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  • 11
    Electronic Resource
    Electronic Resource
    Glucose, insulin concentrations and obesity in childhood and adolescence as predictors of NIDDM (1994)
    Springer
    Diabetologia 37 (1994), S. 617-623 
    Details
    ISSN: 1432-0428
    Keywords: Key words Diabetes mellitus, risk factors, glucose, insulin, childhood
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Metabolic abnormalities antedate the development of non-insulin-dependent diabetes mellitus (NIDDM) by some years. How these metabolic abnormalities relate to the genetic component of the disease and to the subsequent prediction of diabetes is unknown. The present study was designed to examine the association of parental diabetes with relative weight, fasting and 2-h plasma glucose and fasting and 2-h serum insulin in childhood, and to identify which of these variables were most predictive of subsequent NIDDM. Subjects comprised 1258 Pima Indians aged 5–19 years with normal glucose tolerance participating in a longitudinal population-based study. Age-sex-adjusted values of relative weight, fasting and 2-h glucose and fasting and 2-h insulin were positively associated with parental diabetes. Only one of 138 subjects with two non-diabetic parents developed diabetes. Among 1120 subjects with at least one diabetic parent, 101 (9.0 %) developed diabetes during a mean follow up of 8.4 years. Fasting insulin was a significant predictor of diabetes, but did not add to the predictive value of relative weight. Relative weight and 2-h and fasting plasma glucose were the variables most predictive of NIDDM in childhood and adolescence. Against a background of parental diabetes, high fasting insulin concentrations predict diabetes, compatible with the hypothesis that insulin resistance is an early metabolic abnormality leading to NIDDM. In this study, however, its predictive power did not add significantly to that of relative weight, with which it was correlated. Both relative weight and 2-h plasma glucose in youth in those with diabetic parents are highly predictive of subsequent diabetes, and these may be the best measures currently available for identifying high-risk subjects in whom preventive measures might be targeted. [Diabetologia (1994) 37: 617–623]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403382
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  • 12
    Electronic Resource
    Electronic Resource
    Glucose, insulin concentrations and obesity in childhood and adolescence as predictors of NIDDM (1994)
    Springer
    Diabetologia 37 (1994), S. 617-623 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; risk factors ; glucose ; insulin ; childhood
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Metabolic abnormalities antedate the development of non-insulin-dependent diabetes mellitus (NIDDM) by some years. How these metabolic abnormalities relate to the genetic component of the disease and to the subsequent prediction of diabetes is unknown. The present study was designed to examine the association of parental diabetes with relative weight, fasting and 2-h plasma glucose and fasting and 2-h serum insulin in childhood, and to identify which of these variables were most predictive of subsequent NIDDM. Subjects comprised 1258 Pima Indians aged 5–19 years with normal glucose tolerance participating in a longitudinal population-based study. Age-sex-adjusted values of relative weight, fasting and 2-h glucose and fasting and 2-h insulin were positively associated with parental diabetes. Only one of 138 subjects with two non-diabetic parents developed diabetes. Among 1120 subjects with at least one diabetic parent, 101 (9.0%) developed diabetes during amean follow up of 8.4 years. Fastinginsulin was a significant predictor of diabetes, but did not add to the predictive value of relative weight. Relative weight and 2-h and fasting plasma glucose were the variables most predictive of NIDDM in childhood and adolescence. Against a background of parental diabetes, high fasting insulin concentrations predict diabetes, compatible with the hypothesis that insulin resistance is an early metabolic abnormality leading to NIDDM. In this study, however, its predictive power did not add significantly to that of relative weight, with which it was correlated. Both relative weight and 2-h plasma glucose in youth in those with diabetic parents are highly predictive of subsequent diabetes, and these may be the best measures currently available for identifying high-risk subjects in whom preventive measures might be targeted.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403382
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  • 13
    Electronic Resource
    Electronic Resource
    More about obesity and diabetes (1986)
    Springer
    Diabetologia 29 (1986), S. 753-754 
    Details
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00870289
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  • 14
    Electronic Resource
    Electronic Resource
    Medial arterial calcification and its association with mortality and complications of diabetes (1988)
    Springer
    Diabetologia 31 (1988), S. 16-23 
    Details
    ISSN: 1432-0428
    Keywords: Medial arterial calcification ; diabetic complications ; epidemiology ; incidence ; prevalence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Medial arterial calcification was studied among 4,553 subjects in a 20-year, longitudinal study of Pima Indians. The prevalence and incidence of medial arterial calcification were highest among men, the elderly, and patients with Type 2 (non-insulin-dependent) diabetes mellitus. Medial arterial calcification was most commonly observed in the feet and appeared to progress proximally. Proportional hazards analysis was used to evaluate risk factors for medial arterial calcification in the feet and to evaluate medial arterial calcification as a risk factor for death and for complications of diabetes. Among diabetic patients, risk factors for medial arterial calcification were impaired vibration perception, long duration of diabetes, and high plasma glucose concentration (p〈0.01 for each). Among nondiabetic subjects, age, male gender (p〈0.01 for each), and high serum cholesterol concentration (p=0.02) were risk factors for medial arterial calcification. Nondiabetic subjects with medial arterial calcification did not have higher mortality rates than subjects without medial arterial calcification (rate ratio = 0.95, 95% confidence interval = 0.7–1.3). Diabetic patients with medial arterial calcification, compared with diabetic patients without medial arterial calcification, had 1.5-fold the mortality rate (95% confidence interval = 1.0–2.1), 5.5-fold the rate of amputations (95% confidence interval = 2.1–14.1), 2.4-fold the rate of proteinuria (95% confidence interval = 1.3–4.5), 1.7-fold the rate of retinopathy (95% confidence interval = 0.98–2.8), and 1.6-fold the rate of coronary artery disease (95% confidence interval = 0.48–5.4).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00279127
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  • 15
    Electronic Resource
    Electronic Resource
    Incidence of end-stage renal disease in Type 2 (non-insulin-dependent) diabetes mellitus in pima indians (1988)
    Springer
    Diabetologia 31 (1988), S. 730-736 
    Details
    ISSN: 1432-0428
    Keywords: End-stage renal disease ; diabetic nephropathy ; Type 2 (non-insulin-dependent) diabetes ; incidence ; Pima Indians
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The incidence of end-stage renal disease was determined in the Pima Indians of the Gila River Indian Community in Arizona, a population with a high prevalence of Type 2 (non-insulin-dependent) diabetes mellitus. Between 1975 and 1986, from a study population of 5059 subjects, end-stage renal disease occurred in 80 persons, 76 (95%) of whom had Type 2 diabetes. A review of the cases with end-stage renal disease indicated that among the diabetic subjects only two cases could be attributed to nondiabetic renal disease; all other cases were attributable to diabetic nephropathy. In diabetic Pima Indians the incidence rate of end-stage renal disease did not change during the study period, was similar in men and women, and was not effected by age at diagnosis of diabetes or by attained age, but did increase significantly with hypertension (p〈0.05). The incidence of end-stage renal disease attributed to diabetic nephropathy increased from 0 cases/1000 person-years at 0–5 years to 40.8 cases/1000 person-years at ≥ 20 years duration of diabetes. In these subjects with Type 2 diabetes, the incidence rate of end-stage renal disease was similar to that in subjects with Type 1 (insulin-dependent) diabetes who were followed at the Joslin Clinic in Boston, Massachusetts when those with similar duration of diabetes were compared.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00274774
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  • 16
    Electronic Resource
    Electronic Resource
    Familial predisposition to renal disease in two generations of Pima Indians with Type 2 (non-insulin-dependent) diabetes mellitus (1990)
    Springer
    Diabetologia 33 (1990), S. 438-443 
    Details
    ISSN: 1432-0428
    Keywords: Type 2 (non-insulin-dependent) diabetes mellitus ; American Indians ; diabetic renal disease ; genetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied the occurrence of renal disease by measuring serum creatinine and urine protein concentrations in the diabetic members of 316 Pima Indian families with Type 2 (non-insulin-dependent) diabetes in two successive generations to determine if diabetic renal disease aggregates in families. After adjustment for sex and other risk factors, proteinuria occurred among 14.3% of the diabetic offspring if neither parent had proteinuria, 22.9% if at least one diabetic parent had proteinuria, and 45.9% if both parents had diabetes and proteinuria. Among male offspring, an elevated serum creatinine concentration (≥177 μmol/l) was present in 11.7% if the parent had an elevated creatinine and in 1.5% if the parent did not. Thus, proteinuria and high serum creatinine aggregated in diabetic families, suggesting that susceptibility to renal disease is inherited independently of diabetes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00404096
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  • 17
    Electronic Resource
    Electronic Resource
    Albuminuria in Type 2 (non-insulin-dependent) diabetes mellitus and impaired glucose tolerance in Pima Indians (1989)
    Springer
    Diabetologia 32 (1989), S. 870-876 
    Details
    ISSN: 1432-0428
    Keywords: Albuminuria ; prevalence ; diabetic nephropathy ; Type 2 (non-insulin-dependent) diabetes mellitus ; impaired glucose tolerance ; American Indians
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prevalence of abnormal urinary albumin excretion, defined by a urine albumin to creatinine ratio〉-30 mg/g (approximately equivalent to an albumin excretion rate of 〉-30 mg/24 h), was determined in 2728 Pima Indians aged 〉-15 years from the Gila River Indian Community in Arizona, a population with a high prevalence of Type 2 (non-insulin-dependent) diabetes mellitus. Excessive albumin excretion was present in 8% of subjects with normal glucose tolerance, 15% of those with impaired glucose tolerance, and 47% of subjects with diabetes. The intermediate prevalence of abnormal albuminuria in those with impaired glucose tolerance suggests that hyperglycaemia even at levels below those diagnostic of diabetes is associated with renal abnormalities in some subjects and that these abnormalities may precede the onset of diabetes. Abnormal albuminuria at levels not reliably detected by the usual dipstick methods was commonly observed in Pima Indians with diabetes, even those with diabetes of recent onset. Associations were found with age, duration of diabetes, level of glycaemia, blood pressure, and treatment with insulin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00297452
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  • 18
    Electronic Resource
    Electronic Resource
    Glycated haemoglobin, plasma glucose and diabetic retinopathy: cross-sectional and prospective analyses (1993)
    Springer
    Diabetologia 36 (1993), S. 428-432 
    Details
    ISSN: 1432-0428
    Keywords: Glycated haemoglobin A1 ; plasma glucose ; diabetic retinopathy ; risk factor ; receiver operating characteristic (ROC) analysis ; Pima Indians
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among Pima Indians with Type 2 (non-insulin-dependent) diabetes mellitus the relationships between glycated haemoglobin (HbA1), fasting or 2-h post-load plasma glucose and diabetic retinopathy were examined by cross-sectional and prospective analyses, and the strengths of the associations were directly compared by receiver operating characteristic analysis. In the cross-sectional analysis, HbA1, fasting and 2-h plasma glucose were each significantly related to retinopathy among 789 diabetic subjects by separate logistic models. In a stepwise multiple logistic model in which HbA1, fasting and 2-h plasma glucose were included, HbA1 was selected as having the strongest association with retinopathy and neither fasting nor 2-h plasma glucose contributed significantly to the model once HbA1 was entered. Similarly, in the prospective analysis, HbA1, fasting and 2-h plasma glucose all predicted retinopathy in 227 diabetic subjects by separate proportional-hazards models. In a stepwise proportional-hazards model with HbA1, fasting and 2-h plasma glucose available to the model, HbA1 was again selected as having the strongest association with the incidence of retinopathy, and neither fasting nor 2-h plasma glucose significantly added to the prediction of retinopathy. A receiver operating characteristic analysis was used to determine if HbA1 was statistically significantly better than fasting or 2-h plasma glucose in assessing the risk for retinopathy. In neither the cross-sectional nor the prospective data did the area under the receiver operating characteristic curve for HbA1 differ significantly from that for fasting or 2-h plasma glucose (p〉0.05 for each). In conclusion, HbA1, an integrated measure of blood glucose concentration over a period of 2–3 months, is slightly more closely associated with the prevalence and incidence of diabetic retinopathy than a single blood glucose determination. However, the differences between HbA1 and fasting or 2-h plasma glucose in assessing the association with or the risk for retinopathy are not significant.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00402279
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  • 19
    Electronic Resource
    Electronic Resource
    C-peptide measurement in the differentiation of Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes mellitus (1985)
    Springer
    Diabetologia 28 (1985), S. 264-268 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; Type 2 diabetes ; plasma C-peptide ; urinary C-peptide Pima Indian
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To determine whether individual subjects with Type 1 (insulin-dependent) diabetes or Type 2 (non-insulin-dependent) diabetes, who are treated with insulin, could be reliably distinguished, C-peptide concentrations and urinary C-peptide excretion were measured in 10 Caucasoids and 10 Pima Indians. All the subjects had developed diabetes before 21 years of age and were receiving insulin treatment. Fasting C-peptide concentrations were significantly higher in the Pima Indians (0.73±0.17 versus 0.02±0.01 nmol/l in Caucasoids; p〈0.001), but there were slight overlaps in individual values. Urinary C-peptide excretion, an index of 24-h-insulin excretion, was also higher in the Pima Indian group (27.6±1.85 versus 0.72±0.18 pmol/min in Caucasoids; p〈0.001) and there was no overlap in the individual values between the groups. The Pima Indians with early onset diabetes have been previously shown to have Type 2 diabetes, and the Caucasoids with an early onset are most likely to have Type 1 diabetes. These results suggest that distinction between these two major types of diabetes can be made effectively by using C-peptide measurements provided that overt renal disease is absent. This differentiation between insulin-treated patients will be useful for a variety of research applications and possibly in making clinical management decisions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00271682
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  • 20
    Electronic Resource
    Electronic Resource
    Evaluation of the efficacy and tolerance of the antiarrhythmic agent transcainide (R 54718) (1987)
    Springer
    European journal of clinical pharmacology 32 (1987), S. 449-456 
    Details
    ISSN: 1432-1041
    Keywords: transcainide ; antiarrhythmic drugs ; cardiac arrhythmias ; adverse effects ; ventricular arrhythmias ; supraventricular arrhythmias
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The antiarrhythmic efficacy of transcainide has been studied in 41 patients. It abolished ventricular arrhythmias in 10 out of 12 patients after i.v. administration and in 11 out of 14 after oral administration. It also reduced ventricular arrhythmias during recovery from exercise. The maximum intravenous dose prolonged the PR-interval by 43% and QRS-duration by 37%. Side-effects observed in 6 out of 41 patients included Mobitz Type I AV block, complete bundle branch block, hypotension and increased arrhythmia frequency. Transcainide is a promising new antiarrhythmic drug which should be used with caution in patients with conduction disorders and impaired cardiac function. Its value and safety in the chronic oral treatment of life-threatening arrhythmias remains to be established.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00637668
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