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  • 1
    Online Resource
    Online Resource
    A Sero-Epidemiologic Study of Nondiabetic First-Degree Relatives of IDDM Cases
    American Diabetes Association ; 1985
    In:  Diabetes Care Vol. 8, No. 6 ( 1985-11-01), p. 627-628
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 8, No. 6 ( 1985-11-01), p. 627-628
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.8.6.627
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1985
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  • 2
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    Employment Spectrum of IDDM
    American Diabetes Association ; 1989
    In:  Diabetes Care Vol. 12, No. 9 ( 1989-10-01), p. 615-622
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 12, No. 9 ( 1989-10-01), p. 615-622
    Abstract: Occupational issues in 158 insulin-dependent diabetes mellitus (IDDM) individuals and 158 matched nondiabetic siblings were examined in a case-control design to evaluate the role of diabetes in the employability of people with IDDM. Overall, the IDDM cases were more likely to report refusal for a job at some point in their lives (56 vs. 42%, P = .02) than were the nondiabetic control siblings. Surprisingly, individuals who told job interviewers about their diabetes were more likely to report job refusal than their siblings (64 vs. 42%, P = .005), whereas individuals who did not mention their diabetes reported rates of refusal similar to their siblings (44 vs. 41%). IDDM cases were also less likely to be employed full time compared with siblings (55 vs. 73%, P = .001). Reduced employment in IDDM respondents was related to work disability. Reported work disability was more than seven times greater in the IDDM than the sibling group. The presence of diabetic complications was the primary factor related to work disability. Although 13% of IDDM respondents were unable to work because of disability, absenteeism among IDDM cases currently working did not differ from that of the nondiabetic siblings. Diabetes was not significantly associated with career levels or household income levels reported by the IDDM group. Disability, however, had a strong detrimental influence on these variables. The results suggest that hiring practices by employers may still be discriminatory toward individuals with IDDM. Once hired, the employment experiences of the IDDM population appear to be similar to the experiences of the nondiabetic population, provided thedevelopment of disabling diabetic complications has not taken place.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.12.9.615
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1989
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  • 3
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    Online Resource
    Motor Vehicle Accidents and IDDM
    American Diabetes Association ; 1988
    In:  Diabetes Care Vol. 11, No. 9 ( 1988-10-01), p. 701-707
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 11, No. 9 ( 1988-10-01), p. 701-707
    Abstract: A case-control study examining the 1-yr motor vehicle accident experiences of 158 insulin-dependent diabetes mellitus (IDDM) cases and 158 nondiabetic siblings was undertaken to evaluate the risk of motor vehicle accidents among drivers with IDDM. In multivariate analyses the overall accident risk of the cases and control subjects did not differ significantly. Female diabetic drivers, however, showed a marked increased risk for motor vehicle accidents. The accident risk among female cases was five times higher than among the female control subjects (P & lt; .05). Age and marital status were also significantly associated with accident probability in the multivariate model. The results suggest that IDDM could have an effect on the accident rate of diabetic drivers, particularly women. However, the traditional risk factors for automobile accidents, i.e., age and marital status, appear to have an equally strong influence on accident occurrence. Further studies are needed to 1) document the role of IDDM in accidents among representative samples of the IDDM population and 2) properly evaluate the licensing restrictions recommended for diabetic drivers.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.11.9.701
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1988
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  • 4
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    Online Resource
    The Pittsburgh Insulin-dependent Diabetes Mellitus (IDDM) Morbidity and Mortality Study: Case-Control Analyses of Risk Factors for Mortality
    American Diabetes Association ; 1985
    In:  Diabetes Care Vol. 8, No. Supplement_1 ( 1985-09-01), p. 54-60
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 8, No. Supplement_1 ( 1985-09-01), p. 54-60
    Abstract: Although children with IDDM are at a sevenfold increased risk of dying when compared with nondiabetic individuals of the same age, the factors associated with the excess in mortality remain unclear. To investigate potential determinants of mortality among IDDM patients, a case-control study was conducted. These retrospectively obtained data indicated that shorter relative height at onset, frequent diabetes-related readmissions, the presence of diabetes complications, a family history of diabetes, premature familial mortality, no participation in school team sports, and a lower level of education were related to subsequent mortality among males. Among females, however, a shorter duration of diabetes clinic attendance and the presence of diabetes complications were the only significant associations to mortality.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.8.1.S54
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1985
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  • 5
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    Online Resource
    Health, Life, and Automobile Insurance Characteristics in Adults With IDDM
    American Diabetes Association ; 1991
    In:  Diabetes Care Vol. 14, No. 4 ( 1991-04-01), p. 318-324
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 14, No. 4 ( 1991-04-01), p. 318-324
    Abstract: To determine whether people with insulindependent diabetes mellitus (IDDM) were compromised in their access to insurance. Research Design and Methods A case-control study of 158 people with IDDM and 158 nondiabetic siblings matched for age and sex was conducted to evaluate the health, life, and automobile insurance characteristics and history of people with IDDM. Results Health insurance coverage (yes/no) among the IDDM and sibling control subjects was similar. More than 90% of the IDDM and control respondents had insurance through a private third-party source, and this insurance did not differ by type of plan, coverage, or premium. However, Medicare coverage was more common among the IDDM subjects and was associated with the presence of severe diabetic complications. IDDM subjects were also more likely to have been denied a health insurance policy by an insurer than were the control subjects (23 vs. 1%, P & lt; 0.001). Similarly, there was no difference between the IDDM and sibling control subjects in the number who had a life or automobile insurance policy. However, life and automobile insurance refusal was much more frequent among the IDDM respondents, more so for life (55 vs. 0%, P & lt; 0.001) than for automobile (12 vs. 4%, P & lt; 0.05) insurance. Conclusions These results suggest that access to insurance is severely compromised for people with IDDM. Although most of those with IDDM are able to find some form of insurance, it is evident that on average they must go to extra lengths to find it. These data and a changing insurance environmentemphasize the need to reexamine, as a society, the importance of insurance for people with chronic disease, particularly IDDM.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.14.4.318
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1991
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  • 6
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    The Cardiovascular Risk Profile of Adolescents with Insulin-dependent Diabetes Mellitus
    American Diabetes Association ; 1985
    In:  Diabetes Care Vol. 8, No. 2 ( 1985-03-01), p. 118-124
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 8, No. 2 ( 1985-03-01), p. 118-124
    Abstract: Cardiovascular risk factors including blood pressure, lipoprotein concentrations, physical activity, and diet were assessed in 149 diabetic adolescents and 45 nondiabetic siblings. All diabetic subjects had had insulin-dependent diabetes mellitus (IDDM) for a minimum of 2 yr and were currently attending the Children's Hospital of Pittsburgh Diabetes Clinic. For both boys and girls, cardiovascular risk profiles were mildly disturbed among diabetic subjects compared with nondiabetic siblings. These disturbances included higher systolic (P = 0.002) and diastolic (P = 0.024) blood pressures and higher HDL3 cholesterol concentrations. The diabetic girls showed higher total cholesterol concentrations during adolescence in contrast to the usual fall seen in nondiabetic adolescents (and evidenced in the siblings studied). In addition, the diabetic girls' mean pulse rate was 12 bpm higher than that of the sibling girls, a finding not seen in the boys. Multiple linear regression analyses showed that neither glycemic control (worse in diabetic girls), diet, nor physical activity were important explanatory variables for any of the lipoprotein or blood pressure measures. These results suggest that the cardiovascular risk profile of diabetic girls may be relatively more disturbed than that of diabetic boys. This difference could not be explained by the slightly higher glycosylated hemoglobin levels in the girls. The loss of the sex differential in the risk for cardiovascular disease experienced by adults with IDDM may partly relate to these adolescent risk factor differences.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.8.2.118
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1985
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  • 7
    Online Resource
    Online Resource
    Celiac Autoimmunity Is Associated With Lower Blood Pressure and Renal Risk in Type 1 Diabetes
    The Endocrine Society ; 2018
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 103, No. 10 ( 2018-10-01), p. 3828-3836
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 103, No. 10 ( 2018-10-01), p. 3828-3836
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/jc.2018-00908
    RVK:
    XA 10000
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2018
    detail.hit.zdb_id: 2026217-6
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  • 8
    Online Resource
    Online Resource
    Factors Associated With Avoidance of Severe Complications After 25 Yr of IDDM: Pittsburgh Epidemiology of Diabetes Complications Study I
    American Diabetes Association ; 1990
    In:  Diabetes Care Vol. 13, No. 7 ( 1990-07-01), p. 741-747
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 13, No. 7 ( 1990-07-01), p. 741-747
    Abstract: To identify characteristics associated with long-term avoidance of insulin-dependent diabetes mellitus (IDDM) complications, subjects taking part in an epidemiologic natural history study of childhood-onset IDDM, with a duration of disease ≥25 yr, were studied. Nineteen percent of 175 subjects had avoided overt nephropathy, definite cardiovascular and peripheral vascular disease, clinical neuropathy, and proliferative retinopathy. Approximately half of the nonrenal complications occurred in the absence of renal disease. Subjects free of these advanced complications were characterized by a longer duration of disease (P & lt; 0.05), better lipid profile and blood pressure (P & lt; 0.01), and considerably lower glycosylated hemoglobin levels (P & lt; 0.001). Health-related behaviors, including recent medical contact, regular glucose monitoring, physical activity in youth, and avoidance of cigarette smoking, did not relate to complication status, although regular (at least weekly) alcohol consumption was more prevalent (P & lt; 0.05) in those without complications. We conclude that a lower mean glycosylated hemoglobin level is strongly related to the avoidance of all IDDM complications.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.13.7.741
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1990
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  • 9
    Online Resource
    Online Resource
    Predictors of Microalbuminuria in Individuals with IDDM: Pittsburgh Epidemiology of Diabetes Complications Study
    American Diabetes Association ; 1993
    In:  Diabetes Care Vol. 16, No. 10 ( 1993-10-01), p. 1376-1383
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 16, No. 10 ( 1993-10-01), p. 1376-1383
    Abstract: To examine the relationships between microalbuminuria and the development of overt diabetic nephrology, elevated blood pressure, and a more atherogenic lipid profile; and to identify risk factors for the development of microalbuminuria in individuals with IDDM. Microalbuminuria has been associated with the subsequent development of overt diabetic nephropathy in individuals with IDDM. It is associated with elevated blood pressure and a more atherogenic lipid profile, but the temporal relationship between the development of microalbuminuria and the changes in these factors is unclear. RESEARCH DESIGN AND METHODS Baseline characteristics were examined in 256 individuals with IDDM who had normal albumin excretion (urinary AER ≤20 μg/min in ≥2 timed urine collections) and were re-examined 2 yr later. RESULTS At follow-up, 24 had developed microalbuminuria (AER 20–200 (Ag/min in ≥2 timed urine collections) and 1 had developed overt nephropathy (AER ≥200 μg/min). Overall, the significant independent predictors of microalbuminuria were HbA1 (P & lt; 0.001), low-density lipoprotein (P & lt; 0.01), duration of IDDM (P & lt; 0.05), and systolic blood pressure (P = 0.05). Sex-specific analyses showed HbA1 age, and baseline AER were particularly important for men; whereas, for women, the main predictors were duration of IDDM and triglycerides. Duration-specific analyses showed that HbA1 was an important predictor both for individuals with & lt; and & gt;20-yr duration. Low-density lipoprotein cholesterol was more important for subjects with shorter durations; whereas triglycerides were important for those with longer durations. CONCLUSIONS These results suggest that glycemic control, age or duration of IDDM, disturbed lipids, and possibly elevated blood pressure all may contribute to the development of microalbuminuria; and, further, that the adverse cardiovascular risk profile seen in individuals with overt nephropathy may begin to develop even before the detection of microalbuminuria.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.16.10.1376
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1993
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  • 10
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    Online Resource
    The Association Between a Family History of Type 2 Diabetes and Coronary Artery Disease in a Type 1 Diabetes Population
    American Diabetes Association ; 1998
    In:  Diabetes Care Vol. 21, No. 4 ( 1998-04-01), p. 610-614
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 21, No. 4 ( 1998-04-01), p. 610-614
    Abstract: To examine whether a potential marker for type 2 diabetes (family history) is related to CAD in type 1 diabetic subjects. The two major types of primary diabetes, type 1 and type 2, are both associated with an increased risk of developing coronary artery disease (CAD). However, the etiology and associated risk factors may differ by type of diabetes. In type 2 diabetes, CAD is likely to be linked with the insulin resistance associated with the type 2 “process,” while CAD in type 1 diabetes has, so far, been more closely linked to renal disease. 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). RESEARCH DESIGN AND METHODS We evaluated the interrelationships between family history of type 2 diabetes (age at onset & gt;30 years, no insulin for 1st year) and presence of CAD in a cohort of childhood-onset type 1 diabetic subjects using the Pittsburgh Epidemiology of Diabetes Complications study (n = 658). RESULTS A first-degree family history of type 2 diabetes was reported in 112 subjects, and CAD was present in 119 subjects. Those subjects reporting a family history of type 2 diabetes were significantly older, had a longer duration of type 1 diabetes, had higher triglyceride and LDL cholesterol levels, and had a borderline significantly increased Beck depression inventory. Sex differences in CAD risk factors were also noted. Using logistic regression analysis, the odds ratio (95% CI) for the presence of CAD in association with a family history of NIDDM was 1.89 (1.27–2.84). The odds ratio (95% CI) after adjusting for disease duration, triglycerides, hypertension, Beck depression, and nephropathy status was 1.45 (0.87–2.28). CONCLUSIONS We conclude that a family history of type 2 diabetes is a risk factor for CAD in type 1 diabetic subjects. This supports the concept that insulin resistance may contribute to development of CAD in type 1 diabetes.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.21.4.610
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 1998
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