32 results on '"Jacober, S. J."'
Search Results
2. Addition of insulin lispro protamine suspension or insulin glargine to oral type 2 diabetes regimens: a randomized trial
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Strojek, K., Shi, C., Carey, M. A., and Jacober, S. J.
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- 2010
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3. Primary care physician beliefs about insulin initiation in patients with type 2 diabetes
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Hayes, R. P., Fitzgerald, J. T., and Jacober, S. J.
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- 2008
4. A comparison of intensive mixture therapy with basal insulin therapy in insulin-naïve patients with type 2 diabetes receiving oral antidiabetes agents
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Jacober, S. J., Scism-Bacon, J. L., and Zagar, A. J.
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- 2006
5. Reduced peripheral activity leading to hepato‐preferential action of basal insulin peglispro compared with insulin glargine in patients with type 1 diabetes
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Mudaliar, S., primary, Henry, R. R., additional, Ciaraldi, T. P., additional, Armstrong, D. A., additional, Burke, P. M., additional, Pettus, J. H., additional, Garhyan, P., additional, Choi, S. L., additional, Knadler, M. P., additional, Lam, E. C. Q., additional, Prince, M. J., additional, Bose, N., additional, Porksen, N. K., additional, Sinha, V. P., additional, Linnebjerg, H., additional, and Jacober, S. J., additional
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- 2016
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6. Different effects of basal insulin peglispro and insulin glargine on liver enzymes and liver fat content in patients with type 1 and type 2 diabetes
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Cusi, K., primary, Sanyal, A. J., additional, Zhang, S., additional, Hoogwerf, B. J., additional, Chang, A. M., additional, Jacober, S. J., additional, Bue-Valleskey, J. M., additional, Higdon, A. N., additional, Bastyr, E. J., additional, Haupt, A., additional, and Hartman, M. L., additional
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- 2016
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7. Basal insulin peglispro: Overview of a novel long-acting insulin with reduced peripheral effect resulting in a hepato-preferential action
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Jacober, S. J., primary, Prince, M. J., additional, Beals, J. M., additional, Hartman, M. L., additional, Qu, Y., additional, Linnebjerg, H., additional, Garhyan, P., additional, and Haupt, A., additional
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- 2016
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8. Glucodynamics of long-acting basal insulin peglispro compared with insulin glargine at steady state in patients with type 1 diabetes: substudy of a randomized crossover trial
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Morrow, L. A., primary, Hompesch, M., additional, Jacober, S. J., additional, Leng Choi, S., additional, Qu, Y., additional, and Sinha, V. P., additional
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- 2016
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9. Contrasting weight changes with LY2605541, a novel long‐acting insulin, and insulin glargine despite similar improved glycaemic control in T1DM and T2DM
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Jacober, S. J., primary, Rosenstock, J., additional, Bergenstal, R. M., additional, Prince, M. J., additional, Qu, Y., additional, and Beals, J. M., additional
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- 2013
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10. Response to Comment on: Bergenstal et al. A Randomized, Controlled Study of Once-Daily LY2605541, a Novel Long-Acting Basal Insulin, Versus Insulin Glargine in Basal Insulin-Treated Patients With Type 2 Diabetes. Diabetes Care 2012;35:2140-2147
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Bergenstal, R. M., primary, Rosenstock, J., additional, Arakaki, R. F., additional, Prince, M. J., additional, Qu, Y., additional, Sinha, V. P., additional, Howey, D. C., additional, and Jacober, S. J., additional
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- 2013
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11. Basal insulin peglispro versus insulin glargine in insulin-naïve type 2 diabetes: IMAGINE 2 randomized trial.
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Davies, M. J., Russell‐Jones, D., Selam, J.‐L., Bailey, T. S., Kerényi, Z., Luo, J., Bue‐Valleskey, J., Iványi, T., Hartman, M. L., Jacobson, J. G., and Jacober, S. J.
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INSULIN therapy ,TYPE 2 diabetes treatment ,GLYCOSYLATED hemoglobin ,RANDOMIZED controlled trials ,TRIGLYCERIDES ,PEOPLE with diabetes - Abstract
Aims To compare, in a double-blind, randomized, multi-national study, 52- or 78-week treatment with basal insulin peglispro or insulin glargine, added to pre-study oral antihyperglycaemic medications, in insulin-naïve adults with type 2 diabetes. Material and methods The primary outcome was non-inferiority of peglispro to glargine with regard to glycated haemoglobin ( HbA1c) reduction (margin = 0.4%). Six gated secondary objectives with statistical multiplicity adjustments focused on other measures of glycaemic control and safety. Liver fat content was measured using MRI, in a subset of patients. Results Peglispro was non-inferior to glargine in HbA1c reduction [least-squares ( LS) mean difference: −0.29%, 95% confidence interval ( CI) −0.40, −0.19], and had a lower nocturnal hypoglycaemia rate [relative rate 0.74 (95% CI 0.60, 0.91); p = .005), more patients achieving HbA1c <7.0% without nocturnal hypoglycaemia [odds ratio ( OR) 2.15 (95% CI 1.60, 2.89); p < .001], greater HbA1c reduction (p < .001), and more patients achieving HbA1c<7.0% [ OR 1.97 (95% CI 1.57, 2.47); p < .001]. Total hypoglycaemia rate and fasting serum glucose did not achieve statistical superiority. At 52 weeks, peglispro-treated patients had higher triglyceride (1.9 vs 1.7 mmol/L). alanine transaminase (34 vs 27 IU/ L), and aspartate transaminase levels (27 vs 24 IU/ L). LS mean liver fat content was unchanged with peglispro at 52 weeks but decreased 3.1% with glargine [difference: 2.6% (0.9, 4.2); p = .002]. More peglispro-treated patients experienced adverse injection site reactions (3.5% vs 0.6%, p < .001). Conclusions Compared with glargine at 52 weeks, peglispro resulted in a statistically superior reduction in HbA1c, more patients achieving HbA1c targets, less nocturnal hypoglycaemia, no improvement in total hypoglycaemia, higher triglyceride levels, higher aminotransferase levels, and more injection site reactions. [ABSTRACT FROM AUTHOR]
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- 2016
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12. A randomized clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 1 diabetes: IMAGINE 1.
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Garg, S., Dreyer, M., Jinnouchi, H., Mou, J., Qu, Y., Hartman, M. L., Rosilio, M., Jacober, S. J., and Bastyr, E. J.
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INSULIN therapy ,HEMOGLOBIN genetics ,TYPE 1 diabetes ,GLYCEMIC control ,HYPOGLYCEMIA ,CLINICAL trials ,GENETICS ,PREVENTION - Abstract
Aims The primary objective was to demonstrate that basal insulin peglispro ( BIL) was non-inferior compared with insulin glargine ( GL) for haemoglobin A1c ( HbA1c) at 26 weeks with a non-inferiority margin of 0.4%. Materials and Methods IMAGINE 1 was a Phase 3, open-label, parallel-arm study conducted in nine countries. Adults with type 1 diabetes ( n = 455) were randomized (2:1) to bedtime BIL or GL in combination with prandial insulin lispro for 78 weeks, with a primary endpoint of 26 weeks. An electronic diary facilitated data capture and insulin dosing calculations for intensive insulin management. Results At 26 weeks, mean HbA1c was 7.06% ± 0.04% and 7.43% ± 0.06% for patients assigned to BIL (N = 295) and GL (N = 160), respectively (difference -0.37% [95% CI: −0.50 to −0.23], P < .001); more patients on BIL achieved HbA1c <7% (44.9% vs 27.5%, P < .001). Compared with GL, patients using BIL lost weight, with lower fasting serum glucose and between-day fasting blood glucose variability, and 36% less nocturnal hypoglycemia, 29% more total hypoglycemia and more severe hypoglycemia. Total and prandial insulin doses were lower with BIL; basal insulin doses were higher. Alanine aminotransferase increased with BIL, with more patients having elevations ≥3 × ULN. BIL treatment was associated with more frequent injection site reactions and an increase from baseline in serum triglycerides. Conclusions In patients with type 1 diabetes, treatment with BIL compared to GL for 26 weeks was associated with lower HbA1c, less nocturnal hypoglycemia, lower glucose variability and weight loss. Increases in total and severe hypoglycemia, triglycerides, aminotransferases and injection site reactions were also noted. [ABSTRACT FROM AUTHOR]
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- 2016
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13. A randomized clinical trial of basal insulin peglispro vs NPH in insulin-naïve patients with type 2 diabetes: the IMAGINE 6 trial.
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Grunberger, G., Chen, L., Rodriguez, A., Tinahones, F. J., Jacober, S. J., and Bue‐Valleskey, J.
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INSULIN therapy effectiveness ,PEOPLE with diabetes ,PHYSIOLOGICAL effects of insulin ,HYPERGLYCEMIA prevention ,GLYCEMIC control ,CLINICAL trials - Abstract
Aims Basal insulin peglispro ( BIL) has a longer duration of action than conventional insulin analogues and a hepato-preferential mechanism of action. This study assessed whether BIL was non-inferior to isophane insulin ( NPH) in reducing HbA1c in insulin-naïve patients with type 2 diabetes, when added to pre-study oral anti-hyperglycaemic medications. Materials and methods This was a Phase 3, open-label, treat-to-target ( TTT), randomized trial with a 2-week lead-in, 26-week treatment and a 4-week safety follow-up period. Patients were randomized to bedtime ( pm) NPH, morning ( am) BIL or pm BIL in a 1:1:1 ratio. Results Six hundred and forty-one patients [ NPH, n = 213; BIL, n = 428 ( am, n = 213; pm, n = 215)] received study drug. BIL was non-inferior to NPH for HbA1c change from baseline at Week 26 with a between-treatment difference (95% confidence interval) of −0.37% (−0.50, −0.23%). HbA1c at baseline was 8.5%, and was lower in BIL- vs NPH-treated patients after 26 weeks of treatment (6.8% vs 7.1%; P < .001). More BIL-treated patients achieved HbA1c <7.0% and HbA1c <7.0% without nocturnal hypoglycaemia. Fasting serum glucose levels and nocturnal hypoglycaemia rates were lower in BIL-treated patients; total hypoglycaemia rates were similar. Treatment-emergent adverse events were similar between groups. Fasting triglycerides decreased from baseline in both groups and to a greater extent with NPH, but were not significantly different between groups at Week 26. Mean alanine aminotransferase (ALT) increased with BIL treatment, but there was no evidence of acute severe hepatotoxicity. Conclusions In this TTT study, BIL treatment showed clinically relevant improvements in glycaemic control and a significant reduction in nocturnal hypoglycaemia compared to NPH. [ABSTRACT FROM AUTHOR]
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- 2016
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14. Comparison of pharmacodynamic intrasubject variability of insulin lispro protamine suspension and insulin glargine in subjects with type 1 diabetes
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Ocheltree, S M, primary, Hompesch, M, additional, Wondmagegnehu, E T, additional, Morrow, L, additional, Win, K, additional, and Jacober, S J, additional
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- 2010
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15. The influence of treatment modality and ethnicity on attitudes in type 2 diabetes
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Fitzgerald, J. T., primary, Gruppen, L. D., additional, Anderson, R. M., additional, Funnell, M. M., additional, Jacober, S. J., additional, Grunberger, G., additional, and Aman, L. C., additional
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- 2000
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16. Exercise and hypertension
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Jacober, S. J., primary
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- 1995
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17. A Prospective Study Identifying Risk Factors for Discontinuance of Insulin Pump Therapy
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Floyd, J. C., primary, Cornell, R. G., additional, Jacober, S. J., additional, Griffith, L. E., additional, Funnell, M. M., additional, Wolf, L. L., additional, and Wolf, F. M., additional
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- 1993
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18. The reliability of the Diabetes Care Profile for African Americans.
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Fitzgerald JT, Anderson RM, Gruppen LD, Davis WK, Aman LC, Jacober SJ, Grunberger G, Fitzgerald, J T, Anderson, R M, Gruppen, L D, Davis, W K, Aman, L C, Jacober, S J, and Grunberger, G
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The Diabetes Care Profile (DCP) is an instrument used to assess social and psychological factors related to diabetes and its treatment. The reliability of the DCP was established in populations consisting primarily of Caucasians with type 2 diabetes. This study tests whether the DCP is a reliable instrument for African Americans with type 2 diabetes. Both African American (n = 511) and Caucasian (n = 235) patients with type 2 diabetes were recruited at six sites located in the metropolitan Detroit area. Scale reliability was calculated by Cronbach's coefficient alpha. The scale reliabilities ranged from .70 to .97 for African Americans. These reliabilities were similar to those of Caucasians, whose scale reliabilities ranged from .68 to .96. The Feldt test was used to determine differences between the reliabilities of the two patient populations. No significant differences were found. The DCP is a reliable survey instrument for African American and Caucasian patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]
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- 1998
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19. Diabetes and pregnancy. Factors associated with seeking pre-conception care.
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Janz, N K, Herman, W H, Becker, M P, Charron-Prochownik, D, Shayna, V L, Lesnick, T G, Jacober, S J, Fachnie, J D, Kruger, D F, and Sanfield, J A
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- 1995
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20. Jejunostomy feeding in the management of gastroparesis diabeticorum.
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JACOBER, S. J., NARAYAN, A., STRODEL, W. E., and VINIK, A. I.
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- 1986
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21. 40 EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004
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Veitenhansl, M., Stegner, K., Hierl, F-X, Dieterle, C., Feldmeier, H., Gutt, B., Landgraf, R., Garrow, A. P., Vileikyte, L., Findlow, A., Waterman, C., Boulton, A. J. M., Shankhdhar, K., Shankhdhar, L., Shankhdhar, U., Petrova, N. L., Foster, A. V. M., Edmonds, M. E., Ferraresi, R., Caravaggi, C., Giglio, R., Cavaiani, P., Pogliaghi, I., Sommariva, E., Katz, I. A., Harlan, A., Miranda-Palma, B., Prieto-Sanchez, L., Armstrong, D. G., Bowker, J. H., Mizel, M. S., Cernea, S., Wohlgelernter, J., Kidron, M., Modi, P., Raz, I., Arbit, E., Nosek, L., Kapitza, C., Beckett, P., Gelfand, R., Goldberg, M., Heise, T., Testa, M. A., Turner, R. R., Hayes, J. F., Scranton, R. E., Simonson, D. C., Yang, Y-W, Hsu, Y-J, Naujok, O., Francini, F., Jorns, A., Tiedge, M., Lenzen, S., Abdel-Wahab, Y. H. A., Marenah, L., Orr, D. F., Shaw, C., Flatt, P. R., Chokkalingam, K., Mansell, P. I., Clausen, P., Ekbom, P., Damm, P., Feldt-Rasmussen, U., Nielsen, B., Mathiesen, E. R., Feldt-Rasmussen, B., Dewan, S., Da Silva, N., Ternan, P. Mc, Leong, K. S., Wilding, J. P. H., Asatiani, N., Kurashvili, R., Dundua, M., Shelestova, E., Pagava, K., Ramazashvili, M., Hod, M., Smirnov, S., Petersen, J. L. A., Justesen, T. I., Ringholm Nielsen, L., Muller, C., Hojlund, K., Wensaas, A., Kase, E. T., Aas, V., Rustan, A. C., Thoresen, G. H., Levin, K., Beck-Nielsen, H., Gaster, M., Im, S-S, Kang, S-Y, Kim, S-Y, Ahn, Y-H, Lihn, A. S., Schmoll, D., Werner, T., Kienitz, A., Meyer, M., Barthel, A., Ailett, F., Sutherland, C., Walther, R., Grempler, R., Sasson, S., Reich, R., Tenenbaum, T., Alpert, E., Anfossi, G., Russo, I., Traversa, M., Massucco, P., Mattiello, L., Doronzo, G., Trovati, M., Lally, S., Tan, C. Y., Owens, D., Tomkin, G. H., Porchay, I., Pean, F., Bellili, N., Betoulle, D., Balkau, B., Tichet, J., Marre, M., Fumeron, F., Group D.E.S.I.R., Chatellier, G., Alhenc-Gelas, F., Diabhycar, Study Group, Nichols, G. A., Brown, J. B., Hayes, R. P., Bowman, L., Drexel, H., Saely, C. H., Marte, T., Benzer, W., Langer, P., Hoefle, G., Moll, W., Aczel, S., Karagiannis, E., Lubben, G., Urquhart, R., Edwards, G., Bruce, S., Howlett, H. S. C., Cugnardey, N., Turner, K. C., Park, J-S, Fiedorek, F. T., Avogaro, A., Gallo, A., Pinton, P., Rizzuto, R., Murphy, E., Ceolotto, G., Caterson, I., Guy-Grand, B., Hill, J., Barone, M., Aiello, A., Allochis, G., Borzi, V., Cannata, F., Caronna, S., D Avanzo, A., Elli, R., Formoso, G., Paroli, A., Scardapane, R., Sorichetti, P., Tatti, P., Viviani, G., Santeusanio, F., Italian Repaglinide Study Group, Manzella, D., Grella, R., Abbatecola, A. M., Paolisso, G., Sondergaard, L. G., Monster, T. B. M., Johnsen, S. P., Olsen, M. L., Mclaughlin, J. K., Sorensen, H. T., Lervang, H. H., Rungby, J., Lyssenko, V., Fredriksson, J., Almgren, P., Anevski, D., Orho-Melander, M., Sjogren, M., Tuomi, T., Groop, L., Jaziri, R., Aubert, R., Tuomilehto, J., Hu, G., Jousilahti, P., Peltonen, M., Lindstrom, J., Laina, A., Alevizaki, M., Philippou, G., Souvatzoglou, A., Anastasiou, E., Alba, S., Metcalf, B. S., Voss, L. D., Jeffery, A. N., Wilkin, T. J., Gluimer, C., Colagiuri, S., Vistisen, D., Borch-Johnsen, K., Haynes, A., Bower, C., Bulsara, M. K., Jones, T. W., Davis, E. A., Mortensen, H. B., Hougaard, P., Holl, R., Swift, P., Pociot, F., Knip, M., Hansen, L., Szadkowska, A., Pietrzak, I., Zmyslowska, A., Wyka, K., Bodalski, J., Holl, R. W., Swift, R., Hougaard, R., Gerstl, E-M, Engelsberger, I., Rabl, W., Rosenbauer, J., Grobe, H., Hofer, S. E., Krause, U., DPV-Wiss-Study Group, Dabelea, D., Morgan, T., Pettitt, D. J., Dolan, L., Mayer-Davis, E. J., Pihoker, C., Hillier, T. A., Imperatore, G., Ruggiero, A., Hamman, R. E., Stylianou, A., Tentolouris, N., Perrea, D., Tselepis, A. D., Lourida, E., Kitsou, E., Katsilambros, N., Vedovato, M., Dodesini, A. R., Lepore, G., Tiengo, A., Trevisan, R., Penno, G., Miccoli, R., Pucci, L., Lucchesi, D., Bandinelli, S., Fotino, C., Triscornia, S., Baldassari, E., Del Prato, S., Reboldi, P., Santeusanio, E., Fuller, J., Langham, R. G., Gow, R. M., Zhang, Y., Kelly, D. J., Christensen, P. K., Parving, H-H, Gilbert, R. E., Chibalin, A. V., Zhong, Z., Kotova, O., Davidescu, A., Ehren, I., Ekberg, K., Wahren, J., Wassef, L., Buckley, A. J., Rooney, K. B., Briody, J., Thompson, M., Ozanne, S. E., Thompson, C. H., Chamson-Reig, A., Summers, K., Arany, E. J. R., Hill, D. J., Solerte, S. B., Gazzaruso, C., Locatelli, E., Precerutti, S., Schifino, N., Ferrari, E., Fioravanti, M., Phenekos, C. V., Ginis, A., Fragaki, I., Chalkiadaki, M., Tzioras, C., Powell, L. A., Mcguire, G. M., Jewhurst, V., Trimble, E. R., Rasmussen, B. M., Vessby, B., Uusitupa, M., Berglund, L., Pedersen, E., Riccardi, G., Rivellese, A. A., Tapsell, L., Hermansen, K., Kanwu, Study Group, Da Silva Xavier, G., Rutter, J., Rutter, G. A., Briaud, I. M., Lingohr, M. K., Dickson, L. M., Mccuaig, J. R., Lawrence, J. C., Rhodes, C. J., Wikstrom, J. D., Katzman, S. M., Shirihai, O. S., Yang, J., Deng, S., Wang, X., Hessner, M. J., Wu, J., Wong, R. K., Sukumvanich, S., Markman, J. F., Naji, A., Wolf, B. A., Gao, Z., Rubi, B., Del Arco, A., Satrustegui, J., Maechler, P., Del Guerra, S., Lupi, R., Bugliani, M., Sbrana, S., Torri, S., Boggi, U., Vistoli, F., Mosca, F., Marchetti, P., Rennings, A. J. M., Smits, P., Stewart, M. W., Tack, C. J. J., Li, L., Nystrom, T., Gutniak, M., Ahren, B., Holst, J., Sjoholm, A., Gomes, M. B., Cailleaux, S., Tibirica, E., Albertini, J-P, Chen, H., Mather, R., Valensi, P. E., Chisalita, S. I., Arnqvist, H. J., Kraenkel, N., Adams, V., Linke, A., Gielen, S., Schuler, G., Humbrecht, R., Cipollone, F., Iezzi, A., Fazia, M., Pini, B., Cucurullo, C., Cesare, D., Schmidt, A. M., Mazurek, T., Zang, L. F., Mannion, J., Diehl, J., Martin, J., Martella, A., Zalewski, A., Shi, Y., Otter, W., Winter, M., Doering, W., Standi, E., Schnell, O., Kragelund, C., Kober, L., Faber, J., Hildebrandt, P., Steffensen, R., Pankowska, E., Szypowska, A., Lipka, M., Herwig, J., Scholl-Schilling, G., Bohles, H., Robertson, K. J., Schonle, E., Gucev, Z., Mordhorst, L., Tamer, S. C., Gall, M-A, Ludvigsson, J., Hoogma, R. P. L., Hammond, P. J., Gomis, R., Kerr, D., Bruttomesso, D., Bouter, P., Wiefels, K. J., La Calle, H., Schweitzer, D. H., Pfohl, M., Torlone, E., Krinelke, L. G., 205-Nations Study Group, Conget, I., Storms, F., Rodriguez, J., Leperlier, C., Davies, M., At Lantus, Study Group, Peter, R., Luzio, S. D., Dunseath, G., Miles, A., Hare, B., Backx, K., Pauvaday, V., Owens, D. R., Caselli, A., Marfia, G. A., Battista, C., Veves, A., Spallone, V., Uccioli, L., Gonzalez, J. S., Peyrot, M. F., Rubin, R. R., Leventhal, H., Scheffler, N., Ulbrecht, J. S., Cavanagh, P. R., Boulton, A. J., Perrin, N. A., Oglesby, A., Bastyr, E. J., Ziegler, D., Siekierka-Kleiser, E., Meyer, B., Schweers, M., Selvarajah, D., Wilkinson, I. D., Emery, C. J., Shaw, P. J., Griffiths, P. D., Tesfaye, S., Obrosova, I. G., Arezzo, J., Phillips, K., Fidarestat Study Group, Gribble, F. M., Williams, L., Reimann, F., Iakoubov, R., Whiteside, C., Brubaker, P. L., Acitores, A., Gonzalez, N., Sancho, V., Valverde, I., Villanueva-Penacarrillo, M. L., Martin-Duce, A., Trigo, M. V., Arnes, L., Burkart, V., Ichino, N., Ohashi, A., Klein, B. S., Paxian, S., Schmid, R., Karlsen, A. E., Heding, P. E., Frobose, H., Ronn, S. G., Kruhoffer, M., Orntoft, T. F., Nerup, J., Mandrup-Poulsen, T., Billestrup, N., Cardozo, A. K., Ortis, F., Feng, Y-M, Rasschaert, J., Eylen, F., Storling, J., Herchuelz, A., Eizirik, D. L., Wang, H., Kouri, G., Wollheim, C. B., Ribaux, P., Hammar, E., Parnaud, G., Rouiller, D., Bosco, D., Halban, P., Midthjell, K., Carlsson, S., Grill, V., Lau, C., Farch, K., Glumer, C., Tetens, I., Jorgensen, T., Tillin, T., Forouhi, N., Mckeigue, P., Chaturvedi, N., Zethelius, B., Hales, C. N., Berne, C., Coleman, R. L., Stevens, R. J., Holman, R. R., Christensen, J. O., Sandbak, A., Lauritzen, T., Irwin, N., Gault, V. A., Green, B. D., Harriott, P., O Harte, F. P. M., Bouman, S. D., Urso, B., Brand, C. L., Rolin, B., Ribel, U., Schaffer, L., Maggs, D. G., Ceriello, A., Frias, J. P., Wang, Y., Ruggles, J. A., Kolterman, O. G., Piconi, L., Weyer, C., Want, L. L., Ratner, R. E., Uwaifo, G. I., Thornberry, N. A., Eiermann, G., Kim, D., Lankas, G., Leiting, B., Li, Z., Lyons, K., Petrov, A., Sinha Roy, R., Woods, A., Woods, J., Zhang, B. B., Fisher, M., Moller, D. E., Weber, A. E., Dreyer, M., Bellin, C., Schmitz, V., Roesen, R., Nescheret, A. P., Bose, A. K., Mocanu, M. M., Carr, R. D., Yellon, D. M., Manolopoulos, K., Born, S., Wagner, A., Jeziorska, M., Ben Drief, A., Bashir, M., Tomlinson, D., Malik, R. A., Zeymer, U., Schwarzmaier-D Assie, A., Petzinna, D., Chiasson, J-L, Stratton, I. M., Af Bjorkesten, C-G, Fagerudd, J., Rosengard-Barlund, M., Forsblom, C., Pettersson-Fernholm, K., Waden, J., Saraheimo, M., Ronnback, M., Thorn, L., Groop, P-H, Mollsten, A., Svensson, M., Kockum, I., Rudberg, S., Brismar, K., Dahlquist, G., Hovind, P., Hansen, T. K., Tarnow, L., Thiel, S., Jensen, B. R., Flyvbjerg, A., Kankova, K., Hertlova, M., Krusova, D., Schwenke, S., Ott, J., Thom, S. A. M., Mistry, P., Sjolie, A., Larsen, B., Witt, N., Hughes, A. D., Samira, H. H., Lahiry, S., Howlader, S. R., Parveen, S., Azad Khan, A. K., Clarke, P. M., Gray, A., Stevens, R., Holman, R., Phillips, L., Phillips, P. J., Chittleborough, C., Baldock, K., Taylor, A., North West Adelaide Health Study Team, Davis, W. A., Davis, T. M. E., Knuiman, M. 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I., Gkioulmpasanis, I., Panagiotou, I., Vassilikos, G., Skorda, L., Sidira, M., Christoforidou, M., Alaveras, A., Artikis, V., Evdemon, E., Lechleitner, M., Koch, T., Ebenbichler, C., Sturm, W., Moretti, L., Moruzzo, D., Boldrini, E., Pandolfo, C., Kameyama, M., Iwasa, R., Cho, M-H, Nam, J-Y, Kim, C-S, Kim, D-M, Ahn, C-W, Cha, B-S, Lim, S-K, Kim, K-R, Lee, H-C, Huh, K-B, Kaplar, M., Paragh, G., Erdei, A., Csongradi, E., Garai, I., Varga, J., Galuska, L., Udvardy, M., Higa, M., Kaneko, Y., Hiroi, N., Koziarska, D., Nowacki, P., Majkowska, L., Wojciechowska-Luzniak, A., Tushuizen, M. E., Nieuwland, R., Snoeck, D. P., Sturk, A., Diamant, M., Aguiar, L. G. K., Bahia, L., Villela, N., Laflor, C., Conde, C., Bottino, D., Dorigo, D., Bouskela, E., Pu, S., Yu, H. L., Luo, Z. T., Lam, K. S. L., Dan, Q., Xu, A., Shen, J., Cheng, K., Xu, J. Y. U., Thamer, C., Stefan, N., Haap, M., Heller, E., Tschritter, O., Prado, A., Ortiz, A., Ybarra, J., Gich, I., Pou, J. M., Ehren, M., Meyer, M. F., Roggenland, D., Reinsen, B., Klein, H. H., Rittig, K., Stock, J., Kocher, B., Balletshofer, B., Lee, J., Shon, H. S., Chung, D. S., Nakatani, Y., Matsuhisa, M., Kaneto, H., Hatazaki, M., Yoshiuchi, K., Katakami, N., Kawamori, D., Ohtoshi, K., Sakamoto, K., Matsuoka, T-A, Ozawa, K., Ogawa, S., Hori, M., Yamasaki, Y., Zitouni, K., Harry, D., Nourooz-Zadeh, J., Betteridge, J. D., Earle, K. A., Rasmussen, L. M., Olesen, P., Franco, L., Corvaja, C., Semplicini, A., Rosen, P., Lee, I-K, Kim, M-J, Park, K-G, Jung, E-D, Shin, D-W, Jo, S-R, Obuobie, K., Prakash, P. K., Hanna, F. W., Evans, M., Lazarus, J., Varadhan, L., Gurushankar, J., James, D., Sheikh, S., Gaede, P., Li, H., Zou, D., Lee, S. J., Choi, M. G., Kim, D. S., Kim, T. W., Vilarrasa, N., Perez-Maraver, M., Mena, E., Perez, D., Setti, G., Buckingham, R., Urbancic, V., Stefanovska, A., Bernjak, A., Azman-Juvan, K., Kocijancic, A., Glowania, A., Filters, T. S., Fosmark, D. S., Torjesen, P. A., Kilhovd, B., Berg, T. J., Sandvik, L., Hanssen, K. F., Mentink, C. J. A., Kilhovd, B. K., Kuchmerovska, T. M., Shymanskyy, I. O., Donchenko, G. V., Stepanenko, S. P., Klimenko, A. P., Park, J., Maingrette, F., Deng, H. C., Lindenmair, A., Waldhausl, W. K., Freudenthaler, A., Baumgartner-Parzer, S. M., Nizheradze, K., Khoruzhenko, A., Tronko, N., Sheu, W. H. H., Ou, H-C, Shen, H-M, Lin, T-M, Wu, H-S, Yang, C-H, Mogylnytska, L., Mankovsky, B., Schmoelzer, I., Davies, J. I., Band, M., Morris, A., Struthers, A. D., Prazny, M., Skrha, J., Kasalova, Z., Neelotpol, S., Jahan, P., Kauschke, S. G., Harrop, C. A., Schafer, A., Widder, J., Eigenthaler, M., Walter, U., Uchimura, I., Ikebukuro, M., Kaibara, M., Hirata, M., Helal, R., Pervin, F., Khan, A. K. A., Yang, X., Jansson, P-A, Nagaev, I., Jack, M. M., Carvalho, E., Sunnerhagen, K. Stibrant, Cam, M. C., Cushman, S. W., Smith, U., Creely, S. J., Farmer, J., Creely, S., Gustafson, B., Kusminski, C. M., Krusinova, E., Wohl, P., Klementova, M., Lanska, V., Mcdougall, C., Thomas, S. J., Kelly, I., Abbas, Z. G., Lutale, J. K., Archibald, L. K., Karunajeewa, H., Stingemore, N., Stuccio, G., Mcgechie, D., Muller, L. M. A., Hak, E., Goudzwaard, W. L., Montorsi, F., Homering, M., Sprenger, K., Goldstein, I., Asnaghi, V., Ferrari, G., Rastaldi, M., Gabellini, D., Antonio, G., Maestroni, A., Ruggieri, D., Luzi, L., Piemonti, L., Zerbini, G., Anafaroglu, I., Tutuncu, N. B., Sultana, M., Siddiqua, N., Iwasaki, T., Nakajima, A., Yoneda, M., Mukasa, K., Tanaka, S., and Sekihara, H.
22. Randomized, double-blind clinical trial comparing basal insulin peglispro and insulin glargine, in combination with prandial insulin lispro, in patients with type 1 diabetes: IMAGINE 3.
- Author
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Bergenstal, R. M., Lunt, H., Franek, E., Travert, F., Mou, J., Qu, Y., Antalis, C. J., Hartman, M. L., Rosilio, M., Jacober, S. J., and Bastyr, E. J.
- Subjects
TREATMENT of diabetes ,RANDOMIZED controlled trials ,PHARMACOKINETICS ,INSULIN therapy ,PROINSULIN - Abstract
Aims To compare the efficacy and safety of basal insulin peglispro ( BIL), which has a flat pharmacokinetic and pharmacodynamic profile and a long duration of action, with insulin glargine ( GL) in patients with type 1 diabetes. Materials and methods In this phase III, 52-week, blinded study, we randomized 1114 adults with type 1 diabetes in a 3 : 2 distribution to receive either BIL (n = 664) or GL (n = 450) at bedtime, with preprandial insulin lispro, using intensive insulin management. The primary objective was to compare glycated haemoglobin ( HbA1c) in the groups at 52 weeks, with a non-inferiority margin of 0.4%. Results At 52 weeks, mean (standard error) HbA1c was 7.38 (0.03)% with BIL and 7.61 (0.04)% with GL {difference −0.22% [95% confidence interval ( CI) −0.32, −0.12]; p < 0.001}. At 52 weeks more BIL-treated patients reached HbA1c <7% (35% vs 26%; p < 0.001), the nocturnal hypoglycaemia rate was 47% lower (p < 0.001) and the total hypoglycaemia rate was 11% higher (p = 0.002) than in GL-treated patients, and there was no difference in severe hypoglycaemia rate. Patients receiving BIL lost weight, while those receiving GL gained weight [difference −1.8 kg (95% CI −2.3, −1.3); p < 0.001]. Treatment with BIL compared with GL at 52 weeks was associated with greater increases from baseline in levels of serum triglyceride [difference 0.19 mmol/l (95% CI 0.11, 0.26); p < 0.001] and alanine aminotransferase ( ALT) levels [difference 6.5 IU/l (95% CI 4.1, 8.9), p < 0.001], and more frequent injection site reactions. Conclusions In patients with type 1 diabetes, treatment with BIL compared with GL for 52 weeks resulted in a lower HbA1c, more patients with HbA1c levels <7%, and reduced nocturnal hypoglycaemia, but more total hypoglycaemia and injection site reactions and higher triglyceride and ALT levels. [ABSTRACT FROM AUTHOR]
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- 2016
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23. Altered myosin light-chain phosphorylation in resting platelets from premenopausal women with diabetes.
- Author
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Guzmán CB, Walsh M, Reddy V, Donthireddy V, Mahmood F, Bode A, Turner JR, Jacober SJ, and Sowers JR
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- Adolescent, Adult, Aged, Anthropometry, Ascorbic Acid blood, Blood Platelets chemistry, Blood Platelets physiology, Cyclic GMP analysis, Diabetes Mellitus pathology, Female, Glutathione blood, Glutathione Disulfide blood, Humans, Immunoblotting, Matched-Pair Analysis, Middle Aged, Nitric Oxide analysis, Oxidative Stress, Phosphorylation, Postmenopause metabolism, Radioimmunoassay, Blood Platelets metabolism, Diabetes Mellitus metabolism, Myosin Light Chains metabolism, Premenopause metabolism
- Abstract
Gender-related differences in the rate of coronary heart disease (CHD) between premenopausal women and men are greatly diminished in women with diabetes mellitus (DM). This may be related, in part, to altered platelet function in premenopausal diabetic women. Hyperglycemia may contribute to increase platelet aggregation through enhancement of oxidative stress, increased nitric oxide (NO) destruction, and increased myosin light-chain (MLC) phosphorylation (MLC-P). Accordingly, we investigated functional and biochemical parameters of platelet function in 32 women (14 premenopausal and postmenopausal controls and 18 age-matched patients with DM); platelet MLC-P and cyclic guanosine monophosphate ([cGMP] reflecting NO) were assessed. Other parameters including age, body mass index (BMI), waist to hip ratio, total cholesterol, and platelet count were not different in the control and diabetic groups. In the premenopausal women, baseline MLC-P was lower in women with DM versus the control group (P = .02). GMP levels were similar in the two groups at baseline (22.7 +/- 3 fmol/mL in controls v 23.1 +/- 3 fmol/mL in diabetic subjects) and 3 minutes after insulin exposure. The platelet content of ascorbic acid (AA), an endogenous antioxidant compound, was elevated in premenopausal women with DM (P = .02) compared with the controls. Despite similar estradiol (beta,E2) levels, platelets of premenopausal women with DM exhibited reduced MLC-P. This paradoxic difference may be accounted for by an increase in platelet AA, as this suggests decreased platelet oxidative stress in this patient population. These observations indicate that an altered redox state and associated MLC-P of platelets does not contribute to enhanced platelet aggregation and CHD in premenopausal women with DM.
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- 2001
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24. Why do older women with diabetes have an increased fracture risk?
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Nelson DA and Jacober SJ
- Subjects
- Female, Humans, Risk Factors, Aging physiology, Diabetes Mellitus, Type 2 complications, Fractures, Bone etiology
- Published
- 2001
- Full Text
- View/download PDF
25. An update on perioperative management of diabetes.
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Jacober SJ and Sowers JR
- Subjects
- Algorithms, Blood Glucose metabolism, Diabetes Mellitus blood, Diabetes Mellitus drug therapy, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 2 drug therapy, Drug Administration Schedule, Humans, Hypoglycemic Agents administration & dosage, Diabetes Mellitus therapy, Perioperative Care methods
- Abstract
Surgery in the patient with diabetes mellitus is relatively common, as the numbers of persons with diabetes is increasing and diabetes predisposes to medical conditions that require surgical intervention. An estimated 25% of diabetic patients will require surgery, and advances in perioperative care of these patients allow them to safely undergo the most complicated surgical procedures. We will review issues of preoperative, intraoperative, and postoperative care of diabetic patients.
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- 1999
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26. Cardiovascular disease in the diabetic woman.
- Author
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Kaseta JR, Skafar DF, Ram JL, Jacober SJ, and Sowers JR
- Subjects
- Cardiovascular Diseases etiology, Cardiovascular Diseases pathology, Cardiovascular Diseases prevention & control, Clinical Trials as Topic, Diabetes Complications, Diabetes Mellitus pathology, Diabetes Mellitus prevention & control, Female, Humans, Male, Cardiovascular Diseases epidemiology, Diabetes Mellitus epidemiology
- Abstract
The incidence of cardiovascular disease (CVD) with age is increasing in the United States, and elderly women constitute a disproportional component of the aging population. Elderly women also have a relatively high incidence of diabetes, which contributes to this relatively high CVD risk. Although CVD is less common in premenopausal women than in men, this difference begins to disappear after the onset of menopause, presumably related to decreased levels of female sex hormones (estrogen and/or progesterone). Diabetes mellitus removes the normal premenopausal gender-related differences in the prevalence of CVD by mechanisms that are not clearly defined, including metabolic and hemodynamic factors associated with diabetes. Dyslipidemia in diabetes mellitus consists of low high density lipoprotein cholesterol, elevated triglyceride levels, and a small, dense, more atherogenic low density lipoprotein particle (i.e. oxidized). Dyslipidemia interacts with associated hemodynamic (i.e. hypertension) and metabolic abnormalities (i.e. increased platelet aggregation and plasminogen activator inhibitor-1 levels) to promote CVD risks in diabetic women. Recent controlled trials underscore the critical importance of aggressively treating CVD risk factors, especially dyslipidemia, in women with diabetes.
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- 1999
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27. Bisoprolol and captopril effects on insulin receptor tyrosine kinase activity in essential hypertension.
- Author
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Dominguez LJ, Barbagallo M, Jacober SJ, Jacobs DB, and Sowers JR
- Subjects
- Aged, Double-Blind Method, Humans, Hypertension enzymology, Insulin Resistance, Middle Aged, Receptor, Insulin metabolism, Adrenergic beta-Antagonists pharmacology, Angiotensin-Converting Enzyme Inhibitors pharmacology, Bisoprolol pharmacology, Captopril pharmacology, Hypertension drug therapy, Receptor, Insulin drug effects
- Abstract
Angiotension converting enzyme (ACE) inhibitors and beta-blockers have been reported to possess disparate effects on insulin sensitivity. The aim of this study was to study the effects of the selective beta-1 blocker bisoprolol and of the ACE inhibitor captopril on cellular insulin action in hypertensive individuals. After washout, 12 mild to moderate essential hypertensives were randomized in a double-blind manner to 5 mg bisoprolol daily or 25 mg captopril twice daily for 8 weeks. Erythrocyte insulin binding and insulin-stimulated tyrosine kinase (TK) activity were measured before and after therapy. Both agents decreased diastolic blood pressure significantly (bisoprolol 96.5+/-0.9 to 87.8+/-3.1 mm Hg; captopril 96.5+/-0.9 to 91.5+/-1.8 mm Hg; P < .05). Fasting plasma glucose, insulin, and insulin/glucose indices remained unchanged after both therapies, as did lipid profiles. Maximal insulin-stimulated TK activity, assessed by phosphorylation of the exogenous substrate poly-Glu80Tyr20, was significantly higher (P < .05) after bisoprolol treatment, but not after captopril treatment, when compared to placebo (bisoprolol 8.5+/-1.8; captopril 7.3+/-1.5; placebo: 6.4+/-1.3 pmol 32P-ATP/fmol bound insulin). However, captopril, but not bisoprolol, increased the sensitivity of the receptor TK activity, as measured by the half-maximal activity concentration (ED50). Specific insulin binding was not affected by these two agents. Thus, both captopril and bisoprolol may have favorable but different effects on TK activity and insulin action at the cellular level.
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- 1997
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28. The safety of injecting insulin through clothing.
- Author
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Fleming DR, Jacober SJ, Vandenberg MA, Fitzgerald JT, and Grunberger G
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- Adult, Cell Count, Cohort Studies, Cross-Over Studies, Diabetes Complications, Diabetes Mellitus blood, Female, Glycated Hemoglobin analysis, Humans, Injections, Subcutaneous methods, Leukocytes cytology, Male, Middle Aged, Prospective Studies, Self Administration, Single-Blind Method, Time Factors, Clothing, Diabetes Mellitus drug therapy, Hypoglycemic Agents administration & dosage, Insulin administration & dosage, Safety
- Abstract
Objective: Many of the "antiseptic" practices recommended by health care professionals for insulin injection have been successfully challenged as unnecessary. Since people with diabetes have long been observed to inject their insulin through their clothing, this study was undertaken to determine the safety and perceived benefits of administering insulin by this "rogue" technique., Research Design and Methods: Fifty people with insulin-treated diabetes were randomized into a 20-week single-blinded prospective crossover study comparing the conventional subcutaneous injection technique (with skin preparation) to an experimental injection technique through clothing. Skin assessment, glycated hemoglobin levels, and leukocyte count were determined before randomization, at 10 weeks (before crossover), and again at 20 weeks (at completion). The participants injected through a single layer of fabric, which ranged from nylon to denim. Problems, benefits, type of clothing, and other comments were recorded by the subjects in an injection log., Results: Forty-two (84%) subjects completed the study. The mean age was 41 years (range, 23-63 years), 50% were women, 86% were Caucasian, and 80% had type I diabetes. The mean duration of diabetes was 14 years (range, 1-33 years). Fifty-one percent had > 16 years of education. The demographic characteristics of the dropouts were similar to those who completed the study. Over the 20-week period approximately 13,720 injections were performed by participants. None of the subjects experienced erythema, induration, or abscess at injection sites. Neither the glycated hemoglobin levels nor the leukocyte counts differed between the conventional and experimental regimens. During the injection-through-clothing phase of the study, only minor problems, such as blood stains on clothing and bruising, were recorded in the logbooks. However, subjects reported that injection through clothing offered benefits such as convenience and saving time., Conclusions: It is safe and convenient to inject insulin through clothing.
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- 1997
- Full Text
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29. Differences in the impact of dietary restrictions on African Americans and Caucasians with NIDDM.
- Author
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Fitzgerald JT, Anderson RM, Funnell MM, Arnold MS, Davis WK, Aman LC, Jacober SJ, and Grunberger G
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Regression Analysis, Self Care, Social Support, Surveys and Questionnaires, Black or African American psychology, Diabetes Mellitus, Type 2 diet therapy, Diabetes Mellitus, Type 2 ethnology, Diet, Diabetic psychology, Patient Compliance, White People psychology
- Abstract
African-American and Caucasian patients with non-insulin-dependent diabetes mellitus were surveyed to determine differences in self-reported dietary adherence. The relationship between dietary adherence and other psychosocial factors also was explored. The Diabetes Care Profile, an instrument designed to assess psychosocial factors related to diabetes, was completed by 178 patients. Correlation and regression analyses were used to examine the relationship between dietary adherence and 15 other scales in this instrument. Regression analyses revealed that selected scales were better at predicting dietary adherence for African Americans than for Caucasians. Self-care adherence was the most significant predictor of dietary adherence for African Americans while support was the most significant predictor for Caucasians. These findings suggest that cultural and social functions of food and diet should be examined and incorporated in the development of appropriate meal plans and educational interventions.
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- 1997
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30. Hypertensive disorders of pregnancy in southwestern Navajo Indians.
- Author
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Levy MT, Jacober SJ, and Sowers JR
- Subjects
- Adolescent, Adult, Chronic Disease, Female, Humans, Hypertension etiology, Middle Aged, New Mexico epidemiology, Pilot Projects, Pre-Eclampsia etiology, Pregnancy, Pregnancy Complications, Cardiovascular etiology, Prevalence, Retrospective Studies, Risk Factors, United States, United States Indian Health Service, Hypertension ethnology, Indians, North American, Population Surveillance, Pre-Eclampsia ethnology, Pregnancy Complications, Cardiovascular ethnology
- Abstract
Background: The Navajos are the largest Native American tribe. They, like other Native Americans, appear to be in an "epidemiologic transition" and are accordingly experiencing increased rates of hypertension, diabetes, and obesity., Methods: A retrospective chart review of all pregnancies in 1991 at the Crownpoint Indian Health Service Facility in Crownpoint, NM, was conducted to determine the prevalence of hypertensive disorders of pregnancy in this Navajo population., Results: Seventy-five (12.6%) of 594 pregnancies were associated with a hypertensive disorder. There were 18 individuals who developed gestational hypertension and 10 individuals with chronic hypertension that persisted during pregnancy. There were 46 women (7.7%) who developed preeclampsia and one woman (0.3%) who developed eclampsia. Eight women (1.4%) with chronic hypertension developed superimposed preeclampsia during pregnancy. Thus, 12.3% of these pregnancies in Navajo women were associated with the development of, or worsening, hypertension, and there was a prevalence of preeclampsia of 9.1%., Conclusion: The Navajos exhibit a high prevalence of pregnancy-related hypertension and preeclampsia.
- Published
- 1994
31. Postpartum blood pressure and insulin sensitivity in African-American women with recent preeclampsia.
- Author
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Jacober SJ, Morris DA, and Sowers JR
- Subjects
- Adolescent, Adult, Body Mass Index, Female, Glucose Clamp Technique, Glucose Tolerance Test, Humans, Matched-Pair Analysis, Pregnancy, Black or African American, Black People, Blood Pressure, Insulin Resistance, Postpartum Period, Pre-Eclampsia ethnology, Pre-Eclampsia physiopathology
- Abstract
Pregnancy-induced hypertension and preeclampsia are relatively common in nulliparous, inner-city, African-American, pregnant women and contribute to considerable maternal, fetal, and neonatal morbidity and mortality in that population. Recently, insulin resistance has been related to the development of hypertension in young African-Americans and hyperinsulinemia and elevated insulin-to-glucose ratios, suggesting insulin resistance, have been demonstrated in women with preeclampsia. To investigate whether insulin resistance existed postpartum and, therefore, independently of the pregnant state, the hyperinsulinemic, euglycemic technique was used 3 to 6 months postpartum to assess insulin sensitivity in 10 young, black, primiparous, inner-city women with recent preeclampsia and seven age-, weight- and body-mass-index-matched black women with healthy pregnancies. The age, weight, body-mass index, waist-to-hip ratio, the duration since parturition, and fasting plasma glucose and insulin were similar in the preeclamptic and control groups. During the clamp procedure, the insulin levels and mean diastolic blood pressure and mean arterial pressure were also similar for both groups; however, the mean systolic blood pressure of the preeclamptic group (123 +/- 3 mm Hg) was higher than that of the control group (114 +/- 2 mm Hg) (P < .05). Insulin-stimulated glucose disposal was not different between the preeclamptic (5.6 +/- 0.3 mg/kg/min) and control groups (5.7 +/- 0.7 mg/kg/min). This suggests that the elevation in postpartum systolic blood pressure may reflect a persistent abnormality of blood pressure homeostasis which is not associated with insulin resistance.
- Published
- 1994
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32. Quality of life activities associated with adherence to insulin infusion pump therapy in the treatment of insulin dependent diabetes mellitus.
- Author
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Wolf FM, Jacober SJ, Wolf LL, Cornell RG, and Floyd JC Jr
- Subjects
- Activities of Daily Living, Adult, Aged, Attitude to Health, Diabetes Mellitus, Type 1 psychology, Female, Humans, Insulin Infusion Systems adverse effects, Male, Middle Aged, Patient Acceptance of Health Care, Patient Compliance, Retrospective Studies, Diabetes Mellitus, Type 1 drug therapy, Insulin Infusion Systems psychology, Quality of Life
- Abstract
The impact of continuous subcutaneous insulin infusion (CSII) pump therapy on patients' activities of daily living and the prevalence of acute complications were examined in order to characterize patients' experience while on CSII, and to ascertain whether any of these factors could be associated with continued use of CSII. Fifty-one of 55 patients (93%) identified as initiating CSII in our medical center patient population completed retrospective surveys; 37 individuals (73%) were still using pumps and 14 individuals (27%) had discontinued pump use. CSII appeared to affect the quality of daily activities only modestly, neither improving nor interfering with many activities to any great degree. Activities associated with greatest improvements were eating, working, traveling, sleeping, and exercising. Results of logit analyses adjusting for duration of pump therapy indicated that the prevalence of six different acute complications (skin infections at the needle site, mild insulin reactions, more severe insulin reactions requiring assistance, hypoglycemic coma, asymptomatic hypoglycemia, and ketoacidosis) was not statistically associated with patients' decisions to continue or to stop CSII. In contrast, significant differences (p less than 0.05) between the groups continuing and discontinuing CSII were found in 11 of 18 activities of daily living. In general, patients continuing CSII, in contrast to those discontinuing CSII, found that many of their activities were improved significantly during pump therapy. There were few differences between groups in the degree to which CSII was perceived to interfere with daily activities. However, those continuing CSII found it significantly less necessary to take the pump off while doing some activities than did those discontinuing CSII.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1989
- Full Text
- View/download PDF
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