in type 1 diabetic patients in Europe : the EURODIAB Prospective Complications Study (PCS)

    Microsoft Academic Search

    S. S. Soedamah-Muthu; N. Chaturvedi; D. R. Witte; L. K. Stevens; M. Porta; J. H. Fuller

    2008-01-01

    OBJECTIVE—The purpose of this study was to examine risk factors for mortality in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS—Baseline risk factors were measured in the EURODIAB Prospective Cohort Study with 2,787 type 1 diabetic patients (51% men and 49% women) recruited from 16 European countries. Mortality data were collected during a 7-year follow-up. RESULTS—There was an annual

  4. Remodelling of the intracardiac ganglia in diabetic Goto-Kakizaki rats: an anatomical study

    PubMed Central

    2013-01-01

    Background Although cardiac autonomic neuropathy is one of major complications of diabetes mellitus (DM), anatomical data on cardiac innervation of diabetic animal models is scant and controversial. We performed this study to check whether long-term diabetic state impacts the anatomy of intracardiac ganglia in Goto-Kakizaki (GK) rats, a genetic model of type 2 DM. Methods Twelve GK rats (276?±?17 days of age; mean?±?standard error) and 13 metabolically healthy Wistar rats (262?±?5 days of age) as controls were used for this study. Blood glucose was determined using test strips, plasma insulin by radioimmunoassay. Intrinsic ganglia and nerves were visualized by acetylcholinesterase histochemistry on whole hearts. Ganglion area was measured, and the neuronal number was assessed according to ganglion area. Results The GK rats had significantly elevated blood glucose level compared to controls (11.0?±?0.6 vs. 5.9?±?0.1 mmol/l, p?study demonstrate the decreased number of intracardiac neurons in GK rats compared to metabolically healthy Wistar rats of similar age. It is likely that the observed structural remodelling of intracardiac ganglia in GK rats is caused by a long-term diabetic state. PMID:23758627

  5. Genetic risk score associations with cardiovascular disease and mortality in the Diabetes Heart Study.

    PubMed

    Cox, Amanda J; Hsu, Fang-Chi; Ng, Maggie C Y; Langefeld, Carl D; Freedman, Barry I; Carr, J Jeffrey; Bowden, Donald W

    2014-04-01

    OBJECTIVE Given the high rates of cardiovascular disease (CVD) and associated mortality in individuals with type 2 diabetes, identifying and understanding predictors of CVD events and mortality could help inform clinical management in this high-risk group. Recent large-scale genetic studies may provide additional tools in this regard. RESEARCH DESIGN AND METHODS Genetic risk scores (GRSs) were constructed in 1,175 self-identified European American (EA) individuals comprising the family-based Diabetes Heart Study based on 1) 13 single nucleotide polymorphisms (SNPs) and 2) 30 SNPs with previously documented associations with CVD in genome-wide association studies. Associations between each GRS and a self-reported history of CVD, coronary artery calcified plaque (CAC) determined by noncontrast computed tomography scan, all-cause mortality, and CVD mortality were examined using marginal models with generalized estimating equations and Cox proportional hazards models. RESULTS The weighted 13-SNP GRS was associated with prior CVD (odds ratio [OR] 1.51 [95% CI 1.22-1.86]; P = 0.0002), CAC (?-coefficient [?] 0.22 [0.02-0.43]; P = 0.04) and CVD mortality (hazard ratio [HR] 1.35 [1.10-1.81]; P = 0.04) when adjusting for the other known CVD risk factors: age, sex, type 2 diabetes affection status, BMI, current smoking status, hypertension, and dyslipidemia. The weighted 30-SNP GRS was also associated with prior CVD (OR 1.33 [1.08-1.65]; P = 0.008), CAC (? 0.29 [0.08-0.50]; P = 0.006), all-cause mortality (HR 1.28 [1.05-1.56]; P = 0.01), and CVD mortality (HR 1.46 [1.08-1.96]; P = 0.01). CONCLUSIONS These findings support the utility of two simple GRSs in examining genetic associations for adverse outcomes in EAs with type 2 diabetes. PMID:24574349

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

    Microsoft Academic Search

    S E Manley; D R Matthews

    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)

  7. Diabetes treatment patterns and goal achievement in primary diabetes care (DiaRegis) - study protocol and patient characteristics at baseline

    Microsoft Academic Search

    Peter Bramlage; Christiane Binz; Anselm K Gitt; Michael Krekler; Tanja Plate; Evelin Deeg; Diethelm Tschöpe

    2010-01-01

    BACKGROUND: Patients with type 2 diabetes are at an increased risk for disease and treatment related complications after the initial approach of oral mono\\/dual antidiabetic therapy has failed. Data from clinical practice with respect to this patient group are however scarce. Therefore we set up a registry in primary care documenting the course and outcomes of this patient group. METHODS:

  8. Studies in small field inflation

    SciTech Connect

    Dine, Michael; Pack, Lawrence, E-mail: mdine@ucsc.edu, E-mail: larrypack@gmail.com [Physics Department and Santa Cruz Institute for Particle Physics, University of California, 1156 High Street, Santa Cruz, CA 95064 (United States)

    2012-06-01

    We explore some issues in slow roll inflation in situations where field excursions are small compared to M{sub p}. We argue that for small field inflation, minimizing fine tuning requires low energy supersymmetry and a tightly constrained structure. Hybrid inflation is almost an inevitable outcome. The resulting theory can be described in terms of a supersymmetric low energy effective action and inflation completely characterized in terms of a small number of parameters. Demanding slow roll inflation significantly constrains these parameters. In this context, the generic level of fine tuning can be described as a function of the number of light fields, there is an upper bound on the scale of inflation, and an (almost) universal prediction for the spectral index. Models of this type need not suffer from a cosmological moduli problem.

  9. Insulin Use and Risk of Diabetic Macular Edema in Diabetes Mellitus: A Systemic Review and Meta-Analysis of Observational Studies

    PubMed Central

    Zhang, Jun; Ma, Jingxue; Zhou, Nalei; Zhang, Bin; An, Jianbin

    2015-01-01

    Background Diabetes mellitus is a common and serious disorder. A search of the literature reveals no comprehensive quantitative assessment of the association between insulin use and incidence of diabetic macular edema. Therefore, we performed a meta-analysis of observational studies to evaluate the effect of insulin use on the risk of developing macular edema. Material/Methods Comparative studies published until May 2014 were searched through a comprehensive search of the Medline, Embase, and the Cochrane Library electronic databases. A systematic review and quantitative analysis of comparative studies reporting the effect of insulin use on the incidence of macular edema was performed. All analyses were performed using the Review Manager (RevMan) v.5 (Nordic Cochrane Centre, Copenhagen, Denmark). Results A total of 202 905 individuals were included in the present meta-analysis. In a random-effects meta-analysis, the use of insulin was found to be associated with increased risk of macular edema (RR, 3.416; 95% CI, 2.417–4.829; I2, 86.6%). Analysis that just included high-quality studies showed that insulin use increased the risk of macular edema (RR, 2.728; 95% CI, 1.881–3.955; I2=77.7%). In cohort studies (RR, 4.509; 95% CI, 3.100–6.559; I2, 77.7%) but not in case-control studies (RR, 1.455; 95% CI, 0.520 to 4.066; I2, 95.9%), increased incidence of macular edema was observed. Conclusions The results of this meta-analysis of observational studies demonstrate that insulin use is a risk factor for diabetic macular edema. However, available data are still sparse, and in-depth analyses of the assessed associations in the context of additional longitudinal studies are highly desirable to enable more precise estimates and a better understanding of the role of insulin use in incidence of diabetic macular edema. PMID:25816765

  10. Microalbuminuria Reduction with Telmisartan in Normotensive and Hypertensive Japanese Patients with Type 2 Diabetes: A Post-Hoc Analysis of the Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) Study

    Microsoft Academic Search

    Hirofumi Makino; Masakazu Haneda; Tetsuya Babazono; Tatsumi Moriya; Sadayoshi Ito; Yasuhiko Iwamoto; Ryuzo Kawamori; Masahiro Takeuchi; Shigehiro Katayama

    2008-01-01

    The Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) study previously showed that treatment with telmisartan, an angiotensin II receptor blocker, effectively reduced the transition from incipient to overt nephropathy in Japanese type 2 diabetic patients. However, that large study included both normotensive and hypertensive patients. In the present post hoc analysis, we aimed

  11. Investigating parent of origin effects in studies of Type 2 Diabetes and Obesity

    PubMed Central

    Rampersaud, Evadnie; Mitchell, Braxton D.; Naj, Adam C.; Pollin, Toni I.

    2010-01-01

    The role of parent-of-origin effects (POE) in the etiology of complex diseases such as type 2 diabetes (T2DM) and obesity is currently of intense interest, but still largely unclear. POE are transmittable genetic effects whereby the expression of the phenotype in the offspring depends upon whether the transmission originated from the mother or father. In mammals, POE can be caused by genetic imprinting, intrauterine effects, or maternally inherited mitochondrial genes. In this paper, we describe the different mechanisms underlying POE, characterize known examples of POE in rare forms of diabetes, and review the evidence from linkage and association studies for POE in T2DM and obesity. Finally, we summarize some of the new and established statistical and experimental approaches commonly used to detect POE. Through this paper, we hope emphasizes the potentially significant importance of POE in the etiology of T2DM and obesity. PMID:18991601

  12. An update on the use of NOD mice to study autoimmune (Type 1) diabetes

    PubMed Central

    Chaparro, Rodolfo José; DiLorenzo, Teresa P

    2011-01-01

    The widely used nonobese diabetic (NOD) mouse model of autoimmune (Type 1) diabetes mellitus shares multiple characteristics with the human disease, and studies employing this model continue to yield clinically relevant and important information. Here, we review some of the recent key findings obtained from NOD mouse investigations that have both advanced our understanding of disease pathogenesis and suggested new therapeutic targets and approaches. Areas discussed include antigen discovery, identification of genes and pathways contributing to disease susceptibility, development of strategies to image islet inflammation and the testing of therapeutics. We also review recent technical advances that, combined with an improved understanding of the NOD mouse model’s limitations, should work to ensure its popularity, utility and relevance in the years ahead. PMID:20979558

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

    2013-01-01

    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

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

    PubMed Central

    2013-01-01

    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

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

    PubMed Central

    Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah

    2014-01-01

    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

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

    PubMed Central

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

    2012-01-01

    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

  19. Cohort Study of Pioglitazone and Cancer Incidence in Patients With Diabetes

    PubMed Central

    Ferrara, Assiamira; Lewis, James D.; Quesenberry, Charles P.; Peng, Tiffany; Strom, Brian L.; Van Den Eeden, Stephen K.; Ehrlich, Samantha F.; Habel, Laurel A.

    2011-01-01

    OBJECTIVE To explore whether treatment with pioglitazone was associated with risk of incident cancer at the 10 most common sites (prostate, female breast, lung/bronchus, endometrial, colon, non-Hodgkin lymphoma [NHL], pancreas, kidney/renal pelvis, rectal, and melanoma). RESEARCH DESIGN AND METHODS A cohort study of 252,467 patients aged ?40 years from the Kaiser Permanente Northern California Diabetes Registry was conducted. All prescriptions for diabetes medications were identified by pharmacy records. Cox proportional hazards models were used to examine the association between risk of incident cancer and ever use, duration, dose, and time since initiation of pioglitazone (modeled as time-dependent variables). RESULTS In models adjusted for age, sex, year of cohort entry, race/ethnicity, income, smoking, glycemic control, diabetes duration, creatinine levels, congestive heart failure, and use of other diabetes medications, the hazard ratio (HR) for each cancer associated with ever use of pioglitazone ranged from 0.7 to 1.3, with all 95% CIs including 1.0. There was a suggestion of an increased risk of melanoma (HR 1.3 [95% CI 0.9–2.0]) and NHL (1.3 [1.0–1.8]) and a decreased risk of kidney/renal pelvis cancers (0.7 [0.4–1.1]) associated with ever use of pioglitazone. These associations were unaltered with increasing dose, duration, or time since first use. CONCLUSIONS We found no clear evidence of an association between use of pioglitazone and risk of the incident cancers examined. Because the maximum duration of follow-up was fewer than 6 years after the initiation of pioglitazone, longer-term studies are needed. PMID:21447664

  20. Achilles tendon volume in type 2 diabetic patients with or without peripheral neuropathy: MRI study.

    PubMed

    Papanas, N; Courcoutsakis, N; Papatheodorou, K; Daskalogiannakis, G; Maltezos, E; Prassopoulos, P

    2009-11-01

    The aim of this study was to evaluate Achilles tendon (AT) in type 2 diabetic patients with vs. without peripheral neuropathy using Magnetic Resonance Imaging (MRI). The study included 19 patients (group A, mean age 63.9+/-7.4 years) with peripheral neuropathy and 19 patients (group B, mean age 63.6+/-6.1 years) without peripheral neuropathy, as well as 16 healthy controls (group C, mean age 61.6+/-8.4 years). Neuropathy was diagnosed by the Diabetic Neuropathy Index (DNI). The maximum AT thickness and AT volume were measured on sagittal T (1) weighted MRI images. AT volume was calculated by the sum of the tendon surface area of all contiguous sections multiplied by the slice thickness. Diabetic patients had significantly (p<0.001) greater AT volume than controls (9742.0+/-2034.9 mm(3) vs. 7323.8+/-1918.2 mm(3)). This difference was observed both in men (p=0.030) and in women (p<0.001). AT volume was significantly greater in group A vs. C (p=0.003) and in group B vs. C (p<0.001), but there was no difference between groups A and B (p=0.469). Finally, in group A increased AT volume was significantly (p=0.041) associated with clinical severity of neuropathy. CONCLUSIONS Type 2 diabetic patients have increased AT volume as compared to controls. There is no difference in AT volume between patients with and without neuropathy. However, in neuropathic patients increased AT volume is associated with severity of neuropathy. PMID:19834869

  1. Diabetes, glycemic control and risk of medical glaucoma treatment: A population-based case-control study

    PubMed Central

    Welinder, Lotte G; Riis, Anders H; Knudsen, Lars L; Thomsen, Reimar W

    2009-01-01

    Purpose: To examine the association between diabetes and risk of medical glaucoma treatment and to assess the role of long-term glycemic control in the putative association. Design: Population-based case-control study. Methods: Cases of treated glaucoma were all persons filling at least three prescriptions for glaucoma medication for the first time within one year between 2001 and 2006 in Northern Jutland, Denmark. We used risk set sampling to select 10 gender- and age-matched general population controls per case using the Danish Civil Registration System. Data on diabetes, comorbidities, and laboratory tests, including glycosylated hemoglobin (as a measure of glycemic control) were obtained from population-based medical registries. We calculated odds ratio (OR) as an estimate of relative risk for treated glaucoma comparing patients with and without diabetes, adjusted for comorbid conditions and medication use. Results: We included 5,991 persons with incident medical glaucoma treatment and 59,910 population controls. The adjusted OR for treated glaucoma for patients with diabetes was 1.81 (95% confidence interval: 1.65–1.98). The strength of the association between diabetes and glaucoma risk did not vary by diabetes duration or by the level of glycemic control. Conclusions: Regardless of glycemic control, diabetes is associated with a substantially increased risk for medical glaucoma treatment. PMID:20865094

  2. Diabetic Neuropathy

    MedlinePLUS

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

  3. Nurse-patient communication in primary care diabetes management: an exploratory study

    PubMed Central

    2013-01-01

    Background Diabetes is a major health issue for individuals and for health services. There is a considerable literature on the management of diabetes and also on communication in primary care consultations. However, few studies combine these two topics and specifically in relation to nurse communication. This paper describes the nature of nurse-patient communication in diabetes management. Methods Thirty-five primary health care consultations involving 18 patients and 10 nurses were video-recorded as part of a larger multi-site study tracking health care interactions between health professionals and patients who were newly diagnosed with Type 2 diabetes. Patients and nurses were interviewed separately at the end of the 6-month study period and asked to describe their experience of managing diabetes. The analysis used ethnography and interaction analysis. In addition to analysis of the recorded consultations and interviews, the number of consultations for each patient and total time spent with nurses and other health professionals were quantified and compared. Results This study showed that initial consultations with nurses often incorporated completion of extensive checklists, physical examination, referral to other health professionals and distribution of written material, and were typically longer than consultations with other health professionals. The consultations were driven more by the nurses’ clinical agenda than by what the patient already knew or wanted to know. Interactional analysis showed that protocols and checklists both help and hinder the communication process. This contradictory outcome was also evident at a health systems level: although organisational targets may have been met, the patient did not always feel that their priorities were attended to. Both nurses and patients reported a sense of being overwhelmed arising from the sheer volume of information exchanged along with a mismatch in expectations. Conclusions Conscientious nursing work was evident but at times misdirected in terms of optimal use of time. The misalignment of patient expectations and clinical protocols highlights a common dilemma in clinical practice and raises questions about the best ways to balance the needs of individuals with the needs of a health system. Video- recording can be a powerful tool for reflection and peer review. PMID:24028348

  4. Diabetic Retinopathy and Estimated Cerebrospinal Fluid Pressure. The Beijing Eye Study 2011

    PubMed Central

    Wang, Ya Xing; You, Qi Sheng; Yang, Diya; Xie, Xiao Bin; Xu, Liang

    2014-01-01

    Purpose The cerebrospinal fluid pressure (CSFP) is a major determinant of central retinal vein pressure and thus of retinal capillary pressure. We tested the hypothesis whether prevalence and severity of diabetic retinopathy are associated with CSFP. Methods The population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6±9.8 years. A detailed ophthalmic examination was performed including fundus photography for the assessment of diabetic retinopathy according. Based on a previous study with lumbar cerebrospinal fluid pressure (CSFP) measurements, CSFP was calculated as CSFP[mmHg]?=?0.44xBody Mass Index[kg/m2]+0.16 Diastolic Blood Pressure[mmHg]–0.18xAge[Years]?1.91. Results In binary regression analysis, presence of diabetic retinopathy was significantly associated with higher levels of HbA1c (P<0.001; regression coefficient B:0.25; odds ratio (OR):1.28; 95% confidence interval (CI):1.15,1.43), higher blood concentration of glucose (P<0.001; B:0.40;OR:1.49;95%CI:1.36,1.63), longer known duration of diabetes mellitus (P<0.001; B:0.14;OR:1.15; 95%CI:1.11,1.19), higher systolic blood pressure (P<0.001; B:0.03;OR:1.03;95%CI:1.02,1.04), lower diastolic blood pressure (P<0.001; B:?0.06;OR:0.94;95%CI:0.91,0.97), and higher CSFP (P?=?0.002; B:0.13;OR:1.14;95%CI:1.05,1.24). Severity of diabetic retinopathy was significantly associated with higher HbA1c value (P<0.001; standardized coefficient beta: 0.19; correlation coefficient B: 0.07;95%CI:0.05,0.08), higher blood concentration of glucose (P<0.001; beta:0.18;B:0.04;95%CI:0.04,0.05), longer known duration of diabetes mellitus (P<0.001; beta:0.20;B:0.03;95%CI:0.02,0.03), lower level of education (P?=?0.001; beta:?0.05;B:?0.02;95%CI:?0.03,?0.01), lower diastolic blood pressure (P?=?0.002; beta:?0.08;B:?0.001;95%CI:?0.004,?0.001), higher systolic blood pressure (P?=?0.006; beta:0.06;B:0.001;95%CI:0.000,0.001), and higher CSFP (P?=?0.006; beta:0.06;B:0.006;95%CI:0.002,0.010). Conclusions Higher prevalence and severity of diabetic retinopathy were associated with higher estimated CSFP after adjusting for systemic parameters. Higher CSFP through a higher retinal vein pressure may lead to more marked retinal venous congestion and vascular leakage in diabetic retinae. PMID:24789334

  5. Is dietary zinc protective for type 2 diabetes? Results from the Australian longitudinal study on women’s health

    PubMed Central

    2013-01-01

    Background Animal studies have shown that zinc intake has protective effects against type 2 diabetes, but few studies have been conducted to examine this relationship in humans. The aim of this study is to investigate if dietary zinc is associated with risk of type 2 diabetes in a longitudinal study of mid-age Australian women. Methods Data were collected from a cohort of women aged 45-50 years at baseline, participating in the Australian Longitudinal Study on Women’s Health. A validated food frequency questionnaire was used to assess dietary intake and other nutrients. Predictors of 6-year incidence of type 2 diabetes were examined using multivariable logistic regression. Results From 8921 participants, 333 incident cases of type 2 diabetes were identified over 6 years of follow-up. After adjustment for dietary and non-dietary factors, the highest quintile dietary zinc intake had almost half the odds of developing type 2 diabetes (OR?=?0.50, 95% C.I. 0.32–0.77) compared with the lowest quintile. Similar findings were observed for the zinc/iron ratio; the highest quintile had half the odds of developing type 2 diabetes (OR?=?0.50, 95% C.I 0.30-0.83) after multivariable adjustment of covariates. Conclusions Higher total dietary zinc intake and high zinc/iron ratio are associated with lower risk of type 2 diabetes in women. This finding is a positive step towards further research to determine if zinc supplementation may reduce the risk of developing type 2 diabetes. PMID:24093747

  6. DIABETES PREVENTION PROGRAM

    EPA Science Inventory

    The Diabetes Prevention Program (DPP) was a major clinical trial, or research study, aimed at discovering whether either diet and exercise or the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in people with impaired glucose toleranc...

  7. Biomarkers for early diagnosis of type 2 diabetic nephropathy: a study based on an integrated biomarker system.

    PubMed

    Huang, Min; Liang, Qionglin; Li, Ping; Xia, Jianfei; Wang, Yong; Hu, Ping; Jiang, Zhiting; He, Yongxin; Pang, Liqiong; Han, Lida; Wang, Yiming; Luo, Guoan

    2013-08-01

    Diabetic nephropathy is a devastating disease that affects a growing number of diabetic patients. A complete cure is very hard to achieve once the disease has been diagnosed, therefore the diagnosis of early stages in diabetic nephropathy has become a hot area. Numbers of molecules have been proposed to be potential biomarkers for this purpose. However, some problems still remain, such as discovering effective biomarkers to diagnose the disease before obvious clinical evidence appears. Thus, the main purpose of this study was to find plasma biomarkers for early diagnosis of type 2 diabetic nephropathy stage 1 and stage 2, as well as separating them from diabetes. 182 subjects (Chinese) were recruited for this study, including 50 healthy controls, 33 type 2 diabetic patients and 99 type 2 diabetic nephropathy patients (33 of these were stage 3). Important clinical indicators including proteinuria, serum creatinine, and urea nitrogen were measured and the glomerular filtration rate was estimated to assess kidney function; fasting blood glucose, postprandial blood glucose and glycated hemoglobin were measured to assess the blood glucose control. Key metabolites and genes in plasma samples were identified and determined using -omic and quantitative techniques. The potential biomarkers were then combined and carefully screened to determine the most informative ones for early diagnosis of type 2 diabetic nephropathy. An integrated biomarker system (IBS) incorporating 6 clinical indicators, 40 metabolites and 5 genes was established. Correlation analysis results revealed that most of the potential biomarkers significantly correlated with the 6 clinical indicators. Discriminant analysis results showed that the developed IBS gave the highest total predictive accuracy (98.9%). Significant test and receiver operating characteristic analysis results indicated that inosine had the highest sensitivity (0.889), specificity (1.000), positive predictive rate (1.000) and negative predictive rate (0.900) amongst the 48 potential biomarkers when separating patients with diabetes from patients with diabetic nephropathy stage 3. Finally, inosine with a cutoff of 0.086 mg L(-1) was combined with estimated GFR to differentiate between diabetic nephropathy stages 1 and 2 from diabetes. The results demonstrate that IBS combined with a proper statistical analysis technique is a powerful tool for biomarker screening. PMID:23719966

  8. Increased Risk of Diabetes Development in Subjects with the Hypertriglyceridemic Waist Phenotype: A 4-Year Longitudinal Study

    PubMed Central

    Han, Ki Joong; Lee, Shin Yeoung; Kim, Nam Hee; Chae, Hyun Beom; Lee, Tae Hoon; Jang, Choel Min; Yoo, Kyung Mo; Park, Hae Jung; Lee, Min Kyung; Jeon, Won Seon; Park, Se Eun; Park, Cheol-Young; Lee, Won-Young; Oh, Ki-Won; Park, Sung-Woo

    2014-01-01

    Background The hypertriglyceridemic waist (HTGW) phenotype is a simple and inexpensive screening parameter to identify people at increased risk of cardiovascular disease. We evaluated whether the HTGW phenotype predicts diabetes in urban Korean adults. Methods A total of 2,900 nondiabetic subjects (mean age 44.3 years), comprising 2,078 males (71.7%) and 822 females (28.3%) who underwent annual medical check-ups at our center between January 2005 and December 2009, were recruited. The subjects were divided into four groups according to baseline serum triglyceride (TG) level and waist circumference (WC): normal WC-normal TG (NWNT) level, normal WC-high TG level, enlarged WC-normal TG level, and enlarged WC-high TG (EWHT) level. High serum TG level was defined as ?150 mg/dL and enlarged WC was defined as ?90 cm for men and ?85 cm for women. New cases of diabetes were determined according to questionnaires filled in by participants and the diagnostic criteria of the American Diabetes Association. Cox proportional hazards model analysis was used to assess the association of HTGW phenotype with the incidence of diabetes. Results A total of 101 (3.5%) new diabetes cases were diagnosed during the study period. The EWHT group had a higher incidence of diabetes (8.3%) compared with the NWNT group (2.2%). The adjusted hazard ratio for diabetes for subjects with the EWHT phenotype at baseline was 4.113 (95% confidence interval [CI], 2.397 to 7.059) after adjustment for age, and 2.429 (95% CI, 1.370 to 4.307) after adjustment for age, sex, total cholesterol, systolic blood pressure, and alcohol drinking history. It was attenuated by inclusion of baseline fasting glucose level in the model. Conclusion Subjects with the HTGW phenotype showed the highest risk of incident diabetes. This tool could be useful for identifying individuals at high risk of diabetes. PMID:25325274

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

    PubMed Central

    2014-01-01

    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

  10. Early life experiences linked to diabetes mellitus: a study of African-American migration.

    PubMed

    Schneider, D; Greenberg, M; Lu, L

    1997-01-01

    African Americans experienced massive internal migrations that shifted more than 6 million Southern-born blacks to other sections of the United States over the past century, a trend that only recently has been reversed. Whenever mass migration takes place, there is an opportunity to examine the role of the native and relocated environments in the development of disease. This article examines those relationships for diabetes mellitus, a group of diseases that disproportionately affect African-Americans relative to other racial and ethnic groups in the United States. Age-specific and age-adjusted rates with 95% confidence intervals were calculated for males and females for combinations of five regions of birth and four regions of residence at time of death. Southern-born males had statistically significantly higher death rates from diabetes than did their counterparts who died in the same regions in 9 of 16 comparisons. For females, those born in the South had statistically significantly higher rates in 15 of 16 comparisons. The results of this study indicate that place of birth and early life experiences are statistically associated with diabetes mortality among African Americans regardless of place of residence at time of death. PMID:9002414

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

    PubMed Central

    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

    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. PMID:25414769

  12. Diabetes type II, other medical conditions and pancreatic cancer risk: a prospective study in The Netherlands

    PubMed Central

    Eijgenraam, P; Heinen, M M; Verhage, B A J; Keulemans, Y C; Schouten, L J; van den Brandt, P A

    2013-01-01

    Background: To date, only a few risk factors for pancreatic cancer have been established. We examined prospectively relations between several medical conditions and pancreatic cancer incidence. Methods: In 1986, 120?852 participants completed a baseline questionnaire on cancer risk factors, including several self-reported physician diagnosed medical conditions. At baseline, a random subcohort of 5000 participants was selected using a case-cohort approach for analysis. After 16.3 years of follow-up, 448 pancreatic cancer cases (63% microscopically confirmed) were available for analysis. Results: Diabetes mellitus type II and hepatitis were positively associated with pancreatic cancer risk (multivariable-adjusted hazard ratio: 1.79; 95% confidence interval: 1.12–2.87 and hazard ratio: 1.37; 95% confidence interval: 1.04–1.81, respectively). Furthermore, a positive trend in risk with increasing years of diagnosis of diabetes (P=0.004) and of hepatitis (P=0.02) was observed. However, an inverse association was observed between hypertension and pancreatic cancer risk, this was found among microscopically confirmed cases only (hazard ratio: 0.66; 95% confidence interval: 0.49–0.90), while years since diagnosis of hypertension significantly decreased cancer risk (P for trend=0.02). Conclusion: In this prospective study, a positive association was observed between self-reported physician diagnosed diabetes mellitus type II and hepatitis and pancreatic cancer risk, whereas an inverse association was observed with hypertension. PMID:24149173

  13. Comparative study of different control techniques for the regulation of blood glucose level in diabetic patients.

    PubMed

    Ibbini, Mohammed S

    2009-01-01

    Blood glucose regulation is of a great concern for insulin-dependant patients with excessive glucose in blood (hyperglycaemia), or low glucose profile (hypoglycaemia) due to excess insulin delivery. Both conditions can cause dangerous complications for diabetic patients, and hence glucose regulation in blood is of prime importance. Insulin pumps are used to deliver insulin in small quantities, allowing the glucose level to remain as close as possible to that of non-diabetics (near 100 mg dl(-1)). Different control techniques are used to maintain the glucose level and most of them depend on an exact mathematical or empirical model of insulin-glucose interaction. Recently, we have proposed different controllers that are based on fuzzy logic and so do not use mathematical modelling, which in general is nonlinear, complex and suffers from uncertainties. PI fuzzy controllers are physically related to classical PI and PID controllers, which are extremely popular. The parameter settings of classical and fuzzy logic controllers are based on deep common physical background. In this manuscript, a comparative study is proposed to evaluate the use of fuzzy logic controllers over other conventional controllers such as PI and PID controllers to maintain the blood glucose level within a normoglycaemic average especially when a diabetic patient is subjected to different conditions. PMID:19848860

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

    PubMed

    Matsuda, Nozomu; Kobayashi, Shunsuke; Ugawa, Yoshikazu

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  16. Association of Urinary Metal Profiles with Altered Glucose Levels and Diabetes Risk: A Population-Based Study in China

    PubMed Central

    Feng, Wei; Cui, Xiuqing; Liu, Bing; Liu, Chuanyao; Xiao, Yang; Lu, Wei; Guo, Huan; He, Meian; Zhang, Xiaomin; Yuan, Jing; Chen, Weihong; Wu, Tangchun

    2015-01-01

    Background Elevated heavy metals and fasting plasma glucose (FPG) levels were both associated with increased risk of cardiovascular diseases. However, studies on the associations of heavy metals and essential elements with altered FPG and diabetes risk were limited or conflicting. The objective of this study was to evaluate the potential associations of heavy metals and essential trace elements with FPG and diabetes risk among general Chinese population. Methods We conducted a cross-sectional study to investigate the associations of urinary concentrations of 23 metals with FPG, impaired fasting glucose (IFG) and diabetes among 2242 community-based Chinese adults in Wuhan. We used the false discovery rate (FDR) method to correct for multiple hypothesis tests. Results After adjusting for potential confounders, urinary aluminum, titanium, cobalt, nickel, copper, zinc, selenium, rubidium, strontium, molybdenum, cadmium, antimony, barium, tungsten and lead were associated with altered FPG, IFG or diabetes risk (all P< 0.05); arsenic was only dose-dependently related to diabetes (P< 0.05). After additional adjustment for multiple testing, titanium, copper, zinc, selenium, rubidium, tungsten and lead were still significantly associated with one or more outcomes (all FDR-adjusted P< 0.05). Conclusions Our results suggest that multiple metals in urine are associated with FPG, IFG or diabetes risk. Because the cross-sectional design precludes inferences about causality, further prospective studies are warranted to validate our findings. PMID:25874871

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

    Microsoft Academic Search

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

    1996-01-01

    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

  18. To be a teacher, a tutor and a friend: the physician's role according to the Stockholm Diabetes Intervention Study (SDIS)

    Microsoft Academic Search

    Per Reichard

    1996-01-01

    The Stockholm Diabetes Intervention Study (SDIS) showed that lower blood glucose levels led to halted or retarded microvascular complications in patients with insulin-dependent (type 1) diabetes mellitus (IDDM). Modern education was combined with tutoring, which led to improved blood glucose control in a randomized group of patients. In this setting, the expert-physician met an expert-patient in a mutual effort to

  19. Tea consumption and incidence of type 2 diabetes in Europe: the EPIC-InterAct case-cohort study

    Microsoft Academic Search

    E. J. M. Feskens; Woudenbergh van T

    2012-01-01

    Background In previous meta-analyses, tea consumption has been associated with lower incidence of type 2 diabetes. It is unclear, however, if tea is associated inversely over the entire range of intake. Therefore, we investigated the association between tea consumption and incidence of type 2 diabetes in a European population. Methodology\\/Principal Findings The EPIC-InterAct case-cohort study was conducted in 26 centers

  20. Joint association of coffee consumption and other factors to the risk of type 2 diabetes: a prospective study in Finland

    Microsoft Academic Search

    G Hu; P Jousilahti; M Peltonen; S Bidel; J Tuomilehto

    2006-01-01

    Objective:To examine joint associations of coffee consumption and other factors (including physical activity, obesity and alcohol consumption) with the risk of type 2 diabetes.Design:Prospective follow-up study.Subjects:In all, 10 188 Finnish men and 11 197 women aged 35–74 years without a history of stroke, coronary heart disease or diabetes at baseline.Measurement:A self-administered questionnaire data on coffee, tea, alcohol and other food

  1. Immunohistology of islet amyloid polypeptide in diabetes mellitus: Semi-qantitative studies in a post-mortem series

    Microsoft Academic Search

    Christoph Riicken; Reinhold P. Linke; Wolfgang Saeger

    1992-01-01

    Summary Immunoreactivity for islet amyloid polypeptide (IAPP) in the islets of Langerhans of non-insulin-dependent diabetic patients and non-diabetic patients of a non-selected post-mortem series was studied with a new polyclonal IAPP antibody. Out of 133 patients examined, 124 exhibited immunoreactivity for IAPP. Immunoreactivity was localized intra- and extracellularly and was limited to the islets of Langerhans. No extracellular immunoreactivity was

  2. The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: The RENAAL Study

    Microsoft Academic Search

    William F Keane; Barry M Brenner; Dick De Zeeuw; Jean-Pierre Grunfeld; Janet Mcgill; William E Mitch; Artur B Ribeiro; Shahnaz Shahinfar; Roger L Simpson; Steven M Snapinn; Robert Toto

    2003-01-01

    The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: The RENAAL Study.BackgroundDiabetic nephropathy has become the single most important cause of end-stage renal disease (ESRD) worldwide. Strategies to slow the rate of loss of renal function in these patients have been developed. We examined the risk factors that predict loss of kidney function (doubling

  3. Risk of bladder cancer in patients with diabetes mellitus: an updated meta-analysis of 36 observational studies

    PubMed Central

    2013-01-01

    Background Increasing evidence suggests that a history of diabetes mellitus (DM) may be associated with an increased risk of bladder cancer. We performed a systematic review with meta-analysis to explore this relationship. Methods We identified studies by a literature search of Medline (from 1 January 1966) and EMBASE (from 1 January 1974), through 29 February 2012, and by searching the reference lists of pertinent articles. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were calculated with a random-effects model. Results A total of 36 studies (9 case–control studies, 19 cohort studies and 8 cohort studies of patients with diabetes) fulfilled the inclusion criteria. Analysis of all studies showed that DM was associated with an increased risk of bladder cancer (the summary RR = 1.35, 95% CI 1.17–1.56, p < 0.001, I2 = 94.7%). In analysis stratified by study design, diabetes was positively associated with risk of bladder cancer in case–control studies (RR = 1.45, 95% CI 1.13-1.86, p = 0.005, I2 = 63.8%) and cohort studies (RR = 1.35, 95% CI 1.12-1.62, p < 0.001, I2 = 94.3%), but not in cohort studies of diabetic patients (RR = 1.25, 95% CI 0.86–1.81, p < 0.001, I2 = 97.4%). The RRs of bladder cancer were 1.38 (1.08-1.78) for men and 1.38 (0.90-2.10) for women with diabetes, respectively. Noteworthy, the relative risk of bladder cancer was negatively correlated with the duration of DM, with the higher risk of bladder cancer found among patients diagnosed within less than 5 years. Conclusions These findings support the hypothesis that men with diabetes have a modestly increased risk of bladder cancer, while women with diabetes were not the case. PMID:23803148

  4. Autophagy and mitophagy in diabetic cardiomyopathy.

    PubMed

    Kobayashi, Satoru; Liang, Qiangrong

    2015-02-01

    Diabetic cardiomyopathy is a heart muscle-specific disease that increases the risk of heart failure and mortality in diabetic patients independent of vascular pathology. Mitochondria are cellular power plants that generate energy for heart contraction and concurrently produce reactive oxygen species that, if unchecked, may damage the mitochondria and the heart. Elimination of damaged mitochondria by autophagy known as mitophagy is an essential process for maintaining normal cardiac function at baseline and in response to various stress and disease conditions. Mitochondrial structural injury and functional impairment have been shown to contribute to diabetic heart disease. Recent studies have demonstrated an inhibited autophagic flux in the hearts of diabetic animals. Surprisingly, the diminished autophagy appears to be an adaptive response that protects against cardiac injury in type 1 diabetes. This raises several questions regarding the relationship between general autophagy and selective mitophagy in the diabetic heart. However, autophagy may play a different role in the hearts of type 2 diabetic animals. In this review, we will summarize current knowledge in this field and discuss the potential functional roles of autophagy and mitophagy in the pathogenesis of diabetic cardiomyopathy. This article is part of a Special Issue entitled: Autophagy and protein quality control in cardiometabolic diseases. PMID:24882754

  5. Prevalence and risk factors for diabetic retinopathy among Omani diabetics

    Microsoft Academic Search

    Ossama A W El Haddad; Mohammed Kamal Saad

    1998-01-01

    AIMSTo study the prevalence of diabetic retinopathy in a population of patients attending a diabetic clinic and to evaluate the medical risk factors underlying its development.METHODS500 randomly selected diabetic patients attending the diabetes clinic in Al Buraimi hospital were referred to the ophthalmology department where they were fully evaluated for the absence or presence of retinopathy. Any retinopathy present was

  6. Impact of the individual components of the metabolic syndrome and their different combinations on the prevalence of atherosclerotic vascular disease in type 2 diabetes: the Diabetes in Germany (DIG) study

    Microsoft Academic Search

    Markolf Hanefeld; Carsta Koehler; Silvina Gallo; Inge Benke; Petra Ott

    2007-01-01

    BACKGROUND: One of the major controversies surrounding the metabolic syndrome (MetS) in type 2 diabetes is whether its single components act synergistically as risk factors for atherosclerotic vascular disease (AVD). We aimed to answer this by evaluating the relationship, and its various combinations to AVD in comparison to single traits in a population-based study with type 2 diabetes in Germany.

  7. Carbon dioxide emissions and change in prevalence of obesity and diabetes in the United States: an ecological study.

    PubMed

    Zheutlin, Alexander R; Adar, Sara D; Park, Sung Kyun

    2014-12-01

    Recent studies suggest that increasing levels of the greenhouse gas, carbon dioxide (CO2), may influence weight gain and thus may play a role in rising trends in obesity and diabetes. We conducted an ecological study to examine the associations between CO2 emissions from fossil fuel combustion and changes in the prevalence of obesity and diabetes in the United States. County-level data on CO2 emissions, prevalence of obesity and diagnosed diabetes, other sociodemographic factors and neighborhood characteristics related to urbanicity, and fine particles (PM2.5) between 2004 and 2008 were obtained from the Vulcan Project, Centers for Disease Control and Prevention, and American Community Survey. Linear mixed effect modeling of 3019 counties for the associations between average CO2 emissions and changes in diabetes and obesity prevalence between 2004 and 2008 was performed. The average obesity and diabetes prevalence increased between 2004 and 2008 by 3.65% (SD: 1.88%) and 1.65% (SD: 1.70%), respectively. A marginally significant positive association between CO2 emission and changes in obesity prevalence was found with adjustment for sociodemographic factors, indicators of urbanicity and spatial autocorrelation (p-trend=0.06). The association became weaker and nonsignificant with further adjustment for PM2.5 (p-trend=0.17). There was a significant positive association between CO2 emission and changes in diabetes prevalence before controlling for PM2.5 (p-trend=0.05) but the association became null after controlling for PM2.5 (p-trend=0.49), suggesting that PM2.5 is a critical confounder in the association between CO2 emission and changes in diabetes prevalence. This study does not support the hypothesis that CO2 emissions, a leading driver of climate change, may be linked to increasing trends in obesity and diabetes, though there was an indication of possible link between CO2 and obesity. PMID:25108606

  8. PS2-06: Regional Variation in Response to Diabetes Education in the IDEA Study

    PubMed Central

    Beaton, Sarah; Sperl-Hillen, JoAnn; Fernandes, Omar; Von Worley, Ann; Parsons, William; Davis, Herbert; Hanson, Ann; Parker, Emily; Spain, C. Vic

    2011-01-01

    Background/Aims ‘Journey for Control of Diabetes: The IDEA Study’ is an ongoing randomized trial evaluating the efficacy of group diabetes education (GE) using US Diabetes Conversation MapsTM and conventional individual diabetes education (IE) among adults with sub-optimally controlled Type 2 diabetes (A1c>=7%). The study is being conducted at 2 sites, Minneapolis, MN, and Albuquerque, NM. Because the 2 sites are regions with diverse demographic characteristics, the goal of this paper was to identify differences in the main outcome (A1c) between sites. Methods In addition to A1c>=7, study inclusion criteria were patients who were diagnosed with diabetes, and were diabetes education-naive within the last one to two years. Consenting patients were randomly assigned to receive either: GE, IE or usual care (UC) as recommended by the primary care provider. All education was provided through each care system’s ADA-recognized education program. Follow-up A1c levels were obtained from electronic laboratory data. Differences in A1c levels were evaluated using Generalized Linear Models (SAS 9.2). Results There were 623 patients enrolled: 337 from MN and 286 from NM. Sample demographics were: mean age of 60.0 (MN) and 64.0 (NM); percent female, 44.8 (151/337) for MN and 54.9 (157/286) for NM; race/ethnicity, 81.1% (276/337) white, 8.1% (27/337) black, 3.6% (12/337) Hispanic, and 7.2% (24/337) other for MN, and NM 45.6% (130/286) white, 2.5% (7/286) black, 43.9% (126/286) Hispanic, and 8.1% (23/286) other. Mean baseline A1c was 8.1% for MN and 8.3% for NM. There was a significant difference in percentages of patients having an A1c in the post-randomization follow-up period (approximately 6 months), 89.0% (300/337) for MN and 67.5% (193/286) for NM. Of those with an A1c test, NM patients had a significantly greater A1c reduction with GE (?0.947 for NM vs. ?0.136 for MN), IE (?1.093 for NM vs. ?0.497 for MN), and UC (?0.700 for NM vs. ?0.253 for MN), (p<.0001). Conclusions Although it appears that IE and GE were more effective for NM patients compared to MN, the large number of NM patients without A1c values in the follow-up period makes any conclusions tentative. The long-term data analysis is pending and should provide a more definitive conclusion.

  9. Relative Contributions of Naturalistic and Constructed Support: Two Studies of Women with Type 2 Diabetes

    PubMed Central

    Barrera, Manuel; Toobert, Deborah J.; Strycker, Lisa A.

    2014-01-01

    Do distinct sources of social support have differential effects on health? Although previous research has contrasted family and friend support (naturalistic support), research on the relative effects of naturalistic support and constructed support (e.g., support groups) is extremely rare. Two studies of women with type 2 diabetes were conducted that assessed the independent effects of naturalistic and constructed support on physical activity and glycosylated hemoglobin (HbA1c). Participants were women diagnosed with type 2 diabetes from the intervention arms of two randomized controlled trials: primarily European American women (Study 1; N = 163) and exclusively Hispanic women (Study 2; N = 142). Measures assessed physical activity, HbA1c, and friend and family support at baseline and at 6 months, as well as group support after 6 months of intervention. In Study 1, only group support was related to increases in physical activity (?R2 = .036). In Study 2, group support and family support showed independent effects on increases in physical activity (?R2 = .047 and .060, respectively). Also, group support was related to decreases in HbA1c in Study 1 (?R2 = .031) and Study 2 (?R2 = .065). Overall, constructed (group) support was related to outcomes most consistently, but naturalistic (family) support showed some independent relation to physical activity improvement. PMID:23109138

  10. Physiological reduction in fasting plasma glucose concentration in the first trimester of normal pregnancy: The diabetes in early pregnancy study

    Microsoft Academic Search

    James L. Mills; Lois Jovanovic; Robert Knopp; Jerome Aarons; Mary Conley; Y. Jack Lee; Lewis Holmes; Joe L. Simpson; Boyd Metzger

    1998-01-01

    Previous studies indicate that fasting plasma glucose decreases during gestation, but the timing and extent are not consistent from study to study. We had an opportunity to examine this question in the normal pregnancy cohort of women studied in the Diabetes in Early Pregnancy Study. Subjects were monitored to identify pregnancy by human chorionic gonadotropin testing, enrolled within 21 days

  11. Seven-year mortality in heart failure patients with undiagnosed diabetes: an observational study

    PubMed Central

    2011-01-01

    Background Patients with type 2 diabetes mellitus and heart failure have adverse clinical outcomes, but the characteristics and prognosis of those with undiagnosed diabetes in this setting has not been established. Methods In total, 400 patients admitted consecutively with acute heart failure were grouped in three glycaemic categories: no diabetes, clinical diabetes (previously reported or with hypoglycaemic treatment) and undiagnosed diabetes. The latter was defined by the presence of at least two measurements of fasting plasma glycaemia ? 7 mmol/L before or after the acute episode.Group differences were tested by proportional hazards models in all-cause and cardiovascular mortality during a 7-year follow-up. Results There were 188 (47%) patients without diabetes, 149 (37%) with clinical diabetes and 63 (16%) with undiagnosed diabetes. Patients with undiagnosed diabetes had a lower prevalence of hypertension, dyslipidaemia, peripheral vascular disease and previous myocardial infarction than those with clinical diabetes and similar to that of those without diabetes. The adjusted hazards ratios for 7-year total and cardiovascular mortality compared with the group of subjects without diabetes were 1.69 (95% CI: 1.17-2.46) and 2.45 (95% CI: 1.58-3.81) for those with undiagnosed diabetes, and 1.48 (95% CI: 1.10-1.99) and 2.01 (95% CI: 1.40-2.89) for those with clinical diabetes. Conclusions Undiagnosed diabetes is common in patients requiring hospitalization for acute heart failure. Patients with undiagnosed diabetes, despite having a lower cardiovascular risk profile than those with clinical diabetes, show a similar increased mortality. PMID:21569580

  12. OXIDATIVE STRESS IN DIABETES MELLITUS

    Microsoft Academic Search

    S. A. MOUSSA

    2008-01-01

    Our aim was to evaluate oxidative stress in diabetes mellitus by the measurement of biophysical parameters (changes) of hemoglobin macromolecule and some biochemical parameters on two groups of diabetic patients, non-insulin dependent diabetes mellitus (NIDDM), and insulin- dependent diabetes mellitus (IDDM). This study has been conducted on 45 NIDDM, 30 IDDM, compared to 20 healthy subjects. Blood glucose, glycosylated hemoglobin

  13. A pilot study of regional perfusion and oxygenation in calf muscles of individuals with diabetes with a noninvasive measure

    PubMed Central

    Zheng, Jie; Hasting, Mary K.; Zhang, Xiaodong; Coggan, Andrew; An, Hongyu; Snozek, Darrah; Curci, John; Mueller, Michael J.; St. Louis, Mo; Hill, Chapel

    2014-01-01

    Objective To assess alterations in the regional perfusion and oxygenation of the calf muscles in individuals with diabetes. Methods Age-matched individuals with (n = 5) and without diabetes (n = 6) were investigated. Skeletal muscle perfusion, oxygen extraction fraction, and oxygen consumption rate were measured by newly developed noncontrast magnetic resonance imaging (MRI) techniques. The subjects lay supine on the MRI table with their foot firmly strapped to a custom-built isometric exercise device. The measurements were performed at rest and during an isometric plantar flexion muscle contraction. Results Individuals without diabetes had up to a 10-fold increase in muscle perfusion, 25% elevation in muscle oxygen extraction fraction, and a 12-fold increase in oxygen consumption rate in the calf during the plantar flexion isometric contraction. In patients with diabetes, the increases in these parameters were only up to sixfold, 2%, and sixfold, respectively. Exercise oxygen consumption rate was inversely associated with blood HbA1c levels (r2 = .91). Conclusions This is the first study to quantify regional skeletal muscle oxygenation in patients with diabetes using noncontrast MRI and warrants additional study. Attenuation of perfusion and oxygenation during exercise may have implications for understanding diabetic complications in the lower extremities. PMID:24080129

  14. Support systems for and barriers to diabetes management in South Asians and Whites in the UK: qualitative study of patients’ perspectives

    PubMed Central

    Singh, Harsimran; Cinnirella, Marco; Bradley, Clare

    2012-01-01

    Objectives To explore experiences of UK-based South Asian and White patients with diabetes in relation to their support systems for and barriers to diabetes management. Design Qualitative study (semistructured interviews analysed using a form of Interpretative Phenomenological Analysis). Participants 20 outpatients with diabetes (12 British South Asians and 8 British Whites) with either good or poor glycaemic control. Setting Hillingdon Hospital, Uxbridge, UK. Results Qualitative analysis revealed distinct themes for the two ethnic groups. For the South Asian participants, challenges surrounding diet management and social stigma attached to having diabetes were the two predominant barriers to effective diabetes management. Support from immediate family members was commonly reported as a strong support system for optimising diabetes management by the South Asian sample in addition to the perceived positive impact of religion (healing power of prayer), the valuable informational support from their diabetes-care team, patient leaflets and diabetes magazines. Similar to the South Asians, adhering to dietary recommendations was the most difficult aspect of diabetes management for the White participants followed by the inconveniences surrounding injecting insulin. The hospital diabetes-care team was considered as the most effective support system for diabetes management by the White sample and interestingly, this was the only dominant theme in their reported sources of support. Conclusions Both South Asian and White participants emphasised adherence to dietary recommendations as the most difficult aspect of living with diabetes. In addition, social stigma attached to diabetes was a prominent concern among South Asian participants that seemed to have a significant negative impact on their diabetes control and overall management. Given South Asian patients’ reliance on their family for the management of their condition, interventions targeting improved diabetes outcomes in this population may prove more successful if they are designed to involve significant family members. PMID:23151392

  15. Women with gestational diabetes in Vietnam: a qualitative study to determine attitudes and health behaviours

    PubMed Central

    2012-01-01

    Background Diabetes is increasing in prevalence globally, notably amongst populations from low- and middle- income countries. Gestational Diabetes Mellitus(GDM), a precursor for type 2 diabetes, is increasing in line with this trend. Few studies have considered the personal and social effects of GDM on women living in low and middle-income countries. The aim of this study was determine attitudes and health behaviours of pregnant women with GDM in Vietnam. Methods This was a qualitative study using focus group methodology conducted in Ho Chi Minh City. Pregnant women, aged over 18 years, with GDM were eligible to participate. Women were purposely sampled to obtain a range of gestational ages and severity of disease. They were invited to attend a 1-hour focus group. Questions were semi structured around six themes. Focus groups were recorded, transcribed, translated and cross-referenced. Non-verbal and group interactions were recorded. Thematic analysis was performed using a theoretical framework approach. Results From December 2010 to February 2011, four focus groups were conducted involving 34 women. Median age was 31.5 years (range 23 to 44), median BMI 21.8 kg/m2. Women felt confusion, anxiety and guilt about GDM. Many perceived their baby to be at increased risk of death. Advice to reduce dietary starch was confusing. Women reported being ‘hungry’ or ‘starving’ most of the time, unaware of appropriate food substitutions. They were concerned about transmission of GDM through breast milk. Several women planned not to breastfeed. All felt they needed more information. Current sources of information included friends, magazines, a health phone line or the Internet. Women felt small group sessions and information leaflets could benefit them. Conclusions This study highlights the need for culturally appropriate clinical education and health promotion activities for women with GDM in Vietnam. PMID:22873351

  16. Insulin and risk of diabetic retinopathy in patients with type 2 diabetes mellitus: data from a meta-analysis of seven cohort studies

    PubMed Central

    2014-01-01

    Background Type 2 diabetes mellitus (T2DM) is a chronic incurable disease associated with multi-systemic complications. The chronic complications related to T2DM induce growing burden to the national health system. Diabetic retinopathy (DR) is the most serious ocular complication associated with T2DM and one of the leading causes of secondary blindness. The association between insulin use and DR risk has also been reported in different studies. Methods In order to obtain more informative results on the relationship between insulin intake and risk of DR and to take into account more recent evidence, we conducted this meta-analysis by including all available relevant cohort studies. A systemic literature search was performed via electronic databases inclu-apding Pubmed and EMBASE to identify all available relevant studies until February 2014. A total of seven cohort studies were included in this meta-analysis. In this meta-analysis, we conducted a rigorous search of all available published cohort studies to quantify the possible association between insulin use and incidental DR in individuals with type 2 diabetes. Results Although major heterogeneity existed in this study, the significant association between insulin use and risk of DR was detected. The subgroup analyses by study design, region, data source and adjustment of HbA1c generated similar results. Also, when the DM duration was adjusted, no result was reported with significant difference. Conclusion The results of this meta-analysis helps to better explore the role of insulin use in DR risk development. Meanwhile, our results are statistically robust and yield important conclusions. The underlying mechanism by which insulin use increases DR risk should be explored in future in vitro and in vivo studies. Additional large-scale, well-designed studies with sufficient data are needed to confirm our findings. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2003724731291657 PMID:24972631

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

    PubMed

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

    2009-01-01

    A study was undertaken for evaluating the hypoglycemic and hypolipidemic effects of an ayurvedic medicine "Rajanyamalakadi" containing Curcuma longa, Emblica officinalis and Salacia oblonga in type II diabetic patients over a period of 3 months. Ethical committee consent for the study was given by the Director, Indian Systems of Medicine, Kerala. A total of 43 patients with established diabetes mellitus as adjudged from clinical features and FBS values, appeared for the camp (Age group 35-75 yrs). An informed consent for the study was obtained from each patient. The clinical proforma was given to each patient to collect data such as height, weight, diet pattern, previous history of illness etc. The ongoing antidiabetic medications were stopped under medical supervision and the patients were provided with 'Rajanyamalakadi' tablets (dose 1-2 tablets each weighing 500mg). The dosage of the drug was decided by the supervising medical officer on a case to case basis, taking note of the clinical conditions and responsiveness of the patients. The patients were monitored for three months, who were divided into 6 groups based on their age and again into two groups, 5 & 6, based on their mean FBS values. ie; Normal Persons, Diabetics of age groups 35-45yrs, 46-55yrs, >55yrs and those with FBS < 145.9 mg% and > 145.9 mg%. The Ayurvedic medicine "Rajanyamalakadi" has showed significant antidiabetic, hypolipidemic and antioxidant effects. In addition to that significant ameliorating effects on the elevated serum AST and ALT activities were also demonstrated by the treatment. The nutraceuticals present in the drug like Terpenoids, Polyphenols, Curcumin etc are responsible for the medicinal effects. PMID:23105812

  18. Pathobiochemistry of combined diabetes and atherosclerosis studied on a novel animal model. The hyperlipemic-hyperglycemic hamster.

    PubMed Central

    Simionescu, M.; Popov, D.; Sima, A.; Hasu, M.; Costache, G.; Faitar, S.; Vulpanovici, A.; Stancu, C.; Stern, D.; Simionescu, N.

    1996-01-01

    Because accelerated atherosclerosis is the main complication of diabetes, we devised a new animal model that combines these two diseases, and investigated their joint impact on the main plasma components and organs known to be most affected in each disorder. Male Golden Syrian hamsters were subjected to three experimental conditions: streptozotocin-induced diabetes (D), diet-induced hyperlipemia (H), and a combination of hyperlipemia and diabetes (HD). At time intervals ranging from 2 to 24 weeks, the animals were sacrificed, the appropriate plasma constituents were determined, and the ultrastructural modifications of relevant tissues such as the heart, cardiac valves, coronary arteries, aorta, retina, and kidney were examined. The HD hamsters were characterized by marked alternations of plasma components, ie, increase in circulating glucose, cholesterol and lipid peroxide levels, glycation of albumin, and the appearance of irreversibly glycated albumin (AGE-Alb). These humoral changes coexisted with micro- and macroangiopathic lesions characteristic to both diseases, ie, capillary narrowing, hyperplasia of endothelial basal lamina, proliferation of perivascular extracellular matrix (abnormalities reminiscent of type I diabetes), and concomitant intimal accumulation of modified lipoproteins and macrophage-derived foam cells in the aorta, coronaries, and cardiac valves, leading to accelerated formation of atherosclerotic plaques. These changes eventually appeared in the D hamsters also, but at a much slower rate, whereas the H group showed only modifications characteristic for atherosclerosis. Our findings indicate that, overall, 1) diabetes accelerated the early development and progression of atherosclerotic lesions leading to rapid calcification, and 2) hyperlipidemia associated with diabetes accelerated the rate of development of diabetes-induced microvascular disease. The hamster model may be useful to study the impact of various drugs on the diabetes-related vascular complications. Images Figure 1 Figure 6 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 PMID:8774154

  19. Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study

    PubMed Central

    Firouzi, Somayyeh; Barakatun-Nisak, Mohd Yusof; Azmi, Kamaruddin Nor

    2015-01-01

    Background: The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. Materials and Methods: A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Results: Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of <6.5% with no significant differences between genders. The mean body mass index was 26.9 ± 4.7 kg/m2, with 86.5% either were overweight or obese. Only 10.6% of the subjects exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397) (P < 0.05) higher among those who had high density lipoprotein cholesterol levels below the normal range. Those taking one or two types of oral anti-diabetic drugs had 19.9 (2.959-87.391) (P < 0.01) and 14.3 (2.647-77.500) (P < 0.01) higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Conclusion: Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents.

  20. Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study

    PubMed Central

    Abdulhadi, Nadia; Al Shafaee, Mohammed; Freudenthal, Solveig; Östenson, Claes-Göran; Wahlström, Rolf

    2007-01-01

    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 quality of interactions with their primary health-care providers. Methods Four focus group discussions (two women and two men groups) were conducted among 27 purposively selected patients (13 men and 14 women) from six primary health-care centres in Muscat, Oman. Qualitative content analysis was applied. Results The patients identified some weaknesses regarding the patient-provider communication like: unfriendly welcoming; interrupted consultation privacy; poor attention and eye contact; lack of encouraging the patients to ask questions on the providers' side; and inability to participate in medical dialogue or express concerns on the patients' side. Other barriers and difficulties related to issues of patient-centeredness, organization of diabetes clinics, health education and professional competency regarding diabetes care were also identified. Conclusion The diabetes patients' experiences with the primary health-care providers showed dissatisfaction with the services. We suggest appropriate training for health-care providers with regard to diabetes care and developing of communication skills with emphasis on a patient-centred approach. An efficient use of available resources in diabetes clinics and distributing responsibilities between team members in close collaboration with patients and their families seems necessary. Further exploration of the providers' work situation and barriers to good interaction is needed. Our findings can help the policy makers in Oman, and countries with similar health systems, to improve the quality and organizational efficiency of diabetes care services. PMID:17925030

  1. The 3Year Clinical and Functional Course of Schizophrenia Among Individuals With and Without Diabetes at Study Entry

    Microsoft Academic Search

    Haya Ascher-Svanum; Baojin Zhu; Frank R. Ernst; Douglas E. Faries; Jennie G. Jacobson; Caroline C. Doebbeling

    2007-01-01

    Objective: This prospective observational stud