G H Murata

..To describe the clinical, psychological and social factors affecting diabetes knowledge of veterans with established Type 2 diabetes...

..Patient education and medication changes are potential ways of reducing the hypoglycemia rate. However, it remains to be proven that patient education is beneficial in this regard...

..To validate food frequency analysis as a predictor of metabolic status in persons with type 2 diabetes and to identify psychosocial factors affecting dietary adherence...

..To identify clinical factors that affect hypoglycemia perception in type 2 diabetes...

..To develop and validate a method for estimating hypoglycemia risk in stable, insulin-treated subjects with type 2 diabetes mellitus...

..Describe the methodologies and study population of the Diabetes Outcomes in Veterans Study (DOVES)...

..No evidence was found to indicate that body size influences the D/P ratio of small solutes. The portion of the variance in normalized clearance explained by size varies by size indicator and solute (urea versus creatinine)...

..To evaluate once- and twice-daily self-monitored blood glucose testing strategies in assessing glycemic control and detecting hypoglycemia or hyperglycemia in patients with stable insulin-treated type 2 diabetes...

..SMBG provided a strong stimulus for improved self-care resulting in clinically important and sustained reductions in HbA(1c)...

..Therefore, the dose of CAPD required for adequate total clearances may differ between diabetic and non-diabetic subjects...

..We identified factors that account for differences between lean body mass computed from creatinine kinetics (LBM(cr)) and from either body water (LBM(V)) or body mass index (LBM(BMI)) in patients on continuous peritoneal dialysis (CPD)...

..Medication increases were rarely identified as causing hypoglycemic episodes. Efforts to achieve tight glycemic control should recognize that patient behaviors commonly cause hypoglycemia...

..The Cockroft-Gault formula systematically overestimates the effect of age on creatinine excretion in PD patients and is not suitable for predicting creatinine excretion in these subjects...

..We suggest that the finding of LBM/W > or = 0.9 during a clearance study in CAPD should trigger an investigation for non-compliance...

..Further research is needed to identify the height/weight index that has the strongest association both with clinical outcomes and with other, more precise measurements of body fat content...

..CONCLUSIONS: Glycemic control can be efficiently assessed by reviewing at least 5 weeks' worth of monitoring results, focusing on alternate weeks and giving less weight to more remote readings...

..To test whether better nutrition is associated more with adequate urea clearance than with inadequate urea clearance in obese patients on continuous peritoneal dialysis (CPD)...

..Reducing sugar consumption and improving medication compliance might offset the greater glucose fluctuation observed in lean patients with longstanding diabetes...

..This lack of precision, added to the known lack of accuracy of the estimates, confounds the interpretation of the clinical relevance of urea kinetic estimates in PD...

..We examined the association between race/ethnicity and cardiovascular disease risk factor control in a large cohort of insulin-treated veterans with type 2 diabetes...

..Anuric patients on CAPD with 4 daily exchanges require a Dv/V value of 0.304 L/L or better to have a > or = 0.9 probability of achieving a weekly Kpt/Vurea of 1.70 or better...

..Emergency HD carries the risk of excessively rapid decline in tonicity; its benefits in the treatment of DH have not been established...

..Studies reporting the treatment of DH with only insulin therapy can be used to test these theoretical predictions and to analyze the relationship between solute and fluid abnormalities and clinical manifestations...

..Developing medical researchers with an ethical character and knowledge about ethics in medicine may be the most effective safeguard in protecting participants of medical research experiments...

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..In contrast to DKA or NKH, which usually presents with hypovolemia, DH causes hypervolemia manifested occasionally by pulmonary edema. Insulin is adequate treatment for DH...

..Formulation of biocompatible dialysate is a major ongoing research effort and may greatly enhance the success of CPD in the future...

..Current research offers the promise of definitive prevention of both type 2 diabetes and diabetic nephropathy...

..Evaluation of body composition by the anthropometric formulas rests on two assumptions: (1) fat contains no water, and (2) the water content of the fat-free mass is constant (72%)...

..Anthropometric estimates may cause large systematic errors in PD patients whose body composition varies from the average, particularly obese or overhydrated patients...

..The purpose of the present study was to develop and test a population-specific formula predicting average creatinine excretion in CPD...

..The role of inadequate clearances in the development of weight deficit in CAPD populations is difficult to assess. It seems, however, that adequate Kt/V urea may be necessary for weight gain in underweight CAPD patients...

..Classification of weight status by BMI or BF/W in quintiles or quartiles improves substantially the agreement between the two classifications and should be preferred...

..In obese subjects, normalization by W creates inappropriately low values for nutrition indices derived from urea nitrogen and creatinine excretion. Normalization of those indices by DW appears preferable...

..In patients changing dialysis modalities, rate and duration of hospitalizations did not vary between HD and PD. The causes of hospitalization were similar in the HD and PD periods regardless of which modality was applied first...

..The value of self-monitoring blood glucose (SMBG) in type 2 diabetes is controversial...

..Our findings indicate that DW is the proper size indicator for normalizing PNA in PD patients...

..These discrepancies may cause confusion when 2 or more indices are used simultaneously to classify the degree of obesity...

..Some evidence exists that in the long-term (> 10 years), obesity is a risk factor for death in both HD and PD. Further studies are needed to identify the short- and long-term risks and benefits of obesity in the two dialysis modalities...

..CONCLUSIONS: Nutrition indices are worse in older than in younger CAPD patients with the same small solute clearances. Nutrition of CAPD patients is adversely affected by age and requires special attention in the older age group...

..Determine whether colorectal cancer screening adherence is greater with fecal immunochemical tests (FIT) or guaiac-based fecal occult blood tests (gFOBT)...

..To explore the hypothesis that CD36, a scavenger receptor and fatty acid translocase, is upregulated in peripheral blood mononuclear cells (PBMCs) among patients with type 2 diabetes and is a biomarker of PBMC activation and inflammation...

..To identify the extent of underdialysis, chronic inflammation and malnutrition and their interrelationships in Nigerian hemodialysis patients...

..The use of androgen deprivation therapy (ADT) for prostate cancer has increased substantially in recent years, exposing more men to potential treatment complications, including osteoporosis and fractures...

..Convergent validity was also supported for DCP scales within the Hispanic patients as evidenced by correlations in expected directions with external measures...