Trevor J Orchard

..The objective of this study was to determine at which levels of LDL and HDL cholesterol, triglycerides, and blood pressure the relative risks of type 1 diabetic complications increase significantly...

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..The pathogenesis of diabetic nephropathy remains unclear, although previous reports implicate a wide range of putative genetic and metabolic factors...

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..Little is known concerning the primary cause(s) of mortality in type 1 diabetes responsible for the excess mortality seen in this population...

..CONCLUSION: Besides AER, the immunecomplexes and lipoprotein subclasses may provide additional information in the assessment of ON risk in type 1 diabetes...

..8 g/dl. We thus explored whether hemoglobin concentrations are generally higher in type 1 diabetes...

..Kidney disease in patients with type 1 diabetes historically has been believed to be more prevalent in men. Because recent data do not reflect this pattern, we evaluated whether a sex difference persists...

..To investigate the role of hemoglobin (HGB) level in predicting proliferative diabetic retinopathy (PDR)...

..05). Tree-structured survival analysis may help identify genetic predispositions among individuals who, despite low risk, develop diabetes-related complications...

..Although some type 1 diabetes complications (mortality, renal failure, and neuropathy) are declining, others (CAD, overt nephropathy, and proliferative retinopathy) show less favorable changes by 30 years...

..Thus, weight control, in addition to lipid and renal management, may help retard atherosclerosis progression in persons with type 1 DM...

..40, p=0.05), but not 2/2 (HR=0.66, p=0.27), genotype. The association between Lp-PLA(2) activity and CAD differs by CRP and haptoglobin genotype in this group of persons with type 1 diabetes and macroalbuminuria...

..A universal framework for translation of multiple aspects of the DPP intervention, including training, support, and evaluation is needed to enhance treatment fidelity in a variety of settings...

..Although management of type 1 diabetes improved dramatically in the 1980s, the effect on mortality is not clear...

..To determine the independent risk factors for coronary artery disease (CAD) in type 1 diabetes by type of CAD at first presentation...

..To understand the effect of socioeconomic status (SES) on the risk of complications in type 1 diabetes (T1D), we explored the relationship between SES and major diabetes complications in a prospective, observational T1D cohort study...

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..To determine which patient factors contribute to improvements in the ABCs of diabetes following a multi-faceted diabetes care intervention...

..13, 95% Cl=1.03-1.24; HRs are per standard deviation increase) but not hard CAD. Study results suggest that E-selectin may enhance CAD prediction beyond traditional risk factors or markers of oxidative stress in Type 1 diabetes...

..This association persists after adjustment for potential confounders as well as for baseline HbA(1), HDL cholesterol, and smoking history, which were also associated with these PWA measures...

..Pulse wave analysis (PWA) arterial stiffness indices have been associated with cardiovascular disease (CVD) risk factors and outcomes in various populations, but little is known regarding these relationships in T1D...

..This double-edged association emphasises the complex relationship between adiposity and cardiovascular risk in diabetes...

..We investigated the association between the haptoglobin genotype and the incidence of coronary artery disease (CAD) in a cohort of individuals with childhood-onset type 1 diabetes...

..Our data indicate that efforts to rectify this should focus on men and those who do not monitor blood glucose, and should involve primary care practitioners...

..We determined the sequence of kidney disease stages (microalbuminuria, macroalbuminuria, low estimated glomerular filtration rate [eGFR], and end-stage renal disease [ESRD]) and characterized those without albuminuria before a low eGFR...

..CONCLUSIONS: High alpha-tocopherol levels among patients with renal disease and in those using vitamin supplements were associated with lower CAD risk in type 1 diabetes. The specificity of these effects merits further investigation...

..This finding might help explain the loss of the sex difference in CVD in T1D...

..We assessed the cost-effectiveness of a community-based, modified Diabetes Prevention Program (DPP) designed to reduce risk factors for type 2 diabetes and cardiovascular disease...

..Results suggest that GLB-DVD with remote support may provide an effective alternative for GLB delivery...

..Little information is available regarding the long-term incidence of end-stage renal disease (ESRD) and survival after the introduction of renal replacement therapy (RRT) in patients with type 1 diabetes...

..Thus, factors related to the calcification process in addition to vascular risk factors may play a role in determining the extent of CAC...

..Most registries are built based on membership with an insurer or other selection criteria. Little, if any data exist on registries representing demographically heterogeneous populations...

..005), non-HDLc (p=0.0005), WHR (p=0.003), and estimated glucose disposal rate (p=0.002) were associated. Risk factors not considered by the Framingham risk equation may account for the lack of fit and should be examined further...

..To examine the relationship between retinal vessel diameter and coronary artery disease (CAD) incidence in type 1 diabetes (T1D) using data from the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study...

..To create a coronary heart disease (CHD) risk prediction model specific to type 1 diabetes...

..Socioeconomic status (SES) as a risk factor for mortality in type 1 diabetes (T1D) has not been adequately studied prospectively...

..However, studies in humans have reported inverse as well as positive associations between adiponectin concentrations and disease states. This Commentary discusses the apparent conflict in the literature...

..To determine the extent to which patients' awareness, treatment, and control of hypertension and hypercholesterolemia have changed over time and to examine factors associated with awareness and treatment in a type 1 diabetes population...

..In conclusion, health system performance, social distribution of wealth and purchasing power may play important roles in explaining the geographic variation of diabetes complications...

..5 microg/mL provided the optimal cutoff to distinguish those with or without MS. Thus, a lower postpartum adiponectin concentration identifies women at increased cardiovascular risk regardless of pregnancy history...

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..Future research should focus on determining the risk factors accounting for the lack of fit and developing prediction models specific to this high-risk group...

..Evidence suggests that the degree of gluteal-femoral adiposity may be inversely associated with coronary artery disease (CAD) risk; however, this association has not been evaluated in type 1 diabetes (T1D)...

..26, 0.08-0.79). CCB use with or without ACE-I was not related to mortality status. CONCLUSIONS: This data suggests that ACE-I use is not optimal, but more favorably associated with decreased mortality than CCB use...

..This study thus supports the concept that the benefits of specialist care should be available to all patients with type 1 diabetes...

..Geographic variation was seen and was not fully accounted for by demographic or treatment characteristics (all P values < .05)...

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..03). These risk factors merit careful evaluation and management to prevent stroke in T1DM, which occurs at least 20 years earlier than in the general population...

..To what degree this is true in type 1 diabetes is unknown, although cardiovascular risk is increased despite elevated mean HDL-C...

..This article also briefly discusses recent data on general cardiovascular risk factors and provides updated comments concerning the association of coronary artery disease with other diabetes complications, especially renal disease...

..To determine whether middle-aged premenopausal women with type 1 diabetes had more self-reported fractures and lower bone mineral density (BMD) compared with nondiabetic women...

..To determine whether using the chronic care model (CCM) in an underserved community leads to improved clinical and behavioral outcomes for people with diabetes...

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..In conclusion, treatment with simvastatin may have a beneficial effect on early nephropathy and diabetic neuropathy, justifying a fully powered trial. However, this would be difficult under current treatment guidelines...

..Because the etiologies of type 1 and type 2 diabetes are different, it is possible that some CAD in type 1 diabetes may be related to the coexistence of type 2 diabetes susceptibility (i.e., insulin resistance)...

..We examined the effects of antilipemic agents on glomerular filtration rate and proteinuria or albuminuria in patients with renal disease...

..To determine whether diabetes care characteristics and glycemic control differ by use of specialist care in a representative cohort of patients with type 1 diabetes...

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..g., PCOS) to the burden of type 2 diabetes in the total population of middle-aged women...

..Because of the multiracial population living in Hawaii, it is an ideal state in which to study the effect of migration on IDDM incidence...

..We assessed the prospective association between adiponectin concentration and coronary artery disease in individuals with type 1 diabetes...

..CONCLUSIONS: Estimated GDR and ECG ischemia are strong predictors of mortality in type 1 diabetes and may be useful in the identification of those at risk...

..This study's objective was to determine if the association between physical activity and lipids and lipoprotein subclasses in postmenopausal women varies by hormone therapy (HT) use...

..This improvement is consistent with the introduction of HbA1 testing, home blood glucose monitoring, and improved blood pressure therapy in the 1980s...

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..CONCLUSIONS: These results show that the excess mortality in Black people was attributed to acute complications which therefore should be a focus for prevention...

..We thus sought to confirm these observations and, given sex differences in other type 1 diabetes complications and risk factors, assessed whether any such associations differ by sex...

..However, this level of DiaComp, with more complete assessment of risk factors and health care practice, was still not able to completely explain the variation in complication prevalence, except for microalbuminuria...

..The study's findings confirm that the telephone is a useful tool to deliver adherence-enhancing interventions...

..In women, the model with eGDR showed a significantly better fit. Glycemia, insulin resistance, hypertension and renal disease are powerful predictors of symptomatic lower extremity arterial disease in type 1 diabetes...

..CONCLUSIONS: These results suggest little association between PAI-1 and later CAD in patients with T1D. However, tPA-PAI-1 complexes may be involved in the pathogenesis of overt nephropathy...

..As intensified insulin therapy (IIT) may promote weight gain, the impact of weight gain in T1D is of importance. We therefore assessed the association of adiposity with mortality in 655 EDC participants during 20 years of follow-up...

..However, the healthcare practice variables that were measured contributed little toward explaining this variation...

..Despite familial clustering of nephropathy and retinopathy severity in type 1 diabetes, few gene variants have been consistently associated with these outcomes...

..Prior intensive diabetes treatment during the DCCT was associated with less atherosclerosis, largely because of reduced levels of A1C during the DCCT...

..Future research should clarify causal pathways between depressive symptomatology, behavioral and physiological processes, and CHD...

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..CONCLUSIONS: These data suggest a strong link between NDP and proteinuria which is independent of CAN and may be modified by LDLc and hypertension...

..Both lifestyle intervention and metformin therapy reduced the development of the syndrome in the remaining participants...

..We studied whether the use of intensive therapy as compared with conventional therapy during the Diabetes Control and Complications Trial (DCCT) affected the long-term incidence of cardiovascular disease...

..These observational findings should be confirmed through larger prospective studies, given their implications for insulin therapy...

..The aim of this study was to examine cross-cultural differences in prevalence and correlates of symptoms of anxiety and depression in two studies, one in the United Kingdom and one in the United States...

..Concern about the potential risks associated with hormone replacement therapy (HRT) has left post-menopausal women and healthcare providers searching for safe and effective means for cardiovascular disease (CVD) risk factor reduction...

..We examined whether an intensive lifestyle intervention or metformin therapy among overweight pre-diabetic women was associated with a lower prevalence of incontinence...

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..001, respectively). Findings from the current report support the utility of the LDCW to identify women at higher risk for CVD who may be candidates for further cardiovascular testing or intensive lifestyle intervention...

..The investigators state that this study will continue to advance our knowledge of the pathogenesis and prediction of complications of diabetes and lead to appropriate preventive strategies. ..

..women, and in older subjects in the DPP. The current application is for 5 years of funding, although the some of the goals of the projects described will require a 10-year study. ..

..This study will continue to advance our knowledge of diabetes complications and lead to appropriate preventive strategies. ..

..This study will help advance our knowledge of CAD in T1D and hopefully lead to appropriate preventative strategies. ..

..In this way, we will identify the risk factors responsible for complications prospectively and be able to examine the interrelationships of IDDM complications. This should lead to the development of appropriate preventive strategies...

..This study will continue to advance our knowledge of diabetes complications and lead to appropriate preventive strategies. ..