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  • 1
    Electronic Resource
    Electronic Resource
    Diabetic nephropathy: a risk factor for diabetes mellitus in offspring (1995)
    Springer
    Diabetologia 38 (1995), S. 221-226 
    Details
    ISSN: 1432-0428
    Keywords: Familial aggregation ; diabetes mellitus ; nephropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Both non-insulin-dependent diabetes mellitus and diabetic nephropathy show familial aggregation. If diabetes and renal disease have independent determinants (genetic or otherwise), offspring of parents with diabetic renal disease should have a similar risk of diabetes to those offspring of parents with diabetes alone. To test this hypothesis, the prevalence of diabetes was examined in a population-based pedigree study in Pima Indian offspring of three mutually exclusive parental types: 1) diabetic with renal disease, 2) diabetic, but without renal disease and 3) non-diabetic. Among offspring of one diabetic parent and one non-diabetic parent (n=320) the prevalence of diabetes at ages 15–24 years and 25–34 years was 0% and 11%, respectively if the diabetic parent did not have renal disease compared with 6% and 28% respectively if the diabetic parent did have renal disease. Corresponding rates for offspring of two diabetic parents (n=121) were 10% and 17%, respectively if neither parent had renal disease compared with 30% and 50%, respectively if one parent did have renal disease. The presence of renal disease in a parent with diabetes relative to diabetes alone was associated with 2.5 times the odds of diabetes (95% confidence interval 1.4–4.3) in the offspring controlled for age, age at onset of parental diabetes and diabetes in the other parent using logistic regression. These findings provide support for parental diabetic renal disease, independent of age at onset of parental diabetes, conferring an increased risk for diabetes in the offspring. The results are compatible with the hypothesis that the susceptibility to renal disease in the parents and to diabetes in the offspring are due to shared familial environmental factors or to the same gene or set of genes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400098
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  • 2
    Electronic Resource
    Electronic Resource
    Diagnosing diabetes mellitus – do we need new criteria? (1997)
    Springer
    Diabetologia 40 (1997), S. 247-255 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Diabetes mellitus ; diagnosis ; oral glucose tolerance test ; fasting plasma glucose ; 2-h plasma glucose ; haemoglobin A1c ; retinopathy ; nephropathy ; complications.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The current classification and diagnostic criteria for diabetes mellitus were introduced by the United States National Data Group in 1979 and endorsed by the World Health Organization in 1980, with modifications in 1985 and 1994. The criteria, chosen to reflect the risk of complications, were the synthesis of considerable thought and expertise and represented a consensus which, it was hoped, would prove helpful to all those involved with diabetes – practising clinician, research scientist and epidemiologist alike. The inconvenience, variability and nonphysiological nature of the oral glucose tolerance test (OGTT) are well-recognised. In spite of these limitations the 2-h post-load plasma glucose has remained the standard against which all other tests have been evaluated. This article reviews the original justification for the OGTT, and in the light of more recent epidemiological research seeks to place the current diagnostic criteria for diabetes into a pathophysiological, diagnostic and prognostic perspective. [Diabetologia (1997) 40: 247–255]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050671
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Fasting and two-hour post-load glucose levels for the diagnosis of diabetes (1979)
    Springer
    Diabetologia 16 (1979), S. 373-379 
    Details
    ISSN: 1432-0428
    Keywords: Two-hour plasma glucose ; fasting plasma glucose ; bimodality ; oral glucose tolerance tests ; Pima Indians ; diagnosis ; diabetes ; sensitivity ; specificity ; misclassification ; retinopahy ; nephropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The frequency distributions of both the fasting and two-hour post-load plasma glucose levels were bimodal in the Pima Indian population aged 25 years and over. The hyperglycaemic component of this distribution represents those with diabetes mellitus, as some 30 percent of this group had evidence of the specific vascular complications of the disease, whereas these abnormalities were virtually absent in those with lower glucose levels. The bimodal characteristics of the frequency distributions were utilized to define optimal criteria to separate those with and without diabetes. The sensitivity and specificity of these criteria for fasting and two-hour glucose levels were compared and were found to be similar. The fasting glucose determination, however, was more reproducible and stable, as well as being easier to obtain, indicating that it is the better measurement for diagnostic purposes. The optimal level for diagnosis of 7.5 mmol/l (136 mg/dl) for the fasting glucose and the equivalent two-hour value of 14 mmol/l (250 mg/dl), were higher than many previously recommended diagnostic levels. Nevertheless, there was no evidence that subjects with lower levels were at appreciable risk of developing the specific complications of diabetes. Subjects with impaired glucose tolerance (IGT), but without fasting hyperglycaemia, shouldnot be diagnosed as having diabetes mellitus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01223157
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  • 4
    Electronic Resource
    Electronic Resource
    Coronary heart disease and diabetic retinopathy in newly diagnosed diabetes in Da Qing, China: The Da Qing IGT and Diabetes Study (1991)
    Springer
    Acta diabetologica 28 (1991), S. 169-173 
    Details
    ISSN: 1432-5233
    Keywords: Coronary heart disease ; Diabetic retinopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 1986, 110,660 of 281,589 residents aged 25–74 years in Da Qing, Hei Long Jiang Province of China, were surveyed. Based on the results of a 75-g oral glucose tolerance test, 630 subjects were found to have previously undiagnosed diabetes according to 1985 WHO criteria. Among them, 600 diabetics aged 35–74 years (288 men, 312 women) and 410 non-diabetics of similar age with normal glucose tolerance (207 men, 203 women) were examined to determine the prevalence of retinopathy and coronary heart disease (CHD) and to evaluate associated characteristics. Retinal examinations of 423 newly diagnosed diabetics showed that 15.5% had several microaneurysms and/or small intraretinal haemorrhage, 5.5% soft exudates, 7.1% hard exudates, and 2.3% proliferative retinopathy. Among 220 non-diabetics, 13.6% had one or two microaneurysms and/or small intraretinal haemorrhage, and only 1.4% had a few soft exudates; half of the non-diabetics with retinopathy had hypertension. CHD, according to Minnesota coding (1.1–1.3, 5.1–5.3 and 7.1) of resting electrocardiograms, was ten times more frequent in the diabetics (3.59%) than in the controls (0.32%), after adjusting for age and sex. Multiple regression analysis showed that plasma glucose concentration analysis showed that plasma glucose concentration was a risk factor for retinopathy after adjusting for age, sex, body mass index (BMI), smoking and blood pressure. Two-hour plasma glucose concentration (after adjusting for age, sex, BMI, smoking and blood pressure) and blood pressure (after adjusting for age, sex BMI, smoking and 1-h or 2-h plasma glucose level) were associated with CHD among the diabetics and non-diabetics and among the diabetics alone. Thus, both micro-and macrovascular complications occur frequently in previously undiagnosed Chinese diabetics and the frequency of CHD is markedly increased compared to the low frequency among Chinese non-diabetics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00579721
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  • 5
    Electronic Resource
    Electronic Resource
    Hypertension and indicators of coronary heart disease in Wallis Polynesians: An urban-rural comparison (1987)
    Springer
    European journal of epidemiology 3 (1987), S. 247-256 
    Details
    ISSN: 1573-7284
    Keywords: Hypertension ; Coronary heart disease ; Obesity ; Polynesians ; Urban-rural comparison ; Wallis Island ; New Caledonia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A comparative study of hypertension, and indicators of and risk factors for coronary heart disease was undertaken in samples of rural Wallisians of Wallis Island, and first generation Wallisian migrants in the urban centre of Noumea, New Caledonia. Approximately 20% of the adult population of the two communities was included in the study. Higher mean blood pressure and hypertension prevalence in Wallisians in Noumea compared to those in Wallis was documented. There was no significant rise in blood pressure with age in rural Wallisian males. Wallisians in Noumea tended to be more obese than those in Wallis (particularly females). Although differences in the extent of obesity appeared to explain some of the differences in blood pressure between populations of Wallis and Noumea, other environmental factors (such as salt intake) are probably important. There was a trend for a higher prevalence of O wave changes on the ECG in urbanized Wallisians compared to their rural counterparts. There was no significant or consistent differences in plasma lipid concentrations between the two groups. The prevalence of diabetes was 7 and 4 times higher in Noumea compared to Wallis for males and females respectively. Differences in diabetes and hypertension prevalence are more likely to account for the variation in ischaemic heart disease than plasma lipid levels.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00149732
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