A5080379883- Diabetes Management and Research
- Pancreatic function and diabetes
- Diabetes Treatment and Management
- Diabetes and associated disorders
- Heart Rate Variability and Autonomic Control
- Metabolism, Diabetes, and Cancer
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Diet and metabolism studies
- Pharmacology and Obesity Treatment
- Adipose Tissue and Metabolism
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Regulation of Appetite and Obesity
- Cardiovascular and exercise physiology
- Muscle metabolism and nutrition
- Diet, Metabolism, and Disease
- Diabetes Management and Education
- Adipokines, Inflammation, and Metabolic Diseases
- Cardiovascular Function and Risk Factors
- Receptor Mechanisms and Signaling
- Cardiovascular Syncope and Autonomic Disorders
- Liver Disease Diagnosis and Treatment
- Cardiovascular Health and Disease Prevention
- Hormonal and reproductive studies
- Blood Pressure and Hypertension Studies
- Stress Responses and Cortisol
University of Maryland, Baltimore
2015-2024
University of Maryland Medical Center
2011-2024
Yakima Valley Community College
2021
University of Baltimore
2010-2018
University of Michigan–Ann Arbor
2016
Weatherford College
2015
Park Nicollet Health Services
2011
VA Tennessee Valley Healthcare System
2008-2011
Vanderbilt University
2001-2010
Hospital Universitari de Vic
2010
The effects of intensive glucose control on cardiovascular events in patients with long-standing type 2 diabetes mellitus remain uncertain.We randomly assigned 1791 military veterans (mean age, 60.4 years) who had a suboptimal response to therapy for receive either or standard control. Other risk factors were treated uniformly. mean number years since the diagnosis was 11.5, and 40% already event. goal intensive-therapy group an absolute reduction 1.5 percentage points glycated hemoglobin...
Background: Alzheimer disease (AD) may be caused by the toxic accumulation of -amyloid (A).Objective: To test this theory, we developed a clinical intervention using clioquinol, metal-proteinattenuating compound (MPAC) that inhibits zinc and copper ions from binding to A, thereby promoting A dissolution diminishing its properties.Methods: A pilot phase 2 trial in patients with moderately severe disease.Results: Thirty-six subjects were randomized.The effect treatment was significant more...
Recently developed technologies for the treatment of type 1 diabetes mellitus include a variety pumps and with glucose sensors.In this 1-year, multicenter, randomized, controlled trial, we compared efficacy sensor-augmented pump therapy (pump therapy) that regimen multiple daily insulin injections (injection in 485 patients (329 adults 156 children) inadequately diabetes. Patients received recombinant analogues were supervised by expert clinical teams. The primary end point was change from...
Recent large randomized trials have linked adverse cardiovascular and cerebrovascular events with hypoglycemia. However, the integrated physiological vascular biological mechanisms occurring during hypoglycemia not been extensively examined. Therefore, aim of this study was to determine whether 2 h moderate clamped could decrease fibrinolytic balance activate pro-atherothrombotic in individuals type 1 diabetes healthy individuals.Thirty-five volunteers (19 male 16 female subjects age 32 +/-...
Background and Objectives The hepatic 6-hydroxylation of chlorzoxazone in vitro is mediated primarily by CYP2E1, measurement this metabolic pathway may provide an vivo probe the enzyme. In animals, such as rat, levels CYP2E1 are induced both fasting obesity. This study investigated whether these two physiologic factors determinants metabolism disposition humans. Methods plasma concentration-time profiles its 6-hydroxy metabolite were determined after oral administration parent drug (250 mg)....
IN BRIEF The threat and incidence of hypoglycemia is the major limiting factor in intensive glycemic control for both type 1 2 diabetes. This article reviews physiology normal counterregulatory responses to deficient defenses that occur patients with Treatment paradigms establishing good while are also discussed.
OBJECTIVE To examine the effects of crossing over from optimized multiple daily injection (MDI) therapy to sensor-augmented pump (SAP) for 6 months, and 18 months' sustained use SAP. RESEARCH DESIGN AND METHODS The 6-month, single-crossover continuation phase Sensor-Augmented Pump Therapy A1C Reduction (STAR 3) provided SAP 420 subjects who completed 1-year randomized study. primary outcome was change in crossover group. RESULTS values were initially lower continuing-SAP group than (7.4 vs....
To determine the risk factors for severe hypoglycemia and association between serious cardiovascular adverse events all-cause mortality in Veterans Affairs Diabetes Trial (VADT).This post hoc analysis of data from VADT included 1,791 military veterans (age 60.5 ± 9.0 years) with suboptimally controlled type 2 diabetes (HbA1c 9.4 2.0%) 11.5 7.5 years disease duration or without known additional factors. Participants were randomized to intensive <7.0%) versus standard <8.5%) glucose...
The aim of this study was to determine the effects single and repeated episodes clamped hypoglycemia on fibrinolytic balance, proinflammatory biomarkers, proatherothrombotic mechanisms, endothelial function. Twenty healthy individuals (12 male 8 female) were studied during separate 2-day randomized protocols. Day 1 consisted either two 2-h hyperinsulinemic (812 ± 50 pmol/L)-euglycemic (5 0.1 mmol/L) or pmol/L)-hypoglycemic (2.9 clamps. 2 a hyperinsulinemic-hypoglycemic clamp. Two-dimensional...
The aim of the study was to determine effects specific levels antecedent hypoglycemia on subsequent autonomic, neuroendocrine, and metabolic counter-regulatory responses. Eight healthy, overnight-fasted male subjects were studied during 2-day protocols four separate randomized occasions separated by at least 2 months. On day 1, insulin infused a rate 9 pmol · kg−1 min−1 2-h clamped euglycemia (plasma glucose 5.2 ± 0.2 mmol/l) or differing 3.9 0.1, 3.3 2.9 0.1 obtained morning afternoon. next...
The aim of this study was to determine the role increased plasma cortisol levels in pathogenesis hypoglycemia-associated autonomic failure. Experiments were carried out on 16 lean, healthy, overnight fasted male subjects. One group (n = 8) underwent two separate, 2-d randomized experiments separated by at least 2 mo. On day 1 insulin infused a rate 1.5 mU/kg per min and h clamped hypoglycemia (53 +/- mg/dl) or euglycemia (93 3 obtained during morning afternoon. next subjects 2-h...
Significant, sexual dimorphisms exist in counterregulatory responses to commonly occurring stresses, such as hypoglycemia, fasting, and cognitive testing. The question of whether differ during exercise healthy men women remains controversial. aim this study was determine a dimorphism exists neuroendocrine, metabolic, or cardiovascular prolonged moderate exercise. Sixteen (eight eight women) subjects matched for age (28 ± 2 yr), body mass index (22 1 kg/m2), nutrient intake, spectrum physical...
Obesity is associated with alterations in the autonomic nervous system that may contribute to increase blood pressure and resting energy expenditure present this condition. To test hypothesis, we induced withdrawal ganglionic blocker trimethaphan 10 lean (32+/-3 years) obese (35+/-3 subjects. Systolic fell more compared subjects (-17+/-3 versus -11+/-1 mm Hg; P=0.019) because of a greater decrease total peripheral resistance (-310+/-41 33+/-78 dynes/sec/cm(-5); P=0.002). In contrast,...
Exercise-related hypoglycemia is common in intensively treated patients with type 1 diabetes. The underlying mechanisms are not clearly defined. In nondiabetic subjects, blunts counterregulatory responses to subsequent exercise. It unknown whether this also occurs Therefore, the goal of study was test hypothesis that prior could result acute failure during exercise A total 16 diabetic (8 men and 8 women, HbA(1c) 7.8 +/- 0.3%) were investigated 90 min euglycemic cycling exercise, following...
Antecedent moderate-intensity exercise has been shown to blunt autonomic, neuroendocrine, and metabolic counterregulatory responses subsequent hypoglycemia in nondiabetic individuals. The aims of the current study were determine 1) whether this occurs type 1 diabetic patients 2) degree blunting is dependent on intensity. Twenty-seven (13 women 14 men) studied during a single-step, 2-h hyperinsulinemic (9 pmol · kg−1 min−1)-hypoglycemic (∼2.8 mmol/l) clamp day after two 90-min bouts at 30% (n...