Diabetes Research and Clinical Practice RSS feed: Current Issue. Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy. A reduced member subscription rate is available to all International Diabetes Federation affiliates worldwide. For more information, please apply to the Publisher: andrew.miller@elsevier.com . Please click here to view a complete list of Diabetes Research and Clinical Practice Supplements to date. http://www.diabetesresearchclinicalpractice.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Diabetes Research and Clinical Practice0168-8227881April 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.diabetesresearchclinicalpractice.com/article/PIIS016882271000094X/abstract?rss=yesEditorial Board10.1016/S0168-8227(10)00094-XDiabetes Research and Clinical Practice 88, 1 (2010)2010-04-01Diabetes Research and Clinical Practice2010-04-01881S0168-8227(10)X0004-3CO3CO3http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005518/abstract?rss=yesAbstract: We conducted a meta-analysis of studies reporting diabetes case management interventions to examine the impact of case management on blood glucose control (HbA1c). Databases used for the search included Medline, PubMed, Cochrane EPOC, Cumulative Index to Nursing & Allied Health Literature database guide (CINAHL), and PsychInfo. A composite estimate of effect size was calculated using a random effects model and subgroup analyses were conducted. Twenty-nine salient studies involving 9397 patients had sufficient data for analysis. Mean patient age was 63.2 years, 49% were male, and ethnicity/race was 54% White. Type 2 diabetes was the focus in 91% of studies. Results showed a large overall effect size favoring case management intervention over controls or baseline values on HbA1c (ES=0.86, 95%CI: 0.52–1.19, Z=5.0, p<0.001). This corresponds to a mean HbA1c reduction of 0.89 (95%CI: 0.63–1.15). Subgroup analyses showed clinical setting, team composition, and baseline HbA1c were important predictors of effect size, but not diabetes self-management education which was poorly described or absent in most diabetes case management interventions examined. Nurse-led case management provides an effective clinical strategy for poorly controlled diabetes based on a meta-analysis of clinical trials focusing on blood glucose control.Nurse diabetes case management interventions and blood glucose control: Results of a meta-analysisGarry Welch, Jane Garb, Sofija Zagarins, Irina Lendel, Robert A. Gabbay10.1016/j.diabres.2009.12.026Diabetes Research and Clinical Practice 88, 1 (2010)2010-02-01Diabetes Research and Clinical Practice2010-02-01881S0168-8227(10)X0004-3Review16http://www.diabetesresearchclinicalpractice.com/article/PIIS016882270900549X/abstract?rss=yesAbstract: Aim: To compare clinical-metabolic monitoring and coronary risk status in people with type 2 diabetes from Australia, France and Latin America.Methods: Retrospective analysis of data collected at primary care (4540 participants from each population) matched for age, gender and disease duration. Measurements included participants’ characteristics, performance frequency of clinical-metabolic process indicators, and percentage of clinical-metabolic outcomes at recommended target values.Results: The weighted mean of the percentage of process performance was within 68 to 81%; that of outcomes at target dropped to 29 to 45%. Although statistically significant, differences among groups were far from those in healthcare budgets, and probably only of marginal clinical impact. The percentage of patients with low, slight or high coronary risk was similar in the three groups, with most people at high or very high risk.Conclusions: Despite the high difference in health per capita investment and system characteristics among countries, the study populations had striking similarities regarding the low percentage of participants who achieved cardiovascular risk factor and diabetes treatment goals. Therefore, differences in health budget and system characteristics would not be the main drivers in care quality. Diabetes education at every level and quality care registries would contribute to improve this situation and assess such improvement.Comparison of clinical-metabolic monitoring and outcomes and coronary risk status in people with type 2 diabetes from Australia, France and Latin AmericaJuan J. Gagliardino, Line Kleinebreil, Stephen Colagiuri, Jeff Flack, Joaquín E. Caporale, Fernando Siri, Charles Clark10.1016/j.diabres.2009.12.024Diabetes Research and Clinical Practice 88, 1 (2010)2010-02-15Diabetes Research and Clinical Practice2010-02-15881S0168-8227(10)X0004-3Basic research713http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000094/abstract?rss=yesAbstract: Juvenile metabolic syndrome (MetS) is a growing major medical problem in industrialised countries. We estimated its prevalence among two similar clinic-based sequentially recruited cohorts of extremely obese adolescents (age: 12–18 years) from Italy (N=665, males=271, females=394) and Germany (N=661, males=261, females=400) using the recent IDF paediatric criteria. The prevalence of the MetS was 23.3% among the Italians and 40.4% among the Germans. A multivariate logistic regression revealed an increased risk related to age (adjusted odd ratio (AOR): 2.24; 95% confidence interval (CI): 1.59–3.16; p<0.001), BMI SDS (AOR: 3.61; 95% CI: 2.33–5.60; p<0.001), male gender (AOR: 2.36; 95% CI: 1.80–3.10; p<0.001), and in German adolescents (AOR: 2.56; 95% CI: 1.98–3.31; p<0.001). Among Italian adolescents having the MetS, 83% had 3 abnormalities, 16% had 4 abnormalities while less than 1% had all the 5 abnormalities. In the German cohort, 67%, 28% and 5% of affected individuals had 3, 4 and 5 abnormalities, respectively. These results indicate that MetS is highly prevalent among extremely obese adolescents, and suggest that (besides age, obesity and gender) national sociocultural factors, as alimentary trends, could be important. Further tools should be developed to understand international epidemiological differences concerning obesity and its comorbidities in relation to lifestyles in the countries of European Union.Prevalence of the metabolic syndrome among extremely obese adolescents in Italy and GermanyClaudio L. Lafortuna, Fulvio Adorni, Fiorenza Agosti, Alessandra De Col, Kolja Sievert, Wolfgang Siegfried, Alessandro Sartorio10.1016/j.diabres.2010.01.008Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-22Diabetes Research and Clinical Practice2010-01-22881S0168-8227(10)X0004-3Basic research1421http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000082/abstract?rss=yesAbstract: Aims: Hypoglycemia unawareness is a common condition associated with increased risk of severe hypoglycemia. We test the hypothesis that specific changes in the electroencephalogram (EEG) during hypoglycemia can be recorded by subcutaneous electrodes and processed by a general mathematical algorithm, and that hypoglycemia associated EEG changes appear before the development of severe hypoglycemia.Methods: Fifteen patients with type 1 diabetes were exposed to insulin-induced hypoglycemia and EEG was recorded. The cognitive function was evaluated by repeated cognitive testing. Insulin infusion was terminated when plasma glucose reached 1.8mmol/l or when the subjects showed obvious signs of cognitive dysfunction. EEG was analyzed by an automated mathematical algorithm with a predefined threshold of hypoglycemia.Results: Hypoglycemia associated EEG changes were detected by the mathematical algorithm in all subjects. Plasma glucose at the time of EEG changes above the threshold value ranged from 2.0 to 3.4mmol/l and occurred 29±28min (range 3–113min) before termination of insulin infusion.Conclusions: Hypoglycemia associated EEG changes could be detected by an automated mathematical algorithm in all subjects exposed to insulin-induced hypoglycemia. In 12 of 15 patients, EEG changes occurred before severe hypoglycemia as evaluated by the cognitive testing.Automated detection of hypoglycemia-induced EEG changes recorded by subcutaneous electrodes in subjects with type 1 diabetes—The brain as a biosensorClaus B. Juhl, Kurt Højlund, Rasmus Elsborg, Mikael Kjær Poulsen, Peter E. Selmar, Jens Juul Holst, Claus Christiansen, Henning Beck-Nielsen10.1016/j.diabres.2010.01.007Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-15Diabetes Research and Clinical Practice2010-01-15881S0168-8227(10)X0004-3Basic research2228http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000161/abstract?rss=yesAbstract: Aims: To assay the levels of serum omentin-1 in subjects with different levels of glucose regulation and to analyze the relationship between serum omentin-1 levels and body mass index (BMI), glycoslated hemoglobin (HbA1c), plasma glucose, insulin resistance index (HOMA-IR), TNF-α and IL-6 levels.Methods: Forty-six patients with impaired glucose regulation (IGR), 55 patients with newly diagnosed and untreated type 2 diabetes mellitus (T2DM), and 50 subjects with normal glucose tolerance (NGT) were enrolled in this study. The levels of serum omentin-1 and plasma glucose at fasting and at 2h after glucose load and fasting serum levels of TNF-α, IL-6, insulin, and HbA1c were measured. HOMA-IR was calculated.Results: The levels of serum omentin-1 were lower in the IGR and T2DM groups than in the NGT group. Within groups, omentin-1 levels were no significant difference before and after glucose load. The level of serum omentin-1 was negatively correlated to BMI, HOMA-IR, fasting insulin, TNF-α, IL-6, plasma glucose. HOMA-IR and BMI were independent related factors that influenced the levels of serum omentin-1.Conclusions: Serum omentin-1 levels were decreased in impaired glucose regulation subjects. Lack of omentin-1 may contribute to the development of insulin resistance and T2DM.Changes of serum omentin-1 levels in normal subjects and in patients with impaired glucose regulation and with newly diagnosed and untreated type 2 diabetesHong-Yan Pan, Lin Guo, Qiang Li10.1016/j.diabres.2010.01.013Diabetes Research and Clinical Practice 88, 1 (2010)2010-02-03Diabetes Research and Clinical Practice2010-02-03881S0168-8227(10)X0004-3Basic research2933http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005439/abstract?rss=yesAbstract: Aim: To examine the effects of vigorous physical activity (PA) on intra-abdominal fat (IF) levels in obese men.Methods: Thirty-seven obese men (mean age: 47.6±8.6 years) engaged in a 12-week aerobic exercise program on a regular basis (3 days/week). We divided them into low volume of vigorous PA group (n=19) or high volume of vigorous PA group (n=18), based on the median time spent (34.3min/week) in vigorous PA (over 6.1 metabolic equivalents assessed by a single-axis accelerometer) throughout the program.Results: Regular exercise reduced IF levels (measured by computed tomography) from 188.1±53.9cm2 to 170.3±46.6cm2 for the low volume of vigorous PA group and from 167.9±44.3cm2 to 137.9±40.6cm2 for the high volume of vigorous PA group. Two-way (time×group) ANOVA revealed no significant interactions for the IF level. However, correlation analysis for all participants showed that time spent in vigorous PA throughout the program significantly correlated to IF reductions after adjusting for initial levels of IF, vigorous PA and weight changes (r=−0.42, P=0.02).Conclusion: This study suggests that vigorous PA may affect IF reductions in obese men.The effects of vigorous physical activity on intra-abdominal fat levels: A preliminary study of middle-aged Japanese menHiroyuki Sasai, Yasutomi Katayama, Yoshio Nakata, Miki Eto, Takehiko Tsujimoto, Hiroyuki Ohkubo, Kiyoji Tanaka10.1016/j.diabres.2009.12.018Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-14Diabetes Research and Clinical Practice2010-01-14881S0168-8227(10)X0004-3Clinical care and education3441http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005427/abstract?rss=yesAbstract: Aim: To compare effects of three different insulin secretagogues on early-phase insulin secretion, metabolism of glucose and lipids, and lipid peroxidation in newly diagnosed Type 2 Diabetes Mellitus (T2DM).Methods: Totally 60 newly diagnosed T2DM outpatients were randomized to three groups with 1-month monotherapy of repaglinide (Rg), glimepiride (Gm) or gliclazide MR (Gli), respectively. Some indexes of early-phase insulin secretion, glucose, lipids, and lipid peroxidation were inspected.Results: Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c) and fructosamine (FA) were improved in all groups similarly (p>0.05). Rg group was with the highest early-phase insulin secretion index (ΔI30/ΔG30) (p=0.026), lower mean amplitude of glycaemic excursion (MAGE) (p<0.05), lowest mean peak value of post-lunch glucose (p=0.043), and lowest postprandial triglyceride (TG) (p=0.039). Postprandial free fatty acid (FFA) was lower after Rg and Gli treatment (p<0.05). Serum 8-iso prostaglandin F2α (8-iso PGF2α) was improved in all groups, but the improvement showed statistically significant only in Rg group (p=0.04).Conclusion: Rg, Gm and Gli can all decrease blood glucose effectively in newly diagnosed T2DM patients, while Rg performs outstandingly in the aspects of improving early-phase insulin secretion, glucose excursion, postprandial lipids and 8-iso PGF2α.Effects of short-term therapy with different insulin secretagogues on glucose metabolism, lipid parameters and oxidative stress in newly diagnosed Type 2 Diabetes MellitusYan Li, Lijuan Xu, Jie Shen, Jianmin Ran, Yang Zhang, Min Wang, Li Yan, Hua Cheng, Zuzhi Fu10.1016/j.diabres.2009.12.017Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-08Diabetes Research and Clinical Practice2010-01-08881S0168-8227(10)X0004-3Clinical care and education4247http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005403/abstract?rss=yesAbstract: The purpose of this study was to investigate certified diabetes educators’ (CDEs) perceptions of the adequacy of their diabetes education curricula in providing oral health information. A questionnaire was mailed to all CDEs with a mailing address in South Carolina (SC), United States (US). Of the 130 respondents, between 50%–60% indicated that they adequately addressed frequent dental visits, daily brushing and flossing, and importance of good oral hygiene. Almost all (93.8%) reported that their curricula did not include an oral health module; the two predominant reasons were: not having enough time (61.0%), and not knowing enough about oral health and its relationship to diabetes (37.0%). Respondents who expressed that they did not know enough about oral health and its relationship to diabetes were less likely to provide adequate ‘oral-health-related information’ (p=0.008), especially information about the effect of periodontal disease on diabetes (p=0.016). This study indicates that SC CDEs do not routinely provide comprehensive oral health education to people with diabetes primarily due to lack of time and knowledge related to oral health. To better serve their patients, CDEs should integrate oral health education in the diabetes education curriculum.A survey of oral health education provided by certified diabetes educatorsHon K. Yuen, Georgiana Onicescu, Elizabeth G. Hill, Carolyn Jenkins10.1016/j.diabres.2009.12.015Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-15Diabetes Research and Clinical Practice2010-01-15881S0168-8227(10)X0004-3Clinical care and education4855http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005373/abstract?rss=yesAbstract: Aims: To evaluate the effectiveness of a two-arm quality improvement program (QIP) to support general practice with limited tradition in chronic care on type 2 diabetes patient outcomes.Methods: During 18 months, we performed a cluster randomized trial with randomization of General Practices. The usual QIP (UQIP: 53 GPs, 918 patients) merged standard interventions including evidence-based treatment protocol, annual benchmarking, postgraduate education, case-coaching for GPs and patient education. The advanced QIP (AQIP: 67 GPs, 1577 patients) introduced additional interventions focussing on intensified follow-up, shared care and patient behavioural changes. Main outcomes were HbA1c, systolic blood pressure (SBP), and low density lipoprotein cholesterol (LDL-C), analyzed by generalized estimating equations and linear mixed models.Results: In UQIP, endpoints improved significantly after intervention: HbA1c −0.4%, 95% CI [−0.4; −0. 3]; SBP −3mmHg, 95% CI [−4; −1]; LDL-C −13mg/dl, 95% CI [−15; −11]. In AQIP, there were no significant additional improvements in outcomes: HbA1c −0.4%, 95% CI [−0.4; −0.3]; SBP −4mmHg, 95% CI [−5; −2]; LDL-C −14mg/dl, 95% CI [−15; −11].Conclusions: A multifaceted program merging standard interventions in support of general practice induced significant improvements in the quality of diabetes care. Intensified follow-up in AQIP with focus on shared care and patient behaviour changes did not yield additional benefit.Start improving the quality of care for people with type 2 diabetes through a general practice support program: A cluster randomized trialGeert Goderis, Liesbeth Borgermans, Richard Grol, Carine Van Den Broeke, Benoit Boland, Geert Verbeke, An Carbonez, Chantal Mathieu, Jan Heyrman10.1016/j.diabres.2009.12.012Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-04Diabetes Research and Clinical Practice2010-01-04881S0168-8227(10)X0004-3Clinical care and education5664http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005361/abstract?rss=yesAbstract: Aims: We examined whether glycated hemoglobin (HbA1C) levels of Japanese diabetic patients showed seasonal fluctuations.Methods: Subjects included 2511 diabetic patients who regularly visited a single diabetic outpatient clinic for 10 years. A total of 253,477 HbA1C measurements, as well as sex, age, BMI, type of diabetes, and mode of therapy were extracted from a hospital-based database. For the cross-sectional and longitudinal analyses, average monthly HbA1C values of subjects and amplitudes of seasonal fluctuations were calculated. For the time-series analysis, seasonal adjustment factors of each subject were classified as complete, incomplete, or no fluctuation.Results: Subjects showed a clear seasonal fluctuation of HbA1C levels, with highest levels in March (7.69%) and lowest levels in August (7.46%; p<0.001). The amplitudes of the seasonal fluctuations were associated with the mean HbA1C levels. The time-series analysis showed that 78.3% of patients had complete or incomplete seasonal fluctuations. HbA1C levels were highest in winter–spring and lowest in summer–autumn in most patients; however, some patients showed a reverse pattern.Conclusions: Seasonal fluctuations of HbA1C levels were recognized in most of the Japanese diabetic patients. Physiological or metabolic factors related to temperature may be the main cause of seasonal fluctuations in HbA1C levels.Seasonal fluctuations of glycated hemoglobin levels in Japanese diabetic patientsHiroshi Sakura, Yasutomi Tanaka, Yasuhiko Iwamoto10.1016/j.diabres.2009.12.011Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-04Diabetes Research and Clinical Practice2010-01-04881S0168-8227(10)X0004-3Clinical care and education6570http://www.diabetesresearchclinicalpractice.com/article/PIIS016882270900535X/abstract?rss=yesAbstract: Background: To investigate the effects of Glimepiride on blood glucose in patients with newly diagnosed type 2 diabetes mellitus (T2DM) in connection with plasma lipoproteins and plasminogen activity.Methods: A total of 565 T2DM patients were received Glimepiride (n=333) or Glibenclamide (n=232) for 12 weeks. We observed the level of blood glucose (BG), glycated hemoglobin (HbA1C), the insulin resistance (IR) state, plasma lipoproteins, tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor type I (PAI-1) before and after a 12 weeks of treatment.Results: After 12 weeks with Glimepiride treatment, significant reductions were observed in fasting blood glucose (FBG) and 2-h postprandial BG(PBG), HbA1C (from 8.60±3.10 to 7.10±1.60%) and HOMA-IR (from 4.11±0.85 to 2.42±0.91%). The level of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were significantly decreased, whereas that of high-density lipoprotein (HDL) was increased markedly with statistical significance. In addition, there was an obvious improvement in t-PA activity (from 0.225±0.11 to 0.457±0.177IU/ml); whereas the PAI-1 activity was decreased significantly (from 0.898±0.168 to 0.533±0.215AU/ml). No significant changes were observed in plasma lipoprotein profiles and plasminogen activity in Glibenclamide receiving group.Conclusions: Glimepiride can rapidly and stably improve glycemic control and lipoprotein metabolism, significantly alleviate insulin resistance and enhance fibrinolytic activity.Effects of Glimepiride on metabolic parameters and cardiovascular risk factors in patients with newly diagnosed type 2 diabetes mellitusDan-yan Xu, Shui-Ping Zhao, Qiu-xia Huang, Wei Du, Yu-hua Liu, Ling Liu, Xiao-mei Xie10.1016/j.diabres.2009.12.010Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-04Diabetes Research and Clinical Practice2010-01-04881S0168-8227(10)X0004-3Clinical care and education7175http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005440/abstract?rss=yesAbstract: Background: The polymorphism 385 C/A of FAAH has been associated with overweight and obesity. The aim of our study was to investigate the relationship of polymorphism (cDNA 385 C→A) of FAAH gene on obesity parameters in patients with diabetes mellitus type 2.Design: A population of 70 patients with diabetes mellitus type 2 was analyzed. An anthropometric and biochemical nutritional assessment was performed. The statistical analysis was performed for the combined C358A and A358A as a group and wild type C358C as second group.Results: Fifty-five patients (78.7%) had genotype C358C (wild type group) and 15 (21.3%) patients C358A (14 patients, 20.6%) or A358A (1 patient, 0.7%) (mutant group). BMI (38.9±6.4 vs. 39.2±5.7, p<0.05), weight (96.8±17.6kg vs. 102.5±16.8kg, p<0.05), fat mass (42.1±16.1kg. vs. 46.9±11.1kg, p<0.05), waist circumference (115.9±12.8cm vs. 121.3±12.8cm, p<0.05), insulin (22.5±18.8mUI/L vs. 33.9±17.1UI/L, p<0.05) and TNF-alpha (6.1±3.4pg/mL vs. 8.4±3.2pg/mL, p<0.05) were higher in mutant type group than wild type. Adiponectin levels (33.3±20.8ng/mL vs. 22.3±10.8ng/mL, p<0.05) were higher in wild type group than mutant type group.Conclusion: There is an association of the mutant type group A358C and A358A of FAAH with a worse cardiovascular profile (weight, body mass index, waist circumference, insulin,TNF-alpha and adiponectin levels) than wild type group.C358A missense polymorphism of the endocannabinoid degrading enzyme fatty acid amide hydrolase (FAAH) and insulin resistance in patients with diabetes mellitus type 2D.A. de Luis, M. Gonzalez Sagrado, R. Aller, O. Izaola, R. Conde, E. Romero10.1016/j.diabres.2009.12.019Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-07Diabetes Research and Clinical Practice2010-01-07881S0168-8227(10)X0004-3Clinical care and education7680http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005488/abstract?rss=yesAbstract: Aim: To determine the possible factors predicting the insulin requirement in pregnancies complicated by gestational diabetes mellitus (GDM).Method: A total of 294 patients with GDM diagnosed by the 100-g/3-h oral glucose tolerance test (OGTT) were studied. The following factors were analyzed: maternal age, nulliparity, family history of diabetes, prepregnancy BMI, prior GDM, prior fetal macrosomia, multiple pregnancy, polyhydramnios, gestational age at diagnosis of GDM, smoking, hypertension, number of abnormal 100-g/3-h OGTT values, and glycated hemoglobin (HbA1c). The association between each factor and the need for insulin therapy was then analyzed individually. The performance of these factors to predict the probability of insulin therapy was estimated using a logistic regression model.Results: Univariate analysis showed a positive correlation between insulin therapy and prepregnancy BMI, family history of diabetes, hypertension, prior GDM, prior fetal macrosomia, number of abnormal 100-g/3-h OGTT values, and HbA1c (P<0.05). Prepregnancy BMI, family history of diabetes, number of abnormal 100-g/3-h OGTT values and HbA1c were statistically significant variables in the logistic regression model.Conclusions: The probability of insulin therapy can be estimated in pregnant women with GDM based on prepregnancy BMI, family history of diabetes, number of abnormal 100-g/3-h OGTT values, and HbA1c concentration.Factors predicting the need for insulin therapy in patients with gestational diabetes mellitusAndreia David Sapienza, Rossana Pulcineli Vieira Francisco, Thatianne Coutheux Trindade, Marcelo Zugaib10.1016/j.diabres.2009.12.023Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-13Diabetes Research and Clinical Practice2010-01-13881S0168-8227(10)X0004-3Clinical care and education8186http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000033/abstract?rss=yesAbstract: Aims: We investigated whether gene polymorphisms of Ecto-nucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) and matrix metalloproteinase 3 (MMP3) are associated with increased vascular calcification in patients with type 2 diabetes (T2D) and evaluated whether serum MMP3 and osteoprotegerin (OPG) levels are related to calcification.Methods: This study included 464 subjects: 269 patients with T2D and 195 healthy controls in South Korea. We genotyped subjects for four single nucleotide polymorphisms (SNPs): ENPP1 K121Q, ENPP1 A/G+1044TGA, MMP3 −709A>G and MMP3 −1475G>A. The presence or absence of calcifications in the aortic arch was assessed by plain chest radiography.Results: The SNPs ENPP1 K121Q and MMP3 −709A>G showed significant associations with T2D (P=0.001 and P=0.004). The SNP ENPP1 K121Q showed a significant association with aortic arch calcification in T2D (P=0.036). Serum OPG levels were significantly higher in T2D patients than in the control group (P<0.001). However, serum MMP3 levels were significantly lower in T2D patients than in the control group (P<0.001).Conclusions: Our study demonstrates that the ENPP1 K121Q and MMP3 −709A>G polymorphisms are associated with T2D, and that the ENPP1 Q allele is associated with increased aortic arch calcification in a Korean population.Impact of ENPP1 and MMP3 gene polymorphisms on aortic calcification in patients with type 2 diabetes in a Korean populationJung-Eun Lee, Yeon-Kyung Choi, Hyun-Ae Seo, Jae-Han Jeon, Ji-Yun Jeong, Seong-Su Moon, Jung-Guk Kim, Bo-Wan Kim, Su-Won Kim, Min Yoo, Joon-Young Kim, In-Kyu Lee10.1016/j.diabres.2010.01.002Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-21Diabetes Research and Clinical Practice2010-01-21881S0168-8227(10)X0004-3Clinical care and education8796http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000021/abstract?rss=yesAbstract: Aims: To determine if hyperglycemia on admission correlates to infarct size measured by single-photon emission computed tomography (SPECT) in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).Methods: We evaluated 347 STEMI patients who underwent primary PCI. Infarct size was determined by SPECT on Day 5. The population was divided into: hyperglycemia (glycemia on admission >11mmol/L) or non-hyperglycemia (≤11mmol/L) regardless of diabetic status.Results: 61 (17.6%) patients presented with hyperglycemia on admission. There were no significant differences in baseline characteristics or in PCI characteristics between the two groups. Final TIMI 3 flow was achieved in 81.7% of patients with hyperglycemia vs 85.7% of patients with non-hyperglycemia (p=0.43). The infarct size was larger in the hyperglycemia group (6 [2–14]% vs 8.5 [3–18.25]%; p=0.016). A multivariate linear regression analysis showed that hyperglycemia on admission was an independent predictor of infarct size at Day 5 post-MI (p=0.004).Conclusion: In patients with STEMI treated with primary PCI, hyperglycemia on admission is associated with larger infarct size determined by SPECT.Hyperglycemia on admission predicts larger infarct size in patients undergoing percutaneous coronary intervention for acute ST-segment elevation myocardial infarctionIgnacio Cruz-Gonzalez, Stanley Chia, Owen C. Raffel, Maria Sanchez-Ledesma, Fred Senatore, Frans J. Wackers, David M. Nathan, Ik-Kyung Jang10.1016/j.diabres.2010.01.001Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-18Diabetes Research and Clinical Practice2010-01-18881S0168-8227(10)X0004-3Clinical care and education97102http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005476/abstract?rss=yesAbstract: Aim: The aim of this study was to examine the association of serum bilirubin, an endogenous antioxidant, with serum high sensitivity C-reactive protein (hs-CRP) level, HbA1c, and the prevalence of type 2 diabetes in middle-aged and elderly Japanese men and women (n=12,400).Methods: Analysis of covariance and logistic regression analysis were used to estimate geometric means of hs-CRP and HbA1c and odds ratios of prevalent diabetes according to bilirubin concentrations, respectively, with statistical adjustment for behavioral factors and liver enzymes.Results: Geometric means of hs-CRP and HbA1c were progressively lower with increasing concentrations of serum bilirubin in men and women each. An inverse association between serum bilirubin and HbA1c was slightly attenuated after adjustment for hs-CRP, but still remained highly significant (trend P=0.0004 in men and trend P=10−5 in women). Multivariate-adjusted odds ratios of prevalent diabetes for the lowest to highest quintiles of serum total bilirubin were 1.00, 1.00, 0.73, 0.80, and 0.73 (trend P=0.002), without adjustment for hs-CRP, and 1.00, 1.04, 0.76, 0.86, and 0.79 (trend P=0.01), with adjustment for hs-CRP.Conclusions: Higher concentrations of serum bilirubin probably confer protection against the development of type 2 diabetes.Inverse associations of serum bilirubin with high sensitivity C-reactive protein, glycated hemoglobin, and prevalence of type 2 diabetes in middle-aged and elderly Japanese men and womenKeizo Ohnaka, Suminori Kono, Toyoshi Inoguchi, Guang Yin, Makiko Morita, Masahiro Adachi, Hisaya Kawate, Ryoichi Takayanagi10.1016/j.diabres.2009.12.022Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-18Diabetes Research and Clinical Practice2010-01-18881S0168-8227(10)X0004-3Epidemiology103110http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000045/abstract?rss=yesAbstract: Objective: To investigate whether alanine aminotransferase (ALT), even within the reference range, is associated with atherosclerotic burden in apparently healthy adults.Methods: This was an observational study performed on 830 healthy individuals with normal ALT concentration (≤40U/L). Atherosclerotic burden was assessed by carotid arterial intima-media thickness (IMT). All subjects were divided according to the quartile based on their ALT concentrations.Results: Despite all subjects having a normal ALT concentration, ultrasonographic liver steatosis was observed in 48.4% and 36.7% of men and women, respectively. In both genders, subjects in the highest quartile of ALT concentration had a significantly higher waist circumference, triglyceride concentration, HOMA-IR, a higher prevalence of metabolic syndrome, and a greater severity of ultrasonographic liver steatosis than did those in the lower quartiles. In women, the carotid IMT increased significantly with increasing quartiles of ALT concentration (0.62±0.14mm, 0.66±0.15mm, 0.69±0.15mm, vs. 0.72±0.24mm; P for trend<0.001). Based on multivariate regression analysis, the serum ALT, even within the normal range, was associated with the carotid IMT in both men and women, and independently of traditional cardiovascular risk factors.Conclusions: ALT concentrations, albeit within the reference range, were associated with atherosclerotic burden in healthy adults.Normal range of alanine aminotransferase concentration is associated with carotid atherosclerosisSoo-Kyung Kim, Dae-Jung Kim, Se-Hwa Kim, Yeo-Kyung Lee, Seok-Won Park, Yong-Wook Cho, Kap-Bum Huh10.1016/j.diabres.2010.01.003Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-22Diabetes Research and Clinical Practice2010-01-22881S0168-8227(10)X0004-3Epidemiology111116http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822709005506/abstract?rss=yesAbstract: Aims: Comparing waist circumference (WC) role in diabetes risk prediction and diagnosis of metabolic syndrome (MS) in different populations.Methods: Population-based samples from Australia (n=9026) and Iran (n=8259) were studied in 2000 and followed for ∼4 years. Follow-up attendance was ∼58% and mean age was 51 vs. 47. Pearson correlations calculated between WC and other MS components. ROC for the role of WC in the prediction of incident diabetes was used.Results: Prevalences of MS (48% vs. 28%), an increased WC (58.5% vs. 54.5%), low HDL-C (35% vs. 11.2%), high triglyceride (52.2% vs. 29.6%) were significantly higher in Iran. Fasting glucose ≥5.6mmol/L was higher in Australia (26% vs. 23%). Hypertension was no different (∼38%). Pearson correlations between WC and other MS components were stronger in Australians: FPG (0.32 vs. 0.2), HDL (0.47 vs. 0.16), TG (0.38 vs. 0.30) and SBP (0.38 vs. 0.36). Among women, area under ROC curve for WC as a predictor for diabetes was significantly higher for Australians (0.76 vs. 0.68, p<0.001) with no difference among men (0.69 vs. 0.71, p=0.4).Conclusion: WC was more strongly related to other components of MS in Australia. Association between WC and MS or incident diabetes varies between ethnicities.Waist circumference has heterogeneous impact on development of diabetes in different populations: Longitudinal comparative study between Australia and IranNassir Rostambeigi, Jonathan E. Shaw, Robert C. Atkins, Arash Ghanbarian, Adrian J. Cameron, Andrew Forbes, Amirabbas Momenan, Farzad Hadaegh, Parvin Mirmiran, Paul Z. Zimmet, Fereidoun Azizi, Andrew M. Tonkin10.1016/j.diabres.2009.12.025Diabetes Research and Clinical Practice 88, 1 (2010)2010-01-22Diabetes Research and Clinical Practice2010-01-22881S0168-8227(10)X0004-3Epidemiology117124http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000124/abstract?rss=yesAbstract: The aim of this study was to establish a cut-off value of percentage of fat mass (%FM) at which insulin sensitivity (IS) is significantly altered in sedentary postmenopausal women. Our results suggest that maintaining a %FM below 41% would minimize the deterioration of IS and its associated risks.Fat mass threshold associated with a significant deterioration of insulin sensitivity in postmenopausal womenFlorian Bobeuf, Mylène Aubertin-Leheudre, Christine Lord, Mélissa Labonté, Abdelouahed Khalil, Isabelle J. Dionne10.1016/j.diabres.2010.01.010Diabetes Research and Clinical Practice 88, 1 (2010)2010-02-01Diabetes Research and Clinical Practice2010-02-01881S0168-8227(10)X0004-3Brief reportse1e3http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000070/abstract?rss=yesAbstract: A 61-year-old woman with fasting hypoglycemia following total gastrectomy was diagnosed as insulinoma. GIP and GLP-1 levels after a mixed meal were extremely increased. Administration of miglitol, an alpha-glucosidase inhibitor, suppressed the GIP and GLP-1 elevations.A case of insulinoma following total gastrectomy—Effects of an alpha-glucosidase inhibitor on suppressing GIP and GLP-1 elevationsTakehiro Sato, Takuma Narita, Mihoko Hosoba, Masafumi Kakei, Hiroshi Nanjo, Hiroshi Uchinami, Kohei Satoh, Yuzo Yamamoto, Yuichiro Yamada10.1016/j.diabres.2010.01.006Diabetes Research and Clinical Practice 88, 1 (2010)2010-02-01Diabetes Research and Clinical Practice2010-02-01881S0168-8227(10)X0004-3Brief reportse4e6http://www.diabetesresearchclinicalpractice.com/article/PIIS0168822710000288/abstract?rss=yesAbstract: Type 2 diabetes is an increasingly prevalent disease with oral health manifestations. In this study, titanium implants were placed in the femora of 10 type 2 diabetic and 10 age-matched normal rats. We compared the results of bone histomorphometry around the dental implants at 4 and 8 weeks postsurgery.Type 2 diabetes mellitus impairs bone healing of dental implants in GK ratsFeng Wang, Ying-liang Song, De-hua Li, Cui-xia Li, Yao Wang, Ning Zhang, Bao-gang Wang10.1016/j.diabres.2010.01.017Diabetes Research and Clinical Practice 88, 1 (2010)2010-02-08Diabetes Research and Clinical Practice2010-02-08881S0168-8227(10)X0004-3Brief reportse7e9