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 Carejournal_title
Diabetes careauthors
Abraira C,Emanuele N,Colwell J,Henderson W,Comstock J,Levin S,Nuttall F,Sawin Cdoi
10.2337/diacare.15.11.1560subject
Has Abstractpub_date
1992-11-01 00:00:00pages
1560-71issue
11eissn
0149-5992issn
1935-5548journal_volume
15pub_type
临床试验,杂志文章,随机对照试验相关文献
DIABETES CARE文献大全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
更新日期:1988-02-01 00:00:00
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
更新日期:2002-01-01 00:00:00
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
更新日期:2009-02-01 00:00:00
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
更新日期:2018-08-01 00:00:00
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
更新日期:2011-07-01 00:00:00
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
更新日期:1999-03-01 00:00:00
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
更新日期:2017-03-01 00:00:00
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
更新日期:1990-08-01 00:00:00
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
更新日期:2002-08-01 00:00:00
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
更新日期:2014-01-01 00:00:00
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
更新日期:2010-08-01 00:00:00
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
更新日期:2011-11-01 00:00:00
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
更新日期:1994-10-01 00:00:00
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
更新日期:2003-02-01 00:00:00
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
更新日期:2009-05-01 00:00:00
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
更新日期:1997-01-01 00:00:00
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
更新日期:2006-06-01 00:00:00
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
更新日期:2003-12-01 00:00:00
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
更新日期:2015-12-01 00:00:00
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
更新日期:1995-09-01 00:00:00
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
更新日期:1994-05-01 00:00:00
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
更新日期:2016-06-01 00:00:00
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
更新日期:2016-06-01 00:00:00
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
更新日期:1982-07-01 00:00:00
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
更新日期:2009-02-01 00:00:00
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
更新日期:1981-03-01 00:00:00
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
更新日期:1994-03-01 00:00:00
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
更新日期:2004-01-01 00:00:00
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
更新日期:2006-09-01 00:00:00
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
更新日期:2011-08-01 00:00:00