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  1. Article ; Online: Practical strategies to normalize hyperglycemia without undue hypoglycemia in type 2 diabetes mellitus.

    Kodl, Christopher T / Seaquist, Elizabeth R

    Current diabetes reports

    2008  Volume 8, Issue 5, Page(s) 375–382

    Abstract: Hypoglycemia is a common problem in pharmacologically treated patients with type 2 diabetes mellitus and can be a major barrier to achieving optimal glycemic control. For practitioners to minimize and treat hypoglycemia, it is important to understand the ...

    Abstract Hypoglycemia is a common problem in pharmacologically treated patients with type 2 diabetes mellitus and can be a major barrier to achieving optimal glycemic control. For practitioners to minimize and treat hypoglycemia, it is important to understand the physiology, risk factors, and medications associated with hypoglycemia. Through education, lifestyle modifications, medication adjustments, and possibly re-examining glycemic goals, practitioners can reduce the incidence of hypoglycemia while still decreasing the risk of microvascular complications associated with hyperglycemia.
    MeSH term(s) Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Humans ; Hypoglycemia/blood ; Hypoglycemia/etiology ; Hypoglycemia/prevention & control ; Hypoglycemic Agents/therapeutic use ; Risk Assessment ; Risk Factors
    Chemical Substances Hypoglycemic Agents
    Language English
    Publishing date 2008-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2065167-3
    ISSN 1539-0829 ; 1534-4827
    ISSN (online) 1539-0829
    ISSN 1534-4827
    DOI 10.1007/s11892-008-0065-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5628: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Cognitive dysfunction and diabetes mellitus.

    Kodl, Christopher T / Seaquist, Elizabeth R

    Endocrine reviews

    2008  Volume 29, Issue 4, Page(s) 494–511

    Abstract: The deleterious effects of diabetes mellitus on the retinal, renal, cardiovascular, and peripheral nervous systems are widely acknowledged. Less attention has been given to the effect of diabetes on cognitive function. Both type 1 and type 2 diabetes ... ...

    Abstract The deleterious effects of diabetes mellitus on the retinal, renal, cardiovascular, and peripheral nervous systems are widely acknowledged. Less attention has been given to the effect of diabetes on cognitive function. Both type 1 and type 2 diabetes mellitus have been associated with reduced performance on numerous domains of cognitive function. The exact pathophysiology of cognitive dysfunction in diabetes is not completely understood, but it is likely that hyperglycemia, vascular disease, hypoglycemia, and insulin resistance play significant roles. Modalities to study the effect of diabetes on the brain have evolved over the years, including neurocognitive testing, evoked response potentials, and magnetic resonance imaging. Although much insightful research has examined cognitive dysfunction in patients with diabetes, more needs to be understood about the mechanisms and natural history of this complication in order to develop strategies for prevention and treatment.
    MeSH term(s) Animals ; Cognition/physiology ; Cognition Disorders/diagnosis ; Cognition Disorders/epidemiology ; Cognition Disorders/etiology ; Diabetes Complications/diagnosis ; Diabetes Complications/epidemiology ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/physiopathology ; Humans ; Models, Biological
    Language English
    Publishing date 2008-04-24
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 603096-8
    ISSN 1945-7189 ; 0163-769X
    ISSN (online) 1945-7189
    ISSN 0163-769X
    DOI 10.1210/er.2007-0034
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1562: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: High connectivity between reduced cortical thickness and disrupted white matter tracts in long-standing type 1 diabetes.

    Franc, Daniel T / Kodl, Christopher T / Mueller, Bryon A / Muetzel, Ryan L / Lim, Kelvin O / Seaquist, Elizabeth R

    Diabetes

    2010  Volume 60, Issue 1, Page(s) 315–319

    Abstract: Objective: Previous studies have observed disruptions in brain white and gray matter structure in individuals with type 1 diabetes, and these structural differences have been associated with neurocognitive testing deficiencies. This study investigated ... ...

    Abstract Objective: Previous studies have observed disruptions in brain white and gray matter structure in individuals with type 1 diabetes, and these structural differences have been associated with neurocognitive testing deficiencies. This study investigated the relationship between cerebral cortical thickness reductions and white matter microstructural integrity loss in a group of patients with type 1 diabetes and in healthy control subjects using diffusion tensor imaging (DTI).
    Research design and methods: Twenty-five subjects with type 1 diabetes for at least 15 years and 25 age- and sex-matched control subjects underwent structural T1 and proton-density and DTI on a 3.0 Tesla scanner. Fractional anisotropy measurements were made on major cerebral white matter tracts, and DTI tractography was performed to identify cortical regions with high connectivity to these tracts.
    Results: Posterior white matter tracts with reduced fractional anisotropy (optic radiations, posterior corona radiata, and the splenium region of the corpus callosum) were found to have high connectivity with a number of posterior cortical regions, including the cuneus, precuneus, fusiform, and posterior parietal cortical regions. A significant reduction in cortical thickness in the diabetic group was observed in the regions with high connectivity to the optic radiations and posterior corona radiata tracts (P < 0.05).
    Conclusions: The direct relationship between white and gray matter structural pathology has not been previously demonstrated in subjects with long-standing type 1 diabetes. The relationship between posterior white matter microstructural integrity disruption and lower cortical thickness demonstrated using a novel DTI connectivity technique suggests a common or interrelated pathophysiological mechanism in type 1 diabetes.
    MeSH term(s) Adult ; Cerebral Cortex/anatomy & histology ; Cerebral Cortex/pathology ; Cognition Disorders/etiology ; Cognition Disorders/pathology ; Corpus Callosum/anatomy & histology ; Corpus Callosum/pathology ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/pathology ; Diabetes Mellitus, Type 1/psychology ; Diffusion Tensor Imaging/methods ; Female ; Humans ; Male ; Middle Aged ; Nerve Fibers/pathology
    Language English
    Publishing date 2010-10-27
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80085-5
    ISSN 1939-327X ; 0012-1797
    ISSN (online) 1939-327X
    ISSN 0012-1797
    DOI 10.2337/db10-0598
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uh III Zs.175: Show issues Location:
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  4. Article ; Online: Human brain glycogen metabolism during and after hypoglycemia.

    Oz, Gülin / Kumar, Anjali / Rao, Jyothi P / Kodl, Christopher T / Chow, Lisa / Eberly, Lynn E / Seaquist, Elizabeth R

    Diabetes

    2009  Volume 58, Issue 9, Page(s) 1978–1985

    Abstract: Objective: We tested the hypotheses that human brain glycogen is mobilized during hypoglycemia and its content increases above normal levels ("supercompensates") after hypoglycemia.: Research design and methods: We utilized in vivo (13)C nuclear ... ...

    Abstract Objective: We tested the hypotheses that human brain glycogen is mobilized during hypoglycemia and its content increases above normal levels ("supercompensates") after hypoglycemia.
    Research design and methods: We utilized in vivo (13)C nuclear magnetic resonance spectroscopy in conjunction with intravenous infusions of [(13)C]glucose in healthy volunteers to measure brain glycogen metabolism during and after euglycemic and hypoglycemic clamps.
    Results: After an overnight intravenous infusion of 99% enriched [1-(13)C]glucose to prelabel glycogen, the rate of label wash-out from [1-(13)C]glycogen was higher (0.12 +/- 0.05 vs. 0.03 +/- 0.06 micromol x g(-1) x h(-1), means +/- SD, P < 0.02, n = 5) during a 2-h hyperinsulinemic-hypoglycemic clamp (glucose concentration 57.2 +/- 9.7 mg/dl) than during a hyperinsulinemic-euglycemic clamp (95.3 +/- 3.3 mg/dl), indicating mobilization of glucose units from glycogen during moderate hypoglycemia. Five additional healthy volunteers received intravenous 25-50% enriched [1-(13)C]glucose over 22-54 h after undergoing hyperinsulinemic-euglycemic (glucose concentration 92.4 +/- 2.3 mg/dl) and hyperinsulinemic-hypoglycemic (52.9 +/- 4.8 mg/dl) clamps separated by at least 1 month. Levels of newly synthesized glycogen measured from 4 to 80 h were higher after hypoglycemia than after euglycemia (P <or= 0.01 for each subject), indicating increased brain glycogen synthesis after moderate hypoglycemia.<br />Conclusions: These data indicate that brain glycogen supports energy metabolism when glucose supply from the blood is inadequate and that its levels rebound to levels higher than normal after a single episode of moderate hypoglycemia in humans.
    MeSH term(s) Adaptation, Physiological/physiology ; Adult ; Blood Glucose/metabolism ; Brain/metabolism ; Carbon Isotopes ; Energy Metabolism/physiology ; Female ; Glucose/administration & dosage ; Glucose Clamp Technique ; Glycogen/biosynthesis ; Glycogen/metabolism ; Humans ; Hyperinsulinism/metabolism ; Hypoglycemia/metabolism ; Infusions, Intravenous ; Magnetic Resonance Spectroscopy ; Male ; Models, Biological ; Young Adult
    Chemical Substances Blood Glucose ; Carbon Isotopes ; Glycogen (9005-79-2) ; Glucose (IY9XDZ35W2)
    Language English
    Publishing date 2009-06-05
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80085-5
    ISSN 1939-327X ; 0012-1797
    ISSN (online) 1939-327X
    ISSN 0012-1797
    DOI 10.2337/db09-0226
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uh III Zs.175: Show issues Location:
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  5. Article ; Online: Diffusion tensor imaging identifies deficits in white matter microstructure in subjects with type 1 diabetes that correlate with reduced neurocognitive function.

    Kodl, Christopher T / Franc, Daniel T / Rao, Jyothi P / Anderson, Fiona S / Thomas, William / Mueller, Bryon A / Lim, Kelvin O / Seaquist, Elizabeth R

    Diabetes

    2008  Volume 57, Issue 11, Page(s) 3083–3089

    Abstract: Objective: Long-standing type 1 diabetes is associated with deficits on neurocognitive testing that suggest central white matter dysfunction. This study investigated whether diffusion tensor imaging (DTI), a type of magnetic resonance imaging that ... ...

    Abstract Objective: Long-standing type 1 diabetes is associated with deficits on neurocognitive testing that suggest central white matter dysfunction. This study investigated whether diffusion tensor imaging (DTI), a type of magnetic resonance imaging that measures white matter integrity quantitatively, could identify white matter microstructural deficits in patients with long-standing type 1 diabetes and whether these differences would be associated with deficits found by neurocognitive tests.
    Research design and methods: Twenty-five subjects with type 1 diabetes for at least 15 years and 25 age- and sex-matched control subjects completed DTI on a 3.0 Tesla scanner and a battery of neurocognitive tests. Fractional anisotropy was calculated for the major white matter tracts of the brain.
    Results: Diabetic subjects had significantly lower mean fractional anisotropy than control subjects in the posterior corona radiata and the optic radiation (P < 0.002). In type 1 diabetic subjects, reduced fractional anisotropy correlated with poorer performance on the copy portion of the Rey-Osterreith Complex Figure Drawing Test and the Grooved Peg Board Test, both of which are believed to assess white matter function. Reduced fractional anisotropy also correlated with duration of diabetes and increased A1C. A history of severe hypoglycemia did not correlate with fractional anisotropy.
    Conclusions: DTI can detect white matter microstructural deficits in subjects with long-standing type 1 diabetes. These deficits correlate with poorer performance on selected neurocognitive tests of white matter function.
    MeSH term(s) Adult ; Age Factors ; Anisotropy ; Brain/pathology ; Brain/physiopathology ; Cognition/physiology ; Diabetes Mellitus, Type 1/pathology ; Diabetes Mellitus, Type 1/physiopathology ; Diabetes Mellitus, Type 1/psychology ; Diffusion Magnetic Resonance Imaging/methods ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests
    Language English
    Publishing date 2008-08-11
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80085-5
    ISSN 1939-327X ; 0012-1797
    ISSN (online) 1939-327X
    ISSN 0012-1797
    DOI 10.2337/db08-0724
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uh III Zs.175: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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