Diabetes Research and Clinical Practice (DIABETES RES CLIN PR)

Publications in this journal

• Article: Screening for HbA1c-Defined Prediabetes and Diabetes in an At-Risk Greek Population: Performance Comparison of Random Capillary Glucose, the ADA Diabetes Risk Test and Skin Fluorescence Spectroscopy

  Tentolouris N, Lathouris P, Lontou S, Tzemos K, Maynard J
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  ABSTRACT: Background: We examined the accuracy of random capillary glucose (RCG) and two noninvasive screening methods, the ADA diabetes risk test (DRT) and skin fluorescence spectroscopy (SFS) as measured by Scout DS for detecting HbA1c-defined dysglycemia or type 2 diabetes in an at-risk cohort. Methods: Subjects were recruited at two clinical sites for a single non-fasting visit. Each subject had measurements of height, weight and waist circumference. A diabetes score was calculated from skin fluorescence measured on the left forearm. A finger prick was done to measure RCG and HbA1c (A1C). Health questionnaires were completed for the DRT. Increasing dysglycemia was defined as A1C≥5.7% (39 mmol/mol) or ≥6.0% (42 mmol/mol). Type 2 diabetes was defined as A1C≥6.5% (47.5 mmol/mol). Results: 398 of 409 subjects had complete data for analysis with means for age, body mass index, and waist of 52 yrs, 27 kg/m2 and 90 cm. 51% were male. Prevalence of A1C ≥ 5.7%, ≥ 6.0% and ≥ 6.5% were 54%, 34% and 12%, respectively. Areas under the curve (AUC) for detection of increasing levels dysglycemia or diabetes for RCG were 63%, 66% and 72%, for the ADA DRT the AUCs were 75%, 76% and 81% and for SFS the AUCs were 82%, 84% and 90%, respectively. For each level of dysglycemia or diabetes, the SFS AUC was significantly higher than RCG or the ADA DRT. Conclusions: The noninvasive skin fluorescence spectroscopy measurement outperformed both RCG and the ADA DRT for detection of A1C-defined dysglycemia or diabetes in an at-risk cohort.
  Diabetes Research and Clinical Practice 01/2013;
• Article: identification of tow novel variants in PRKAG2 gene in Tunisian type 2 diabetic patients with family history of cardiovascular disease

  S Nouira, I Arfa, I Kamoun, A Abid, H Ouragini, I Dorboz, W Ghasouani, S Ben fadhel, MM Zorgati, S Ben Ammar, SBlouza, S kachboura, S Abdelhak
  Diabetes Research and Clinical Practice 01/2010; 87:e7 -e10.
• Article: Limbert C, Päth G, Jakob F, Seufert J. Beta cell replacement and regeneration strategies of cell based therapy for type 1 diabetes mellitus. Diabetes Res Clin Pr 2008 Mar;79(3):389-99

  Limbert C, Päth G, Jakob F, Seufert J
  Diabetes Research and Clinical Practice 03/2008;
• Article: The relationship of waist circumference muscular strength and cardiorespiratory fitness in New Zealand 10-15 year olds. P-113

  AC Benson, MA Fiatarone Singh
  Diabetes Research and Clinical Practice 01/2008; 79:S97.
• Article: Glycemia and inflammatory markers in acute coronary syndrome: association with late post-hospital outcomes.

  Patrícia Tolledo Maciel, Lucia Campos Pellanda, Vera Lucia Portal, Beatriz D'Agord Schaan
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  ABSTRACT: Glycemia and inflammatory markers were associated with clinical outcomes in patients with acute coronary syndrome (ACS). To evaluate the role of glycemia and inflammatory markers as predictors of late cardiovascular outcomes after ACS. One hundred and ninety-nine ACS patients of a Coronary Care Unit were included, from March to November 2002. They were reassessed clinically after approximately 3 years. Clinical variables, glycemia, CRP and fibrinogen were evaluated as event and mortality predictors. Statistical analyses included Cox multivariate analysis and survival curves (Kaplan-Meier). At admission, 16.7% had normal glycemia. After 3 years, this proportion increased to 55.2%; the 40.6% who belonged to the borderline category decreased to 27.1%; the 42.7% with elevated glycemia decreased to 17.7%. Glycemia was not associated with the development of major cardiovascular events (MACE) and mortality at follow-up ( approximately 3 years). Considering MACE, CRP (p<0.001), but not fibrinogen, was predictive in bivariate analysis. Regarding mortality, both fibrinogen (p=0.020) and CRP (p=0.008) were predictive in bivariate analysis. Glycemia was not associated with late mortality after ACS, but inflammatory markers were, suggesting that these are more sensitive markers to predict events in long-term. Moreover, glucose intolerance prevalence is lower in the follow-up after the ACS episode.
  Diabetes Research and Clinical Practice 12/2007; 78(2):263-9.
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  Available from: mcw.edu

  Article: Prevalence of the metabolic syndrome in Peruvian Andean hispanics: the PREVENCION study.

  Josefina Medina-Lezama, Humberto Zea-Diaz, Oscar L Morey-Vargas, Juan F Bolaños-Salazar, Edgar Muñoz-Atahualpa, Mauricio Postigo-MacDowall, Fernando Corrales-Medina, Zoila Valdivia-Ascuña, Carolina Cuba-Bustinza, Sheyla Paredes-Díaz, Paola Villalobos-Tapia, Julio Chirinos-Pacheco, Ronald B Goldberg, Julio A Chirinos
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  ABSTRACT: Data regarding the prevalence of metabolic syndrome (MTS) in Andean populations are limited. We evaluated the prevalence of MTS according to American Heart Association/National Heart, Lung and Blood Institute criteria among 1878 subjects in the PREVENCION study in Peru. In women, the most common component was low HDL cholesterol (60.9%) followed by abdominal obesity (36.9%). In men, the most common component was elevated triglycerides (52.0%) followed by low HDL cholesterol (32.5%), whereas the prevalence of abdominal obesity was 14%. Abnormal fasting glucose was the least common component in men (5.4%) and women (5.0%). The prevalence of MTS was significantly higher in women compared to men (23.2% versus 14.3%) and increased steeply with age, particularly in women (p<0.0001). Using body mass index (BMI>or=30kg/m2) instead of waist circumference as a component of the MTS lead to equivalent prevalence estimates of MTS in men but significantly underestimated the prevalence in women. The MTS is highly prevalent among Peruvian Andeans, particularly in older women. The pattern of MTS components in this Andean population is characterized by a high prevalence of dyslipidemia and a relatively low prevalence of elevated fasting glucose. Further studies are required to characterize genetic and environmental determinants of these patterns.
  Diabetes Research and Clinical Practice 12/2007; 78(2):270-81.
• Article: Lifestyle factors and incident metabolic syndrome. The Tromsø Study 1979-2001.

  Tom Wilsgaard, Bjarne K Jacobsen
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  ABSTRACT: To assess the relationship between lifestyle characteristics and incident metabolic syndrome. A total of 17,014 men and women without the metabolic syndrome at baseline who participated in at least two of four surveys between 1979-1980 and 2001 were included in this population based longitudinal study in the municipality of Tromsø, Norway. At each survey the participants went through a physical examination, completed two questionnaires, and blood samples were taken. The metabolic syndrome was defined according to the Adult Treatment Panel III criteria with modifications. The age-adjusted incidence rates of the metabolic syndrome per 1000 person-years for people age 20-56 years were 10.0 in men and 8.7 in women. The metabolic syndrome risk significantly increased with age in women, but not in men. Leisure-time physical activity was inversely related to the metabolic syndrome. Smoking more than 20 cigarettes per day was associated with an increased risk compared to non-smokers. The hazard ratios (95% confidence intervals) were 1.27 (1.04-1.54) and 1.40 (1.02-1.92) in men and women, respectively. Alcohol intake and education were inversely associated with metabolic syndrome in women but not in men. Physical inactivity and heavy smoking increased the metabolic syndrome incidence in men and women. Low or no intake of alcohol was also associated with increased risk, but in women only.
  Diabetes Research and Clinical Practice 12/2007; 78(2):217-24.
• Article: Relationship between proinsulin-to-insulin ratio and advanced glycation endproducts in Japanese type 2 diabetic subjects.

  Yoshifumi Saisho, Taro Maruyama, Hiroshi Hirose, Takao Saruta
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  ABSTRACT: Type 2 diabetes (T2DM) is characterized by increased proinsulin-to-insulin ratio (P/I ratio), increased glycation and oxidative stress, and beta-cell dysfunction. Previous reports implicated that increased P/I ratio, glycation and oxidative stress constitute markers of beta-cell dysfunction in T2DM. However, its clinical relevance remains to be elucidated. Therefore, in the present study we investigated the relationship between the P/I ratio, glycation and oxidative stress markers in patients with T2DM, using newly developed intact chemiluminescent immunoassay for proinsulin. Fasting intact proinsulin, insulin, advanced glycation endproducts (AGEs), pentosidine, lipid peroxide and urine 8-isoprostane as well as other metabolic parameters were measured in 64 T2DM subjects. Using univariate analysis, P/I ratio showed significant positive correlations with plasma glucose (r=0.465), HbA1c (r=0.434) and AGEs (r=0.282), and significant negative correlations with insulin (r=-0.330) and HOMA-beta (r=-0.520) even after adjustment for age, sex, duration of diabetes, family history of diabetes, use of sulfonylureas, smoking and body mass index. Additionally, stepwise multiple regression analysis revealed that HOMA-beta, HbA1c and AGEs were independently and significantly correlated with P/I ratio. These findings suggest that not only hyperglycemia per se but also glycation is involved in beta-cell dysfunction in T2DM subjects.
  Diabetes Research and Clinical Practice 12/2007; 78(2):182-8.
• Article: Treatment satisfaction and quality of life using an early insulinization strategy with insulin glargine compared to an adjusted oral therapy in the management of Type 2 diabetes: the Canadian INSIGHT Study.

  Robyn Houlden, Stuart Ross, Stewart Harris, Jean-Francois Yale, Luc Sauriol, Hertzel C Gerstein
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  ABSTRACT: The objective was to compare the impact on treatment satisfaction (TS) and quality of life (QoL) of early insulinization with glargine versus adjusting oral antidiabetic drug (OAD) therapy in people with Type 2 diabetes with uncontrolled glycemia. TS and QoL were assessed at baseline, weeks 12 and 24 within the Canadian INSIGHT, a randomized 24-week trial of Type 2 patients. A total of 366 patients randomized to either the insulin glargine arm (n=182) or the adjusted OAD therapy arm (n=184) completed both questionnaires. At baseline, TS and QoL were similar in both groups. A1c reduction was greater in the insulin glargine arm. TS improved from baseline in both treatment arms; however, there was greater increase with insulin glargine+OAD. Perceived frequency of hypoglycemia and hypoglycemia were lower at week 24, with no differences between the two groups. Perceived frequency of hyperglycemia improved with glargine at week 12, and no difference was found at 24 weeks. Finally, QoL improved in both groups, but significantly more with glargine at both weeks 12 and 24. Improving glucose control by adding insulin glargine to OAD therapy had a positive impact on TS and general QoL without complaints related to hypoglycemia.
  Diabetes Research and Clinical Practice 12/2007; 78(2):254-8.
• Article: Effect of age, degree and distribution of adiposity on the prevalence of the metabolic syndrome in a cohort of obese Italian women.

  Alessandro Sartorio, Fiorenza Agosti, Fulvio Adorni, Franca Pera, Claudio L Lafortuna
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  ABSTRACT: The classification system based on five factors with cut-offs defined by the recent International Diabetes Federation consensus was used to estimate the prevalence of the metabolic syndrome in a cohort of 570 obese Italian women (age: 18-83 years; body mass index (BMI): 30.2-66.7kg/m2). A binary logistic regression analysis model assessed the combined impact of age, BMI, waist circumference (WC) and waist-to-hip ratio (WHR) on such prevalence. The overall prevalence of the syndrome among these obese women was 58.6%. The multivariate binary logistic regression analysis revealed that the prevalence progressively increased with age (p<0.001) attaining an adjusted odd ratio (AOR) of 3.77 in the oldest group, in reference to the younger group, and was significantly higher in women with larger WC (AOR=2.03; p<0.001), and in those with higher WHR (AOR=1.72; p=0.017). In contrast, BMI had no significant effect on the prevalence (AOR=0.84; p=0.441). Among women having the metabolic syndrome, 54.5% had three abnormalities, the prevalent combination (38.5%) being abdominal obesity, low HDL-cholesterol and high blood pressure; four abnormalities were found in 32.0%, displaying in the major part (34.6%) the same above factors plus raised triglycerides, while the remaining 13.5% of affected women had all the five abnormalities. These results indicate a high prevalence of the metabolic syndrome among obese Italian women, although the degree of obesity does not appear to have a significant contributory role per se, unlike the absolute and relative amount of abdominal adiposity, which proved to be independent determinants of the metabolic syndrome, along with advancing age. Considerable variations in number and combinations of abnormalities entailed in the metabolic syndrome indicate that further investigation may possibly identify groups of obese patients at higher risk for targeted intervention.
  Diabetes Research and Clinical Practice 12/2007; 78(2):225-33.
• Article: Relationship between Apolipoprotein E polymorphism and nephropathy in type-2 diabetic patients.

  Elba Leiva, Verónica Mujica, Isabel Elematore, Roxana Orrego, Gonzalo Díaz, María Prieto, Miguel Arredondo
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  ABSTRACT: Twenty to forty percent of type-2 diabetic patients (DM2) present nephropathy. Genetic polymorphism of Apolipoprotein E (Apo E) has been proposed as a risk factor in the development and progression of diabetic nephropathy. The purpose of the study was to evaluate the relationship between Apo E polymorphism and presence of nephropathy in DM2 patients. We studied 85 DM2 patients with a similar nutritional state, environmental and socioeconomic condition and more than 10 years of evolution. They were grouped in DM2 patients with kidney complications (n=56) and without kidney complications (n=29; control group). Apo E genotype was determined by restriction fragment-length polymorphism analysis. A plasmatic biochemical characterization was performed on all the subjects studied. The 85 DM2 patients had arterial hypertension in treatment. The nephropathy diabetic group showed differences (p<0.001) in BMI, systolic blood pressure, glycemia, cholesterol (total, HDL and LDL), HbA1c and creatinine. The e4 allelic frequency was 8% in the nephropathy group versus 25.9% in the control group. Apo e3 allele and E3/3 genotype frequency were higher and E3/4 genotype was lower in the nephropathy group than in controls. These groups also showed differences in total, HDL and LDL cholesterol. DM2 patients without nephropathy presented a higher frequency of e4 allele. These results could suggest a protective role of e4 allele in the development and progression of diabetic nephropathy.
  Diabetes Research and Clinical Practice 12/2007; 78(2):196-201.
• Article: Type 2 diabetes and impaired glucose tolerance in aboriginal populations: a global perspective.

  Catherine H Y Yu, Bernard Zinman
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  ABSTRACT: To perform a systematic review of the prevalence of type 2 diabetes and impaired glucose tolerance (IGT) in aboriginal populations worldwide. A Medline search from 1966 to 2005 was conducted. Studies were selected if they utilized accepted diagnostic criteria for type 2 diabetes. Year of study, sample size, response rate, age range, and prevalence of type 2 diabetes and IGT were documented. Forty-two studies were selected, comprising 59 populations. Although the majority demonstrated a several-fold elevation of type 2 diabetes prevalence as compared to non-aboriginal populations, this was not a universal finding; a small number of populations studied actually had a low prevalence of type 2 diabetes and IGT. Lower prevalences were found in rural compared with urban populations. Interestingly, we were also able to document an inverse relationship between the ratio of IGT/type 2 diabetes and type 2 diabetes prevalence. These data are consistent with the hypothesis that those populations with the very highest rates of type 2 diabetes appear to have progressed past the prediabetes stages in the natural history of this metabolic disorder. Type 2 diabetes and IGT prevalence rates vary widely amongst the world's aboriginal populations. Despite very different histories and cultures, the consequences of rapid changes in nutrition and exercise appear to have very similar metabolic consequences on aboriginal populations, the magnitude of which may be determined by the strength of the genetic susceptibility.
  Diabetes Research and Clinical Practice 12/2007; 78(2):159-70.
• Article: Beer ethanol consumption and plasma homocysteine among patients with type 2 diabetes.

  Hidenari Sakuta, Takashi Suzuki, Teizo Ito, Hiroko Yasuda
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  ABSTRACT: We analyzed the association between beer and other type of ethanol consumption and tHcy levels among type 2 diabetic patients. Male type 2 diabetic patients without overt nephropathy were studied (n=242). Ethanol consumptions of the patients were 35.1+/-37.8mL/day for total ethanol, 13.9+/-15.2mL/day for beer ethanol and 21.2+/-32.1mL/day for non-beer ethanol. Both, total and non-beer ethanol consumption correlated with tHcy, whereas beer ethanol consumption showed a trend to inverse association with tHcy (standard regression coefficient, 0.184, 0.283 and -0.110, respectively). Each intake of 30mL/day ethanol consumption was associated with an increase of tHcy of 0.6micromol/L for total ethanol and 1.1micromol/L for non-beer ethanol and a decrease of tHcy of 0.7micromol/L for beer ethanol. Similar trend was observed in the analysis model which included only drinkers, and also in an adjusted analysis model. Plasma tHcy of beer only drinkers was lower than that of non-beer alcohol only drinkers (8.9+/-1.9micromol/L versus 11.5+/-5.5micromol/L, P=0.003). Non-beer ethanol consumption might be less healthy compared with beer ethanol consumption among type 2 diabetic patients in terms of the effects on tHcy.
  Diabetes Research and Clinical Practice 12/2007; 78(2):202-7.
• Article: Diabetes prevalence and association with social status--widening of a social gradient? German national health surveys 1990-1992 and 1998.

  Andrea Icks, Susanne Moebus, Astrid Feuersenger, Burkhard Haastert, Karl-Heinz Jöckel, Guido Giani
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  ABSTRACT: Widening of social inequality in health is often discussed. Data regarding trends of the association between diabetes prevalence and social status are lacking. Using two German health surveys (age 25-69 years), we estimated diabetes prevalences in 1998 compared to 1990-1992. Interaction of secular time with educational level, adjusted for age and BMI, were estimated in men and women using multiple regression models, considering the sample design. Diabetes prevalences in 1990-1992 and 1998 were 5.1% (95% CI 4.1-6.0) and 4.3% (3.5-5.1) in men, and 4.7% (4.0-5.4) and 3.8% (3.0-4.6) in women. It was significantly higher in older subjects and in obese subjects, and tended to be higher in lower educated subjects. Overall, prevalence tended to be lower in 1998 compared to 1990-1992, however, not statistically significant after adjustment for education and BMI (odds ratio, 95% CI: men 0.73; 0.39-1.37; women 0.41; 0.17-1.03). On a descriptive level, in the lowest education group, the diabetes prevalence was higher in 1998 compared to 1990-1992, whereas, it has decreased in higher educated subjects. However, confidence intervals were large, and we found no statistically significant interaction between calendar year and the educational level. Diabetes prevalence tended to decrease in Germany during the 1990s. A widening of social disparity in diabetes risk might be present, but a significant increase could not be confirmed.
  Diabetes Research and Clinical Practice 12/2007; 78(2):293-7.