Glycemic control and complications in type II diabetes. Design of a feasibility trial. VA CS Group (CSDM)

Abstract:

OBJECTIVE:To determine, after 1 yr of follow-up in type II diabetes patients, whether a statistically and clinically significant difference can be achieved in HbA1c between a standard therapy group and an intensively treated group, while maintaining HbA1c levels in both groups within ranges acceptable in regular community practice. Secondary objectives include assessment of patient adherence to protocol, side effects, and accuracy of data collection. RESEARCH DESIGN AND METHODS:This is a prospective, randomized, controlled VA CS conducted with 151 patients at five VAMCs. Patients are males, age 40-69 yr, treated at entry with a maximum dose of sulfonylurea or with insulin, exhibiting an HbA1c level > 3 SDs above the normal mean (5.05 + 3 x 0.50 = > 6.55%). Standard control is achieved with insulin and intensive control with a step-up regimen including insulin alone or insulin/glipizide combinations. Education and management of cardiovascular risk factors are handled similarly in both groups. Primary macrovascular end points are nonfatal myocardial infarction, congestive heart failure, stroke, amputation, and cardiovascular death. Primary microvascular end points are appearance and progression of retinopathy, documented by centrally read seven-field-stereo fundus photographs. Other measured indicators include resting and ambulatory ECGs, ventricular function (MUGA scan), serum lipid and apolipoprotein levels, plasma fibrinogen, nonsymptomatic peripheral vasculopathy, neuroautonomic status by heart-beat variation on Valsalva maneuver, and microalbuminuria. CONCLUSIONS:This study may be the basis for a long-term trial, involving 1400 patients, to assess the long-term effects of metabolic control on macro- and microvascular end points.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Abraira C,Emanuele N,Colwell J,Henderson W,Comstock J,Levin S,Nuttall F,Sawin C

doi

10.2337/diacare.15.11.1560

subject

Has Abstract

pub_date

1992-11-01 00:00:00

pages

1560-71

issue

11

eissn

0149-5992

issn

1935-5548

journal_volume

15

pub_type

临床试验,杂志文章,随机对照试验
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    abstract::Because recent knowledge indicates that the distribution of fat deposits in men may be a better predictor of cardiovascular disease than the degree of obesity alone, some risk factors for atherosclerosis were evaluated in 51 middle-aged men with non-insulin-dependent diabetes mellitus. Abdominal adiposity (waist/hip r...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.11.2.103

    authors: Van Gaal L,Rillaerts E,Creten W,De Leeuw I

    更新日期:1988-02-01 00:00:00

  • The sulfonylurea glyburide induces impairment of glucagon and growth hormone responses during mild insulin-induced hypoglycemia.

    abstract:OBJECTIVE:The sulfonylurea (SU) glyburide may cause severe and prolonged episodes of hypoglycemia. We aimed at investigating the impact of glyburide on glucose counterregulatory hormones during stepwise hypoglycemic clamp studies. RESEARCH DESIGN AND METHODS:We performed stepwise hypoglycemic clamp studies in 16 healt...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.25.1.107

    authors: ter Braak EW,Appelman AM,van der Tweel I,Erkelens DW,van Haeften TW

    更新日期:2002-01-01 00:00:00

  • Multifaceted determinants for achieving glycemic control: the International Diabetes Management Practice Study (IDMPS).

    abstract:OBJECTIVE:The International Diabetes Mellitus Practice Study is a 5-year survey documenting changes in diabetes treatment practice in developing regions. RESEARCH DESIGN AND METHODS:Logistic regression analysis was used to identify factors for achieving A1C <7% in 11,799 patients (1,898 type 1 diabetic and 9,901 type ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-0435

    authors: Chan JC,Gagliardino JJ,Baik SH,Chantelot JM,Ferreira SR,Hancu N,Ilkova H,Ramachandran A,Aschner P,IDMPS Investigators.

    更新日期:2009-02-01 00:00:00

  • Health Care Utilization and Burden of Diabetic Ketoacidosis in the U.S. Over the Past Decade: A Nationwide Analysis.

    abstract:OBJECTIVE:Diabetes is one of the most common chronic diseases and a leading cause of morbidity and mortality in the U.S. Although our ability to treat diabetes and its associated complications has significantly improved, presentation with uncontrolled diabetes leading to ketoacidosis remains a significant problem. RES...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc17-1379

    authors: Desai D,Mehta D,Mathias P,Menon G,Schubart UK

    更新日期:2018-08-01 00:00:00

  • Metformin and exercise in type 2 diabetes: examining treatment modality interactions.

    abstract:OBJECTIVE:To determine the effect of metformin on the acute metabolic response to submaximal exercise, the effect of exercise on plasma metformin concentrations, and the interaction between metformin and exercise on the subsequent response to a standardized meal. RESEARCH DESIGN AND METHODS:Ten participants with type ...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc10-2207

    authors: Boulé NG,Robert C,Bell GJ,Johnson ST,Bell RC,Lewanczuk RZ,Gabr RQ,Brocks DR

    更新日期:2011-07-01 00:00:00

  • A 1-year multicenter randomized double-blind comparison of repaglinide and glyburide for the treatment of type 2 diabetes. Dutch and German Repaglinide Study Group.

    abstract:OBJECTIVE:Repaglinide is a newly developed oral blood glucose-lowering agent that exerts its effect by stimulating insulin secretion. This multicenter study was designed to compare the efficacy and safety of this drug with glyburide in a 1-year randomized double-blind study of outpatients with type 2 diabetes. RESEARC...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.2337/diacare.22.3.463

    authors: Wolffenbuttel BH,Landgraf R

    更新日期:1999-03-01 00:00:00

  • Novel Protein Glycan-Derived Markers of Systemic Inflammation and C-Reactive Protein in Relation to Glycemia, Insulin Resistance, and Insulin Secretion.

    abstract:OBJECTIVE:N-acetylglucosamine/galactosamine (GlycA) and sialic acid (GlycB) moieties of glycosylated serum proteins are nonspecific measures of inflammation, but conclusive data on their relationship with insulin resistance or insulin secretion are missing. Therefore, we aimed to examine the relation of GlycA, GlycB, a...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc16-1569

    authors: Lorenzo C,Festa A,Hanley AJ,Rewers MJ,Escalante A,Haffner SM

    更新日期:2017-03-01 00:00:00

  • Acute actions of sulfonylurea drugs during long-term treatment of NIDDM.

    abstract::The acute effect of sulfonylurea drugs during long-term treatment was evaluated in two separate studies. In the first study, the levels of plasma glucose, insulin, and C-peptide were measured after intake of 10 mg glyburide alone or together with a standardized mixed meal in 10 non-insulin-dependent diabetes mellitus ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.13.3.26

    authors: Faber OK,Beck-Nielsen H,Binder C,Butzer P,Damsgaard EM,Froland F,Hjollund E,Lindskov HO,Melander A,Pedersen O

    更新日期:1990-08-01 00:00:00

  • Association of type and duration of diabetes with erectile dysfunction in a large cohort of men.

    abstract:OBJECTIVE:Differences in risk of erectile dysfunction (ED) by characteristics of diabetes among older men are not well understood. We examined the association of type and duration of diabetes with erectile function in men >50 years of age in a large prospective cohort study. RESEARCH DESIGN AND METHODS:Subjects includ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.25.8.1458

    authors: Bacon CG,Hu FB,Giovannucci E,Glasser DB,Mittleman MA,Rimm EB

    更新日期:2002-08-01 00:00:00

  • Clinical and genetic determinants of progression of type 2 diabetes: a DIRECT study.

    abstract:OBJECTIVE:To identify the clinical and genetic factors that explain why the rate of diabetes progression is highly variable between individuals following diagnosis of type 2 diabetes. RESEARCH DESIGN AND METHODS:We studied 5,250 patients with type 2 diabetes using comprehensive electronic medical records in Tayside, S...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc13-1995

    authors: Zhou K,Donnelly LA,Morris AD,Franks PW,Jennison C,Palmer CN,Pearson ER

    更新日期:2014-01-01 00:00:00

  • The effect of oral antidiabetic agents on A1C levels: a systematic review and meta-analysis.

    abstract:OBJECTIVE:Previous reviews of the effect of oral antidiabetic (OAD) agents on A1C levels summarized studies with varying designs and methodological approaches. Using predetermined methodological criteria, we evaluated the effect of OAD agents on A1C levels. RESEARCH DESIGN AND METHODS:The Excerpta Medica (EMBASE), the...

    journal_title:Diabetes care

    pub_type: 杂志文章,meta分析,评审

    doi:10.2337/dc09-1727

    authors: Sherifali D,Nerenberg K,Pullenayegum E,Cheng JE,Gerstein HC

    更新日期:2010-08-01 00:00:00

  • Long-term metabolic and immunological follow-up of nonimmunosuppressed patients with type 1 diabetes treated with microencapsulated islet allografts: four cases.

    abstract:OBJECTIVE:To assess long-term metabolic and immunological follow-up of microencapsulated human islet allografts in nonimmunosuppressed patients with type 1 diabetes (T1DM). RESEARCH DESIGN AND METHODS:Four nonimmunosuppressed patients, with long-standing T1DM, received intraperitoneal transplant (TX) of microencapsula...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc11-0731

    authors: Basta G,Montanucci P,Luca G,Boselli C,Noya G,Barbaro B,Qi M,Kinzer KP,Oberholzer J,Calafiore R

    更新日期:2011-11-01 00:00:00

  • Combined analysis of islet cell antibodies that cross-react with mouse pancreas, antibodies to the M(r) 64,000 islet protein, and antibodies to glutamate decarboxylase in type I diabetic patients.

    abstract:OBJECTIVE:A combined analysis of whether islet cell autoantibodies (ICAs) are cross-reactive with mouse pancreas, with glutamate decarboxylase (GAD) antibodies, and with 64K antibodies was performed in a large sample of recently diagnosed type I diabetic patients. The disappearance rates of these different autoantibodi...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.17.10.1115

    authors: Chaillous L,Delamaire M,Martignat L,Maugendre D,Marre M,Mathieu E,Limal JM,Charbonnel B,Allannic H,Saï P

    更新日期:1994-10-01 00:00:00

  • Validation of a counseling strategy to promote the adoption and the maintenance of physical activity by type 2 diabetic subjects.

    abstract:OBJECTIVE:There is enough evidence that physical activity is an effective therapeutic tool in the management of type 2 diabetes. The present study was designed to validate a counseling strategy that could be used by physicians in their daily outpatient practice to promote the adoption and maintenance of physical activi...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.26.2.404

    authors: Di Loreto C,Fanelli C,Lucidi P,Murdolo G,De Cicco A,Parlanti N,Santeusanio F,Brunetti P,De Feo P

    更新日期:2003-02-01 00:00:00

  • Macroalbuminuria and renal pathology in First Nation youth with type 2 diabetes.

    abstract:OBJECTIVE:To determine the prevalence of macroalbuminuria and to describe the clinical and renal pathological changes associated with macroalbuminuria in a population of Canadian First Nation children and adolescents with type 2 diabetes. RESEARCH DESIGN AND METHODS:We conducted a retrospective chart review at a singl...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-1828

    authors: Sellers EA,Blydt-Hansen TD,Dean HJ,Gibson IW,Birk PE,Ogborn M

    更新日期:2009-05-01 00:00:00

  • Low prevalence of islet autoantibodies in patients with gestational diabetes mellitus.

    abstract:OBJECTIVE:To determine the proportion of patients with gestational diabetes mellitus (GDM) who have serological characteristics typical of IDDM. RESEARCH DESIGN AND METHODS:Islet cell antibodies (ICAs), insulin autoantibodies (IAAs), GAD65, and IA-2 antibodies were measured in 145 pregnant women with GDM, 33 with impa...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.20.1.81

    authors: Dozio N,Beretta A,Belloni C,Castiglioni M,Rosa S,Bosi E,Bonifacio E

    更新日期:1997-01-01 00:00:00

  • High-risk individuals' willingness to pay for diabetes risk-reduction programs.

    abstract:OBJECTIVE:The purpose of this study was to estimate how much at-risk individuals are willing to pay for type 2 diabetes primary prevention programs. RESEARCH DESIGN AND METHODS:An Internet-based, choice-format conjoint survey was presented to individuals at elevated risk for type 2 diabetes. Hypothetical diabetes risk...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc05-2221

    authors: Johnson FR,Manjunath R,Mansfield CA,Clayton LJ,Hoerger TJ,Zhang P

    更新日期:2006-06-01 00:00:00

  • Racial variation in the control of diabetes among elderly medicare managed care beneficiaries.

    abstract:OBJECTIVE:To examine racial variation in the poor control of GHb, a GHb value >9.5%, or GHb not tested in 1999 among Medicare beneficiaries aged 65-75 years enrolled in managed care plans. RESEARCH DESIGN AND METHODS:The National Committee on Quality Assurance provides person-level data regarding diabetes care service...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.26.12.3250

    authors: McBean AM,Huang Z,Virnig BA,Lurie N,Musgrave D

    更新日期:2003-12-01 00:00:00

  • Sodium-Glucose Cotransporter Inhibitors: Effects on Renal and Intestinal Glucose Transport: From Bench to Bedside.

    abstract::Type 2 diabetes is a chronic disease with disabling micro- and macrovascular complications that lead to excessive morbidity and premature mortality. It affects hundreds of millions of people and imposes an undue economic burden on populations across the world. Although insulin resistance and insulin secretory defects ...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/dc15-0642

    authors: Mudaliar S,Polidori D,Zambrowicz B,Henry RR

    更新日期:2015-12-01 00:00:00

  • Effect of chronic intermittent intravenous insulin therapy on antihypertensive medication requirements in IDDM subjects with hypertension and nephropathy.

    abstract:OBJECTIVE:The prevalence of systemic hypertension is increased in patients with diabetes. In this prospective, randomized, crossover clinical trial, we assessed antihypertensive effects of chronic intermittent intravenous insulin therapy (CIIIT) on insulin-dependent diabetes mellitus (IDDM) subjects with hypertension a...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.18.9.1260

    authors: Aoki TT,Grecu EO,Prendergast JJ,Arcangeli MA,Meisenheimer R

    更新日期:1995-09-01 00:00:00

  • Community screening for diabetes. Low detection rate in a low-risk population.

    abstract:OBJECTIVE:To evaluate glucose-based community screening for diabetes with regard to detection rate. RESEARCH DESIGN AND METHODS:A retrospective analysis of a community-screening questionnaire data base that included a screening for blood glucose. Referred subjects had fasting glucose levels > 6.4 mM (115 mg/dl) or pos...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.17.5.363

    authors: Newman WP,Nelson R,Scheer K

    更新日期:1994-05-01 00:00:00

  • Heterogeneous Contribution of Insulin Sensitivity and Secretion Defects to Gestational Diabetes Mellitus.

    abstract:OBJECTIVE:To characterize physiologic subtypes of gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS:Insulin sensitivity and secretion were estimated in 809 women at 24-30 weeks' gestation, using oral glucose tolerance test-based indices. In women with GDM (8.3%), defects in insulin sensitivity or secret...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc15-2672

    authors: Powe CE,Allard C,Battista MC,Doyon M,Bouchard L,Ecker JL,Perron P,Florez JC,Thadhani R,Hivert MF

    更新日期:2016-06-01 00:00:00

  • Differences in Hemoglobin A1c Between Hispanics/Latinos and Non-Hispanic Whites: An Analysis of the Hispanic Community Health Study/Study of Latinos and the 2007-2012 National Health and Nutrition Examination Survey.

    abstract:OBJECTIVE:To determine whether, after adjustment for glycemia and other selected covariates, hemoglobin A1c (HbA1c) differed among adults from six Hispanic/Latino heritage groups (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) and between Hispanic/Latino and non-Hispanic white adults wit...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc15-2579

    authors: Avilés-Santa ML,Hsu LL,Arredondo M,Menke A,Werner E,Thyagarajan B,Heiss G,Teng Y,Schneiderman N,Giachello AL,Gallo LC,Talavera GA,Cowie CC

    更新日期:2016-06-01 00:00:00

  • The long-term effects of chlorpropamide on insulin, C-peptide, and proinsulin secretion.

    abstract::It had been suggested that long-term lowering of blood glucose by sulfonylureas in non-insulin-dependent (NIDD) diabetes is not due to a sustained increase in insulin secretion. We have re-examined this question. Thirteen nonobese NIDD patients not controlled on diet alone were studied prospectively on treatment with ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.5.4.427

    authors: Elkeles RS,Heding LG,Paisey RB

    更新日期:1982-07-01 00:00:00

  • Relationship of insulin resistance and related metabolic variables to coronary artery disease: a mathematical analysis.

    abstract:OBJECTIVE:People with diabetes have an increased risk of coronary artery disease (CAD). An unanswered question is what portion of CAD can be attributed to insulin resistance, related metabolic variables, and other known CAD risk factors. RESEARCH DESIGN AND METHODS:The Archimedes model was used to estimate the proport...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-0854

    authors: Eddy D,Schlessinger L,Kahn R,Peskin B,Schiebinger R

    更新日期:2009-02-01 00:00:00

  • Receptor binding and effect of biosynthetic human insulin on 2-deoxyglucose transport.

    abstract::Biosynthetic human insulin (BHI) and purified pork insulin (PPI) were compared for binding properties and stimulatory effect on 2-deoxyglucose transport in isolated rat fat cells. No difference between these types of insulin could be demonstrated. ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.4.2.254

    authors: Wieringa T,van Putten JP,Van Dijk-Besling M,Krans HM

    更新日期:1981-03-01 00:00:00

  • Stroke in the diabetic patient.

    abstract::A higher prevalence of stroke is found in the patient with both diagnosed and undiagnosed diabetes and glucose intolerance. Because of local cerebral acidosis caused by ischemia and hyperglycemia, morbidity and mortality from a stroke are increased. Most studies show that individuals with admission serum glucose > 120...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/diacare.17.3.213

    authors: Bell DS

    更新日期:1994-03-01 00:00:00

  • Risk factors for myocardial infarction case fatality and stroke case fatality in type 2 diabetes: UKPDS 66.

    abstract:OBJECTIVE:Patients with diabetes have a higher case fatality rate in myocardial infarction (MI) or stroke than those without diabetes: that is, MI and stroke are more often fatal if diabetes is present. We investigated whether the risk of MI or stroke being fatal in type 2 diabetes can be estimated using information av...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/diacare.27.1.201

    authors: Stevens RJ,Coleman RL,Adler AI,Stratton IM,Matthews DR,Holman RR

    更新日期:2004-01-01 00:00:00

  • Effect of weight loss with lifestyle intervention on risk of diabetes.

    abstract:OBJECTIVE:Diabetes Prevention Program (DPP) participants randomized to the intensive lifestyle intervention (ILS) had significantly reduced risk of diabetes compared with placebo participants. We explored the contribution of changes in weight, diet, and physical activity on the risk of developing diabetes among ILS par...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc06-0560

    authors: Hamman RF,Wing RR,Edelstein SL,Lachin JM,Bray GA,Delahanty L,Hoskin M,Kriska AM,Mayer-Davis EJ,Pi-Sunyer X,Regensteiner J,Venditti B,Wylie-Rosett J

    更新日期:2006-09-01 00:00:00

  • Effect of case-based training for medical residents on inpatient glycemia.

    abstract:OBJECTIVE:To determine whether an educational intervention for medical house staff improves blood glucose (BG) in hospitalized patients. RESEARCH DESIGN AND METHODS:All 116 medicine residents at an academic medical center were assigned to online or classroom training on inpatient dysglycemia in fall 2008. Both groups ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc11-0517

    authors: Tamler R,Green DE,Skamagas M,Breen TL,Looker HC,Babyatsky M,Leroith D

    更新日期:2011-08-01 00:00:00