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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2007.07.066 Byline: Achim H. Lauruschkat (a), Bert Arnrich (b), Alexander A. Albert (a), Jorg A. Walter (b), Berthold Amann (c), Ulrich P. Rosendahl (a), Tejas Alexander (d), Jurgen Ennker (a) Abbreviations: FEV.sub.1, forced expiratory volume in 1 second; FPG, fasting plasma glucose; FVC, forced vital capacity; ICU, intensive care unit Abstract: In the past few years there has been increasing evidence that the respiratory function of patients with diabetes is impaired in the course of their disease. The objective of this article was to investigate whether patients with diabetes are particularly at risk of pulmonary complications during the perioperative stage of coronary bypass surgery. Author Affiliation: (a) Department of Cardiac, Thoracic, and Vascular Surgery, Heart Institute Lahr/Baden, Lahr, Germany (b) Neuroinformatics Group, Faculty of Technology, Bielefeld University, Bielefeld, Germany (c) Franziskus Hospital Berlin, Berlin, Germany (d) Department of Anaesthesiology, Heart Institute Lahr/Baden, Lahr, Germany Article History: Received 5 February 2007; Revised 4 July 2007; Accepted 10 July 2007

Keywords: insulin-dependent diabetes mellitus; Diabetes Control and Complications Trial; fetal and maternal outcomes; hemoglobin A.sub.1c Abstract: OBJECTIVE: Our purpose was to examine the maternal and fetal outcomes of the 180 women with insulin-dependent diabetes mellitus who became pregnant during the Diabetes Control and Complications Trial. STUDY DESIGN: The Diabetes Control and Complications Trial was a multicenter controlled clinical trial that compared intensive with conventional therapy in insulin-dependent diabetes mellitus. Intensive therapy, with the aim of achieving normal glycemic control, was initiated in women originally assigned to conventional therapy who actively sought to become pregnant or who became pregnant. RESULTS: A total of 180 women completed 270 pregnancies between 1983 and 1993, with 191 total live births. The mean glycosylated hemoglobin level was significantly different between the treatment groups at conception (7.4% [+ or -] 1.3% in intensive vs 8.1% [+ or -] 1.7% in conventional therapy, p = 0.0001) but was similar during gestation (6.6% [+ or -] 0.8% and 6.6% [+ or -] 1.3%). Nine congenital malformations were identified (4.7%), eight of which occurred in women originally assigned to conventional therapy (p = 0.06). There were 32 spontaneous abortions, 13.3% in the intensive and 10.4% in the women originally assigned to conventional treatment (not significant). There were no significant differences in outcome between the women with conventional treatment who initiated intensive therapy preconception and those who began it after conception. CONCLUSIONS: Timely institution of intensive therapy is associated with rates of spontaneous abortion and congenital malformation similar to those in the nondiabetic population. (AM J OBSTET GYNECOL 1996;174:1343-53.) Author Affiliation: Bethesda, Maryland Article History: Received 28 March 1995; Revised 22 May 1995; Accepted 27 September 1995 Article Note: (footnote) [star] Supported by the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, through cooperative agreements and a research contract. Additional support provided by the National Heart, Lung, and Blood Institute, the National Eye Institute, and the National Center for Research Resources., [star][star] Reprint requests: The Diabetes Control and Complications Trial Research Group, Box NDIC/DCCT, Bethesda, MD 20892., a 6/1/69705

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2010.05.013 Byline: Yusuke Kawamura, Yasuji Arase, Kenji Ikeda, Miharu Hirakawa, Tetsuya Hosaka, Masahiro Kobayashi, Satoshi Saitoh, Hiromi Yatsuji, Hitomi Sezaki, Norio Akuta, Fumitaka Suzuki, Yoshiyuki Suzuki, Hiromitsu Kumada Keywords: Diabetes; Hepatocellular carcinoma; Interferon; Sustained virologic response Abstract: This retrospective cohort study assessed the impact of diabetes mellitus on hepatocarcinogenesis and determined the predictors of hepatocarcinogenesis in noncirrhotic, interferon-treated patients with hepatitis C virus infection. Author Affiliation: Department of Hepatology, Toranomon Hospital, Tokyo, Japan Article Note: (footnote) Funding: Okinaka Memorial Institute for Medical Research and Japanese Ministry of Health, Labour and Welfare., Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript., Authorship: All authors had access to the data and played a role in writing this manuscript.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2008.05.018 Byline: Biff F. Palmer Keywords: Angiotensin-converting enzyme inhibitor; Angiotensin receptor blocker; Blood pressure; High cardiovascular risk; Hypertension; Renoprotection Abstract: Treatment of patients at high risk for developing cardiovascular disease aims at controlling blood pressure, optimizing blood glucose levels, and providing renoprotection. Chronic kidney disease (CKD) and diabetes mellitus are prevalent causes of cardiovascular disease owing to associations with major cardiovascular risk factors, such as hypertension, and they are substantial health burdens. Even mild-to-moderate CKD and prehypertension increase cardiovascular risk. First-line agents for reducing cardiovascular risk are inhibitors of the renin-angiotensin system: angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). In clinical trials, treatment of high-risk patients with ACE inhibitors and ARBs delays or prevents the onset of diabetes and prevents progression of renal disease and cardiovascular events, including cardiovascular mortality. Current evidence indicates that the clinical efficacy of these end points includes effects that may be beyond blood pressure reduction. Author Affiliation: Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA Article Note: (footnote) Statement of author disclosure: Please see the Author Disclosures section at the end of this article.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2008.03.052 Byline: Steven A. Pergam (1), Chia C. Wang (1), Carolyn M. Gardella (2), Taylor G. Sandison (1), Warren T. Phipps (1), Stephen E. Hawes (3) Keywords: drug use; gestational diabetes; hepatitis C; pregnancy complications Abstract: The objective of the study was to determine the effect of hepatitis C virus (HCV) on selected maternal and infant birth outcomes. Author Affiliation: (1) Department of Medicine, University of Washington School of Medicine, Seattle, WA (2) Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA (3) Department of Epidemiology, University of Washington School of Medicine, Seattle, WA. Article History: Received 15 September 2007; Revised 20 December 2007; Accepted 21 March 2008 Article Note: (footnote) Cite this article as: Pergam SA, Wang CC, Gardella CM, et al. Pregnancy complications associated with hepatitis C: data from a 2003-2005 Washington state birth cohort. Am J Obstet Gynecol 2008;199:38.e1-38.e9. , This study was supported by National Institute of Allergy and Infectious Diseases Grants T32 AI007044 (to S.A.P.) and AI-30731 (to C.M.G.); National Institutes of Health Grant T32 AI007140 (to W.T.P. and T.G.S.); and National Institutes of Health Grant 5 K23 AI51523 (to C.C.W.). Drs Wang and Gardella are members of the speaker's bureau for Roche and GlaxoSmithKline laboratories, respectively. Roche markets a test for hepatitis C, and GlaxoSmithKline is developing a drug intended for use in a treatment program for hepatitis C. Neither company contributed to the design, execution, review, or funding of this study.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0002-9343(96)00266-5 Byline: George L. Bakris (a), Matthew R. Weir (b), James R. Sowers (c) Abstract: Obesity, diabetes mellitus, and hypertension are common and interrelated medical problems in Westernized, industrialized societies. These medical conditions are associated with an increased risk of cardiovascular disease and are more prevalent among minorities, such as African-American and Hispanic populations. The associated cardiovascular risks of these problems are more thoroughly addressed in another review in this supplement. Obesity markedly enhances the development of type II diabetes. Moreover, it enhances the cardiovascular risk associated with other risk factors, such as hypertension and dyslipidemia. Weight reduction in association with an aerobic exercise program improves metabolic abnormalities and reduces blood pressure in individuals with diabetes and hypertension. Frequently, however, pharmacologic treatment is required to lower blood pressure. Individual therapy with an angiotensin-converting enzyme (ACE) inhibitor is preferred initially in these individuals, with the addition of either a low dose diuretic or a nondihydropyridine calcium antagonist if additional blood pressure reduction is required. These additive agents are recommended, since each has been shown individually to reduce cardiovascular morbidity and to preserve renal function among diabetic patients. Other issues, such as aggressive therapy of lipids and adequate glycemic control, are also important strategies for reducing cardiovascular and renal morbidity and mortality in this very highrisk population. Author Affiliation: (a) From the Departments of Preventive and Internal Medicine, Rush Medical School and Division of Nephrology, University of Illinois Medical Center at Chicago, Chicago, Illinois, USA (b) From the Department of Medicine, Division of Nephrology, University of Maryland Medical School, Baltimore, Maryland, USA (c) From the the Department of Medicine, Division of Endocrinology, Wayne State University Medical School, Detroit, Michigan, USA