Diabetes research and clinical practice
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Diabetes Res. Clin. Pract. · Mar 2005
Microalbuminuria and risk factors in type 1 and type 2 diabetic patients.
A prospective study of normoalbuminuric diabetic patients was performed between 1997 and 2002 on 4097 type 1 and 6513 type 2 diabetic patients from the Swedish National Diabetes Register (NDR); mean study period, 4.6 years. The strongest independent baseline risk factors for the development of microalbuminuria (20-200 microg/min) were elevated HbA(1c) and diabetes duration in both types 1 and 2 diabetic patients. Other risk factors were high BMI, elevated systolic and diastolic BP in type 2 patients, and antihypertensive therapy in type 1 patients. ⋯ In conclusion, high HbA(1c), BP and BMI were independent risk factors for the development of microalbuminuria in types 1 and 2 diabetic patients. These risk factors as well as triglycerides, HDL-cholesterol and smoking were independently associated with established microalbuminuria. Treatment targets were achieved by a relatively few patients with microalbuminuria.
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Diabetes Res. Clin. Pract. · Sep 2004
Comparative StudyComparative estimates of the financial burden to the UK health system of hospital care for people with and without diabetes in the year before death.
To quantify hospital costs prior to death for patients with and without diabetes. ⋯ The costs of inpatient care for all patients increases markedly in the final year of life. People with diabetes were found to be more financially costly, even in this stage of their care, than were people who did not have diabetes.
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Diabetes Res. Clin. Pract. · Sep 2004
Randomized Controlled Trial Clinical TrialBeneficial effect of low carbohydrate in low calorie diets on visceral fat reduction in type 2 diabetic patients with obesity.
The adequate composition of carbohydrate and fat in low calorie diets for type 2 diabetes mellitus patients with obesity is not fully established. The aim of this study was to investigate the effects of low carbohydrate diet on glucose and lipid metabolism, especially on visceral fat accumulation, and comparing that of a high carbohydrate diet. Obese subjects with type 2 diabetes mellitus were randomly assigned to take a low calorie and low carbohydrate diet (n = 11, 1000 kcal per day, protein:carbohydrate:fat = 25:40:35) or a low calorie and high carbohydrate diet (n = 11, 1000 kcal per day, protein:carbohydrate:fat = 25:65:10) for 4 weeks. ⋯ There was a larger decrease in visceral fat area measured by computed tomography in the low carbohydrate diet group compared to the high carbohydrate diet group (-40 cm(2) versus -10 cm(2), P < 0.05). The ratio of visceral fat area to subcutaneous fat area did not change in the high carbohydrate diet group (from 0.70 to 0.68), but it decreased significantly in the low carbohydrate diet group (from 0.69 to 0.47, P < 0.005). These results suggest that, when restrict diet was made isocaloric, a low calorie/low carbohydrate diet might be more effective treatment for a reduction of visceral fat, improved insulin sensitivity and increased in HDL-C levels than low calorie/high carbohydrate diet in obese subjects with type 2 diabetes mellitus.
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Diabetes Res. Clin. Pract. · Aug 2004
In an Aboriginal birth cohort, only child size and not birth size, predicts insulin and glucose concentrations in childhood.
The objectives were to describe cross-sectional growth in 279 Australian Aboriginal children aged 8-14 years in order to test the hypothesis that birth size interacts with child size to predict glucose and insulin metabolism. Cross-sectional growth outcomes were described using standard deviation scores or z-scores for height for age (HAZ) and weight for age (WAZ) calculated from CDC 2000 reference values in Epi Info 2000. Interrelationships were examined using standard regression models with current height and weight and birth weight, ponderal index and birth weight below the 10th percentile for gestational age. ⋯ Current child height and weight had positive relationships with both fasting insulin and glucose concentrations with a greater proportional change for insulin. For every increment of 1cm in height or 1 kg in weight, insulin concentrations rose 2% whereas glucose increased by only 0.2%. In this indigenous Australian cohort with poor post-natal growth, only current child size is related to measures of glucose and insulin metabolism.
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Diabetes Res. Clin. Pract. · Jul 2004
Comparative StudyEffect of carbohydrate source on post-prandial blood glucose in subjects with type 1 diabetes treated with insulin lispro.
Our purpose was to determine if the glycemic index (GI) and proportion of carbohydrate absorbed as glucose (Pg) affected glycemic responses and occurrence of post-prandial hypoglycemia in subjects with type 1 diabetes treated with insulin lispro. Subjects (n=8) were studied on five separate occasions after 10-12 h overnight fasts following a standard dinner. After their morning insulin dose, subjects ate 50 g carbohydrate from a starchy food (Pg=1; mashed potato GI=83, white bread GI=71, spaghetti GI=41, barley GI=25) or pineapple juice (Pg=0.5; GI=46). ⋯ Thus, in subjects with type 1 diabetes treated with insulin lispro, GI predicts glycemic responses of carbohydrate foods. Pg may affect the occurrence of post-prandial hypoglycemia, while GI may affect its timing. Further studies using mixed meals are required to confirm how carbohydrate source affects glycemic responses and occurrence of hypoglycemia in normal meal setting.