2015
Association of inpatient and outpatient glucose management with inpatient mortality among patients with and without diabetes at a major academic medical center
Butala NM, Johnson BK, Dziura JD, Reynolds JS, Bozzo JE, Balcezak TJ, Inzucchi SE, Horwitz LI. Association of inpatient and outpatient glucose management with inpatient mortality among patients with and without diabetes at a major academic medical center. Journal Of Hospital Medicine 2015, 10: 228-235. PMID: 25627860, PMCID: PMC4390436, DOI: 10.1002/jhm.2321.Peer-Reviewed Original ResearchConceptsAcademic medical centerGlycemic controlGlucose controlMedical CenterIntensive care unit admissionCross-sectional observational studyCare unit admissionNon-ICU patientsOutpatient glycemic controlCardiovascular risk managementOdds of mortalityLength of stayMajor academic medical centerInpatient glycemic controlDisproportionate reductionHospital mortalityUnit admissionInpatient mortalityICU patientsSurgical patientsDischarge diagnosisNonobstetric patientsGlucose managementObservational studyInpatient discharges
2014
Reversal of Early Abnormalities in Glucose Metabolism in Obese Youth: Results of an Intensive Lifestyle Randomized Controlled Trial
Savoye M, Caprio S, Dziura J, Camp A, Germain G, Summers C, Li F, Shaw M, Nowicka P, Kursawe R, DePourcq F, Kim G, Tamborlane WV. Reversal of Early Abnormalities in Glucose Metabolism in Obese Youth: Results of an Intensive Lifestyle Randomized Controlled Trial. Diabetes Care 2014, 37: 317-324. PMID: 24062325, PMCID: PMC3898759, DOI: 10.2337/dc13-1571.Peer-Reviewed Original ResearchConceptsStandard of careClinical careBlood glucoseObese adolescentsObese youthOral glucose tolerance test glucoseIntensive lifestyle modificationDiabetes Prevention ProgramStandard clinical careInsulin sensitivity indexHealthy lifestyle programType 2 diabetesRisk of T2DChildhood obesity epidemicΒ-cell dysfunctionLifestyle modificationControlled TrialsOGTT glucosePrimary outcomeGlucose toleranceInsulin resistanceLifestyle programAnthropometric assessmentEarly abnormalitiesGlucose levels
2012
Insulin resistance is associated with elevated serum pigment epithelium–derived factor (PEDF) levels in morbidly obese patients
Gattu AK, Birkenfeld AL, Jornayvaz F, Dziura J, Li F, Crawford SE, Chu X, Still CD, Gerhard GS, Chung C, Samuel V. Insulin resistance is associated with elevated serum pigment epithelium–derived factor (PEDF) levels in morbidly obese patients. Acta Diabetologica 2012, 49: 161-169. PMID: 22547263, DOI: 10.1007/s00592-012-0397-y.Peer-Reviewed Original ResearchConceptsPigment epithelium-derived factorMorbidly obese patientsPEDF levelsInsulin resistanceDiabetes mellitusHigh glucose mediumObese patientsSerum pigment epithelium-derived factor (PEDF) levelsPigment epithelium-derived factor levelsSerum pigment epithelium-derived factorHomeostasis model assessment scoreCounter-regulatory factorsSerum PEDF concentrationGastric bypass surgeryHuman hepatocytesSignificant risk factorsModel assessment scoreSerum PEDF levelsEpithelium-derived factorPrimary human hepatocytesHOMA scorePEDF concentrationDiabetes medicationsGastric bypassIR patientsEffects on post-prandial glucose and AGE precursors from two initial insulin strategies in patients with Type 2 diabetes uncontrolled by oral agents
Sakharova OV, Lleva RR, Dziura JD, Spollett GR, Howell SK, Beisswenger PJ, Inzucchi SE. Effects on post-prandial glucose and AGE precursors from two initial insulin strategies in patients with Type 2 diabetes uncontrolled by oral agents. Journal Of Diabetes And Its Complications 2012, 26: 333-338. PMID: 22541894, DOI: 10.1016/j.jdiacomp.2012.03.027.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, OralAgedBlood GlucoseBody WeightCross-Over StudiesDiabetes Mellitus, Type 2FastingFemaleGlycated HemoglobinGlycation End Products, AdvancedHumansHypoglycemic AgentsInsulin GlargineInsulin LisproInsulin, Long-ActingMaleMiddle AgedPostprandial PeriodTreatment FailureTreatment OutcomeConceptsOral anti-hyperglycemic drugsPost-prandial glucoseInsulin strategiesFree fatty acidsType 2Post-prandial glucose metabolismProgressive β-cell dysfunctionType 2 diabetes patientsPost-prandial glucose levelsDaily insulin glargineInitial insulin regimenPrecursor of AGEsSingle-center studyClinical Research CenterLong-term diabetic complicationsAnti-hyperglycemic drugsType 2 diabetesΒ-cell dysfunctionCross-over designInitial insulinInsulin regimenOral agentsInsulin regimensInsulin therapyOAD therapy
2011
Modulation of β-Adrenergic Receptors in the Ventromedial Hypothalamus Influences Counterregulatory Responses to Hypoglycemia
Szepietowska B, Zhu W, Chan O, Horblitt A, Dziura J, Sherwin RS. Modulation of β-Adrenergic Receptors in the Ventromedial Hypothalamus Influences Counterregulatory Responses to Hypoglycemia. Diabetes 2011, 60: 3154-3158. PMID: 22013013, PMCID: PMC3219955, DOI: 10.2337/db11-0432.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-2 Receptor AgonistsAdrenergic beta-AntagonistsAnimalsBlood GlucoseEpinephrineEthanolaminesFormoterol FumarateGlucagonGlucose Clamp TechniqueHypoglycemiaImidazolesInsulinMaleNorepinephrinePropanolaminesRatsRats, Sprague-DawleyReceptors, Adrenergic, betaVentromedial Hypothalamic NucleusConceptsCounterregulatory responsesVentromedial hypothalamusGlucose counterregulationAwake male Sprague-Dawley ratsB2AR agonistMale Sprague-Dawley ratsCounterregulatory hormone releaseDefective glucose counterregulationExogenous glucose requirementsHyperinsulinemic-hypoglycemic clamp studySprague-Dawley ratsLocal catecholamine releaseArtificial extracellular fluidΒ-Adrenergic ReceptorsEpinephrine responseGlucagon responseDiabetic patientsEpinephrine releaseSimilar insulinCatecholamine releaseHormone releaseGuide cannulaeClamp studiesTherapeutic benefitHypoglycemia
2010
Early Pharmacokinetic and Pharmacodynamic Effects of Mixing Lispro With Glargine Insulin Results of glucose clamp studies in youth with type 1 diabetes
Cengiz E, Tamborlane WV, Martin-Fredericksen M, Dziura J, Weinzimer SA. Early Pharmacokinetic and Pharmacodynamic Effects of Mixing Lispro With Glargine Insulin Results of glucose clamp studies in youth with type 1 diabetes. Diabetes Care 2010, 33: 1009-1012. PMID: 20150302, PMCID: PMC2858163, DOI: 10.2337/dc09-2118.Peer-Reviewed Original ResearchConceptsType 1 diabetesGlucose clamp studiesGlucose excursionsClamp studiesMeal-related glucose excursionsRapid-acting insulin analoguesRapid-acting insulinEuglycemic glucose clampTime-action curvePharmacodynamic peakA1c levelsTreatment burdenPharmacodynamic effectsDaily injectionsUnits/Pharmacodynamic actionClinical studiesGlucose clampMixed injectionGlargineEarly pharmacokineticsInsulin analoguesObjective clinicianInsulin pharmacokineticsLispro
2009
Specific Relation Between Abdominal Obesity and Early-Phase Hyperglycemia Is Modulated by Hepatic Insulin Resistance in Healthy Older Women
DiPietro L, Dziura J, Yeckel CW. Specific Relation Between Abdominal Obesity and Early-Phase Hyperglycemia Is Modulated by Hepatic Insulin Resistance in Healthy Older Women. Diabetes Care 2009, 33: 165-167. PMID: 19808930, PMCID: PMC2797964, DOI: 10.2337/dc09-1365.Peer-Reviewed Original ResearchConceptsHepatic insulin resistanceOral glucose tolerance testAbdominal obesityGlucose tolerance testHealthy older womenInsulin resistanceOlder womenTolerance testLow-dose insulin infusionHepatic glucose productionGlucose excursionsInsulin infusionPlasma glucoseAbdominal circumferenceInsulin concentrationsInsulin suppressionMin postchallengeObesityGlycemic responseClamp techniqueGlucose productionWomenHyperglycemiaProduction suppressionPostchallenge
2008
Effect of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump Therapy
Swan KL, Dziura JD, Steil GM, Voskanyan GR, Sikes KA, Steffen AT, Martin ML, Tamborlane WV, Weinzimer SA. Effect of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump Therapy. Diabetes Care 2008, 32: 240-244. PMID: 19017777, PMCID: PMC2628686, DOI: 10.2337/dc08-0595.Peer-Reviewed Original ResearchConceptsInsulin pump therapyGlucose infusion rateType 1 diabetesDay 1Day 4Pump therapyInsulin aspartPharmacodynamic parametersInsulin actionInsulin bolusRapid acting analogsEuglycemic clamp procedureExogenous glucose infusionGIR curveEffect of agePharmacodynamic measuresPharmacodynamic characteristicsClamp procedureInfusion siteGlucose infusionInfusion rateInsulin analoguesType 1AspartOverall insulin actionProgressive improvement in glucose tolerance following lower-intensity resistance versus moderate-intensity aerobic training in older women.
Dipietro L, Yeckel CW, Dziura J. Progressive improvement in glucose tolerance following lower-intensity resistance versus moderate-intensity aerobic training in older women. Journal Of Physical Activity And Health 2008, 5: 854-69. PMID: 19164820, DOI: 10.1123/jpah.5.6.854.Peer-Reviewed Original ResearchConceptsOral glucose tolerance testFree fatty acidsGlucose toleranceOlder womenFFA concentrationsModerate-intensity aerobic trainingBasal FFA concentrationLight resistance trainingModerate-intensity aerobicLast exercise sessionGlucose tolerance testInactive older womenResistance training groupLevels of FFALow-intensity resistanceTolerance testPlasma glucoseAerobic trainingExercise sessionsSerial improvementInsulin actionOlder peopleTraining groupProgressive improvementGlucose concentration
2007
High Visceral and Low Abdominal Subcutaneous Fat Stores in the Obese Adolescent A Determinant of an Adverse Metabolic Phenotype
Taksali SE, Caprio S, Dziura J, Dufour S, Calí A, Goodman TR, Papademetris X, Burgert TS, Pierpont BM, Savoye M, Shaw M, Seyal AA, Weiss R. High Visceral and Low Abdominal Subcutaneous Fat Stores in the Obese Adolescent A Determinant of an Adverse Metabolic Phenotype. Diabetes 2007, 57: 367-371. PMID: 17977954, DOI: 10.2337/db07-0932.Peer-Reviewed Original ResearchConceptsMetabolic syndromeObese adolescentsInsulin resistanceVisceral fatSubcutaneous fatAdverse metabolic phenotypeC-reactive proteinSevere metabolic complicationsAbdominal subcutaneous fatBMI z-scoreProton magnetic resonance spectroscopyMulti-ethnic cohortFat-free massSubcutaneous fat depotsMagnetic resonance imagingSubcutaneous fat storesMetabolic complicationsTotal adiponectinHepatic fatLiver fatTriglyceride levelsInterleukin-6Visceral depotsOdds ratioC-peptideDegree of Obesity and Glucose Allostasis Are Major Effectors of Glucose Tolerance Dynamics in Obese Youth
Weiss R, Cali AM, Dziura J, Burgert TS, Tamborlane WV, Caprio S. Degree of Obesity and Glucose Allostasis Are Major Effectors of Glucose Tolerance Dynamics in Obese Youth. Diabetes Care 2007, 30: 1845-1850. PMID: 17475938, DOI: 10.2337/dc07-0325.Peer-Reviewed Original ResearchConceptsOral glucose tolerance testDegree of obesityElevated glucose levelsObese youthGlucose toleranceAmbient glycemiaInsulin sensitivityGlucose levelsSecond oral glucose tolerance testBaseline BMI z-scoreGlucose tolerance testBMI z-scoreAltered glucose metabolismCross-sectional analysisTolerance testInsulin sensitizationGlucose metabolismObesityZ-scoreLongitudinal assessmentLongitudinal changesMajor effectorGlycemiaSignificant reduction
2005
The “Obese Insulin-Sensitive” Adolescent: Importance of Adiponectin and Lipid Partitioning
Weiss R, Taksali SE, Dufour S, Yeckel CW, Papademetris X, Cline G, Tamborlane WV, Dziura J, Shulman GI, Caprio S. The “Obese Insulin-Sensitive” Adolescent: Importance of Adiponectin and Lipid Partitioning. The Journal Of Clinical Endocrinology & Metabolism 2005, 90: 3731-3737. PMID: 15797955, DOI: 10.1210/jc.2004-2305.Peer-Reviewed Original ResearchConceptsInsulin sensitivityVisceral fatLipid depositionObese insulin-resistant adolescentsObese insulin-sensitive subjectsNormal glucose tolerancePeripheral insulin sensitivityIntramyocellular lipid contentBody mass indexInsulin-sensitive subjectsHyperinsulinemic-euglycemic clampInsulin-resistant adolescentsInsulin-sensitive controlsWide interindividual variationLipid partitioningLower lipid depositionPercent body fatMagnetic resonance imagingImportance of adiponectinObese insulinObese groupGlucose toleranceMass indexObese adolescentsIntramyocellular lipids
2004
The Normal Glucose Tolerance Continuum in Obese Youth: Evidence for Impairment in β-Cell Function Independent of Insulin Resistance
Yeckel CW, Taksali SE, Dziura J, Weiss R, Burgert TS, Sherwin RS, Tamborlane WV, Caprio S. The Normal Glucose Tolerance Continuum in Obese Youth: Evidence for Impairment in β-Cell Function Independent of Insulin Resistance. The Journal Of Clinical Endocrinology & Metabolism 2004, 90: 747-754. PMID: 15522932, DOI: 10.1210/jc.2004-1258.Peer-Reviewed Original ResearchConceptsBeta-cell responsivenessNormal glucose tolerancePlasma glucose levelsGlucose levelsGlucose toleranceInsulin sensitivityPlasma glucoseObese youthOral glucose tolerance testType 2 diabetes mellitusDecreased insulinogenic indexGlucose tolerance continuumGlucose tolerance testInsulin sensitivity indexContinuum of riskDelta insulinInsulinogenic indexDiabetes mellitusInsulin resistancePlasma levelsTolerance testNormal rangeFunction IndependentDlGlucose concentrationExperience with the continuous glucose monitoring system in a medical intensive care unit.
Goldberg PA, Siegel MD, Russell RR, Sherwin RS, Halickman JI, Cooper DA, Dziura JD, Inzucchi SE. Experience with the continuous glucose monitoring system in a medical intensive care unit. Diabetes Technology & Therapeutics 2004, 6: 339-47. PMID: 15198837, DOI: 10.1089/152091504774198034.Peer-Reviewed Original ResearchConceptsIntensive care unitMedical intensive care unitIll patientsContinuous glucose monitoring systemMedical ICUGlucose monitoring systemGlycemic excursionsCare unitStrict glycemic controlRole of hyperglycemiaBlood glucose levelsMICU patientsDiabetes mellitusGlycemic controlICU patientsClinical outcomesNursing workloadInpatient settingGlucose levelsPatientsStudy subjectsLarger studyBG readingsSES differencesFrequent monitoringImplementation of a Safe and Effective Insulin Infusion Protocol in a Medical Intensive Care Unit
Goldberg PA, Siegel MD, Sherwin RS, Halickman JI, Lee M, Bailey VA, Lee SL, Dziura JD, Inzucchi SE. Implementation of a Safe and Effective Insulin Infusion Protocol in a Medical Intensive Care Unit. Diabetes Care 2004, 27: 461-467. PMID: 14747229, DOI: 10.2337/diacare.27.2.461.Peer-Reviewed Original ResearchConceptsInsulin infusion protocolBlood glucose levelsGlucose levelsBlood glucose valuesIll patientsInfusion protocolMedical intensive care unit patientsGlucose valuesTarget blood glucose levelsMedical intensive care unitIntensive care unit patientsCare unit patientsSignificant adverse eventsIntensive care unitPrimary outcome measurementRelevant clinical variablesNarrow target rangeMICU nursesInsulin requirementsInsulin therapyUnit patientsAdverse eventsGlycemic controlCare unitClinical outcomes
2003
Mitochondrial Dysfunction in the Elderly: Possible Role in Insulin Resistance
Petersen KF, Befroy D, Dufour S, Dziura J, Ariyan C, Rothman DL, DiPietro L, Cline GW, Shulman GI. Mitochondrial Dysfunction in the Elderly: Possible Role in Insulin Resistance. Science 2003, 300: 1140-1142. PMID: 12750520, PMCID: PMC3004429, DOI: 10.1126/science.1082889.Peer-Reviewed Original ResearchMeSH KeywordsAdipose TissueAdolescentAdultAgedAged, 80 and overAgingBlood GlucoseBody Mass IndexFemaleHumansInsulinInsulin ResistanceLiverMaleMiddle AgedMitochondriaMitochondrial DiseasesMuscle, SkeletalNuclear Magnetic Resonance, BiomolecularOxidation-ReductionOxygen ConsumptionPhosphorylationTriglyceridesConceptsInsulin resistanceInsulin-stimulated muscle glucose metabolismType 2 diabetesMuscle glucose metabolismLean body massElderly study participantsAge-associated declineMitochondrial function contributesFat massFat accumulationGlucose metabolismYoung controlsStudy participantsLiver tissueFunction contributesMitochondrial dysfunctionYounger participantsPossible roleMitochondrial oxidativeBody massMagnetic resonance spectroscopyParticipantsDiabetesDysfunctionPathogenesis
1999
Effects of recurrent hypoglycemia on brainstem function in diabetic BB rats: protective adaptation during acute hypoglycemia.
Jacob RJ, Dziura J, Blumberg M, Morgen JP, Sherwin RS. Effects of recurrent hypoglycemia on brainstem function in diabetic BB rats: protective adaptation during acute hypoglycemia. Diabetes 1999, 48: 141-145. PMID: 9892235, DOI: 10.2337/diabetes.48.1.141.Peer-Reviewed Original ResearchConceptsAntecedent recurrent hypoglycemiaRecurrent hypoglycemiaNondiabetic ratsDM ratsInsulin therapyBB ratsDiabetic ratsPlasma glucoseDiabetic BB ratsIntensive insulin therapyRelease of catecholaminesAuditory-evoked potentialsHypoglycemia counterregulationBrainstem dysfunctionDiabetic patientsHypoglycemic stimulusChronic hyperglycemiaAcute hypoglycemiaBrainstem functionAdrenergic responseInferior colliculiHypoglycemiaRatsAdverse effectsProtective adaptation