James Gavin - Academia.edu (original) (raw)

Papers by James Gavin

American Journal of Physiology Endocrinology and Metabolism, 1986

International Journal of Clinical Practice, 2012

This investigation determined the proportion of adults newly diagnosed as having type-2 diabetes ... more This investigation determined the proportion of adults newly diagnosed as having type-2 diabetes mellitus (T2DM), and ascertained risk predictors for development of self-reported T2DM. The US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) survey was a 5-year longitudinal study of adults with and without diabetes mellitus. Adults completed a baseline health questionnaire in 2004 and ≥1 annual follow-up survey through 2009. Respondents with no self-reported diagnosis of diabetes at baseline were followed to measure rate of and assess risk factors for development of T2DM over 5 years. Among 8582 respondents without diabetes at baseline, 622 (7.2%) reported a diagnosis of T2DM over the subsequent 5 years. Increasing age, family history of T2DM, body mass index ≥30 kg/m(2), abdominal obesity, excessive thirst, asthma, gestational diabetes and 'high blood sugar without diabetes' significantly increased the risk of developing T2DM (p < 0.05 for each). Good to excellent health status and self-reported circulatory problems decreased the risk (p < 0.05 for each). Among this representative US adult population, the rate of developing T2DM was 7.2% over 5 years. Predictors of T2DM diagnosis identified in this analysis were readily obtainable via self-report.

Bone, 1987

To assess the affect of mild diabetes on calcium metabolism in an animal model, we evaluated calc... more To assess the affect of mild diabetes on calcium metabolism in an animal model, we evaluated calcium homeostasis before pregnancy and during gestation and lactation in non-insulindependent (NIDD) diabetic rat mothers and their neonates (NeoDM). Plasma glucose, calcium (Ca), magnesium (Mg), phosphate (Pi), and immunoreactive parathyroid hormone (iPTH) were measured in the NIDD rats and controls before pregnancy, during the first, second, and third gestational week, and during lactation 12, 24, 48 and 72 h postpartum. The same measurements were performed on NeoDM and controls 12, 24, 48, and 72 h after birth. In the mothers, plasma calcitonin was assayed before pregnancy and at 72 h postpartum. Higher plasma glucose values before pregnancy (216 +/- 9 mg/dl vs 126 +/- 4) and during the second (105 +/- 5 vs 73 +/- 6) and third (114 +/- 8 vs 91 +/- 3) gestational week were observed in diabetic mothers when compared to controls. Glucose values decreased during the second and third gestational week in both groups compared to pregestational values. Plasma Ca, Mg, and Pi were similar in both groups during gestation and lactation except for the third gestational week when plasma Mg was lower in the diabetic mothers (P less than 0.05). Plasma iPTH rose to similar values in both groups during pregnancy. During lactation, plasma iPTH levels were higher and plasma calcitonin levels were lower compared to controls (P less than .05, P less than 0.01, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Biochemical and Biophysical Research Communications, 1972

Specffic insulin receptors from human lymphocytes in culture have been prepared using the nonioni... more Specffic insulin receptors from human lymphocytes in culture have been prepared using the nonionic detergent NP-40. Receptors were solubilized from intact cells and from crude plasma membrane fractions. Insulin receptors prepared in this manner retain many of the characteristics of the receptors studied in intact cells. We have recently demonstrated the presence of specific insulin receptors in human circulating cells (1). The insulin receptors in isolated peripheral lymphocytes displayed characteristics very similar to those studied in fat cells and liver membranes of rats (2,3,4). Several reports have appeared on the isolation and characterization of solubilized insulin receptors from fat cells and liver from rats, providing evidence that these receptors are localized in the plasma membrane fraction of these tissues (5,6,7). The presence of receptors on cultured human lymphocytes and the availability of large numbers of these cells make it possible to study insulin receptors in tissue of human origin. This report describes the isolation of a solubilized insulin receptor from cultured human lymphocytes using the nonionic detergent NP-40. MATERIALS AND METHODS Cultured lymphocytes (RPM1 4265) were grown under conditions previously Copyright 0 19 72 by Academic Press, Inc. 870 A# rights of reproduction in any form reserved.

resents the quintessential scientist, ed-ucator, trailblazer, and type of leader most people aspi... more resents the quintessential scientist, ed-ucator, trailblazer, and type of leader most people aspire to become. The breadth and depth of his contributions to the scientific and medical community in the area of diabetes are unparalleled, while his passion has pushed him to un-precedented heights in American medi-cine. His original research as a young investigator at the National Institute of Diabetes and Digestive and Kidney Dis-eases at the National Institutes of Health (NIH) has greatly contributed to our un-derstanding of insulin receptor binding and function. This factor advanced the understanding of the mechanism of in-sulin resistance and the role of hyper-insulinemia in obesity and type 2 diabetes. These observations have be-come the pathophysiologic hallmarks of both diseases.

Ethnicity & disease, 2006

Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite p... more Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite previous downward trends, which have not persisted, CHD mortality remains higher in African Americans than in Whites. Among African American and White adolescents and adults are trends of increased physical inactivity, smoking, and obesity. Approximately 47 million Americans have metabolic syndrome, a constellation of obesity, hypertension, dyslipidemia, and insulin resistance leading to diabetes. Despite a lower prevalence of metabolic syndrome, African Americans are more insulin resistant than Whites at similar degrees of adiposity, have higher blood pressures, and among women, have more obesity. Since African Americans tend to be diagnosed later and have more risk factors, which confers greater than additive risks, we propose the term "African American multiple-risk patient (AAMRP)." The AAMRP poses clinical and public health challenges for healthcare providers. We provide cl...

Ethnicity & disease, 2006

Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite p... more Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite previous downward trends, which have not persisted, CHD mortality remains higher in African Americans than in Whites. Among African American and White adolescents and adults are trends of increased physical inactivity, smoking, and obesity. Approximately 47 million Americans have metabolic syndrome, a constellation of obesity, hypertension, dyslipidemia, and insulin resistance leading to diabetes. Despite a lower prevalence of metabolic syndrome, African Americans are more insulin resistant than Whites at similar degrees of adiposity, have higher blood pressures, and among women, have more obesity. Since African Americans tend to be diagnosed later and have more risk factors, which confers greater than additive risks, we propose the term "African American multiple-risk patient (AAMRP)." The AAMRP poses clinical and public health challenges for healthcare providers. We provide cl...

Diabetes Technology & Therapeutics, 2021

Journal of Biological Chemistry, 1973

Journal of Biological Chemistry, 1974

The interaction of human growth hormone with human lymphocytes from an established culture (IM-9)... more The interaction of human growth hormone with human lymphocytes from an established culture (IM-9) was studied using lz51-human growth hormone. The binding of l*51human growth hormone was rapid; with human growth hormone at 0.1 no a steady state was observed in 90 min at 30".

Journal of Biological Chemistry, 1974

The interaction of human growth hormone with human lymphocytes from an established culture (IM-9)... more The interaction of human growth hormone with human lymphocytes from an established culture (IM-9) was studied using lz51-human growth hormone. The binding of l*51human growth hormone was rapid; with human growth hormone at 0.1 no a steady state was observed in 90 min at 30".

US Endocrinology, 2016

Type 2 diabetes has been definitively characterized as one of the most physiologically complex an... more Type 2 diabetes has been definitively characterized as one of the most physiologically complex and heterogeneous metabolic known diseases. The extraordinary depth of knowledge that has been achieved regarding the pathophysiology has helped to stimulate an explosive array of therapeutic regimens and monitoring tools for improving outcomes in this disease. Indeed, the clinical narrative about ‘control’ of diabetes has shifted markedly in the last two years, away from a focus on glucose-mediated vascular complications to defining diabetes control as cardiovascular risk reduction and end organ protection. The new tools for management coupled with new pathophysiologic insights have brought a tide of good news for the millions of people living with type 2 diabetes.

Diabetes technology & therapeutics, 2017

Diabetes care, Aug 1, 2016

Diabetes care, 2016

The current classification system presents challenges to the diagnosis and treatment of patients ... more The current classification system presents challenges to the diagnosis and treatment of patients with diabetes mellitus (DM), in part due to its conflicting and confounding definitions of type 1 DM, type 2 DM, and latent autoimmune diabetes of adults (LADA). The current schema also lacks a foundation that readily incorporates advances in our understanding of the disease and its treatment. For appropriate and coherent therapy, we propose an alternate classification system. The β-cell-centric classification of DM is a new approach that obviates the inherent and unintended confusions of the current system. The β-cell-centric model presupposes that all DM originates from a final common denominator-the abnormal pancreatic β-cell. It recognizes that interactions between genetically predisposed β-cells with a number of factors, including insulin resistance (IR), susceptibility to environmental influences, and immune dysregulation/inflammation, lead to the range of hyperglycemic phenotypes ...

European journal of applied physiology, 2015

Exercise-induced muscle damage and lowered glycogen are common during heavy training periods, and... more Exercise-induced muscle damage and lowered glycogen are common during heavy training periods, and may prolong recovery. We examined the effects of lowered glycogen on cardiorespiratory, metabolic and perceptual responses to downhill running. Twelve men performed two downhill runs (-12 % gradient, 12.1 ± 1.1 km h(-1)) separated by 6 weeks, under normal (NORM) and reduced glycogen (RED) conditions in a crossover design. For RED, participants performed exhaustive cycling at 60 % [Formula: see text]O2max power (95 ± 13 min) in the evening, and the next morning completed a downhill run comprising of five stages of 8 min running, with 2 min recovery (1 % gradient, 8 km h(-1)) between each stage. Expired gas, heart rate, rating of perceived exertion (RPE) and blood lactate (bLa) and glucose were measured for each stage. Blood glucose (P < 0.05) and respiratory exchange ratio (P < 0.01) were lower in RED, than NORM, throughout the downhill run. RED demonstrated higher bLa until stage ...

Journal of Electromyography and Kinesiology, 2015

The aim of this study was to examine the effect of low muscle glycogen on the neuromuscular respo... more The aim of this study was to examine the effect of low muscle glycogen on the neuromuscular responses to maximal eccentric contractions. Fourteen healthy men (22±3 yr) performed single-leg cycling (20 min at ~75% maximal oxygen uptake (VO 2max); eight 90 s sprints at a 1:1 work-to-rest ratio (5% decrements from 90 to 55% VO 2max); and ~85% VO 2max until exhaustion) the evening before 100 eccentric knee extensions (1.57 rad•s-1) with reduced (RED) and normal glycogen (NORM). Neuromuscular responses were measured during and up to 48 h after with maximal voluntary and involuntary (twitch, 20 Hz and 50 Hz) isometric contractions. During eccentric contractions, peak torque decreased (RED:-16.1±2.5%; NORM:-6.2±5.1%) and EMG frequency increased according to muscle length. EMG activity decreased for RED only. After eccentric contractions, maximal isometric force was reduced up to 24 h for NORM (-13.5±5.8%) and 48 h for RED (-7.4±10.9%). Twelve hours after eccentric contractions, twitch force and the 20:50 Hz ratio were decreased for RED but not for NORM. Immediate involuntary with prolonged voluntary force loss suggests that reduced glycogen is associated with increased susceptibility to mild muscle-damaging eccentric exercise with contributions of peripheral and central mechanisms to be different during recovery.

American family physician, Jan 15, 2003

Cardiovascular disease is responsible for 65 percent of deaths in persons with type 2 diabetes. H... more Cardiovascular disease is responsible for 65 percent of deaths in persons with type 2 diabetes. However, awareness of cardiovascular disease risk factors among patients with diabetes remains low, resulting in missed opportunities to lower risks for coronary events and strokes. The National Diabetes Education Program has begun a campaign to increase patient participation in risk-reduction practice s by promoting the "ABCs" of diabetes care: A(1c) level, Blood pressure, and Cholesterol level. By increasing patient awareness of the link between diabetes and heart disease, family physicians can encourage patients to take medications (including aspirin), stop smoking, lower blood pressure, and lower cholesterol and blood glucose levels.

Risk Management and Healthcare Policy, 2009

This investigation evaluated the role of obesity in health status and behaviors for weight manage... more This investigation evaluated the role of obesity in health status and behaviors for weight management and exercise among individuals with type 2 diabetes mellitus (T2DM) or cardiometabolic risk factors. Methods: Self-reported health status, exercise behaviors, and weight management were assessed in the SHIELD study for respondents with T2DM or high risk (HR) for diabetes (ie, Ն3 of the following: abdominal obesity, body mass index [BMI] Ն28 kg/m 2 , self-reported diagnosis of dyslipidemia, hypertension, or history of cardiovascular disease). Respondents were stratifi ed into three BMI categories: Ͻ25 kg/m 2 (underweight or normal weight), 25.0−29.9 kg/m 2 (overweight), and Ն30 kg/m 2 (obese), with comparisons made using analysis of variance. Comparisons between T2DM and HR were made using chi-square tests. Results: T2DM (n = 3,918) and HR (n = 5,464) groups were similar for age (mean = 59 years), race (Ն85% white), and obesity. Overweight (31%) or obese T2DM (18%) respondents were signifi cantly less likely to report excellent health compared with overweight or obese HR respondents (42% and 30%, respectively), p Ͻ 0.001. There were no differences between T2DM and HR groups for exercise behaviors. More obese respondents (20% T2DM, 21% HR) were "contemplating exercising", and fewer (21%−23%) were currently "exercising regularly" compared with overweight and normal weight respondents, p Ͻ 0.001. More obese respondents (78% T2DM, 83% HR) attempted weight management than normal (28%−35%) or overweight (57%−61%) respondents, p Ͻ 0.001. Conclusions: Obesity was negatively associated with self-perception of current health, exercising regularly, and weight maintenance for those with or at risk for diabetes.

American Journal of Physiology Endocrinology and Metabolism, 1986

International Journal of Clinical Practice, 2012

This investigation determined the proportion of adults newly diagnosed as having type-2 diabetes ... more This investigation determined the proportion of adults newly diagnosed as having type-2 diabetes mellitus (T2DM), and ascertained risk predictors for development of self-reported T2DM. The US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) survey was a 5-year longitudinal study of adults with and without diabetes mellitus. Adults completed a baseline health questionnaire in 2004 and ≥1 annual follow-up survey through 2009. Respondents with no self-reported diagnosis of diabetes at baseline were followed to measure rate of and assess risk factors for development of T2DM over 5 years. Among 8582 respondents without diabetes at baseline, 622 (7.2%) reported a diagnosis of T2DM over the subsequent 5 years. Increasing age, family history of T2DM, body mass index ≥30 kg/m(2), abdominal obesity, excessive thirst, asthma, gestational diabetes and &amp;amp;amp;amp;amp;amp;#39;high blood sugar without diabetes&amp;amp;amp;amp;amp;amp;#39; significantly increased the risk of developing T2DM (p &amp;amp;amp;amp;amp;amp;lt; 0.05 for each). Good to excellent health status and self-reported circulatory problems decreased the risk (p &amp;amp;amp;amp;amp;amp;lt; 0.05 for each). Among this representative US adult population, the rate of developing T2DM was 7.2% over 5 years. Predictors of T2DM diagnosis identified in this analysis were readily obtainable via self-report.

Bone, 1987

To assess the affect of mild diabetes on calcium metabolism in an animal model, we evaluated calc... more To assess the affect of mild diabetes on calcium metabolism in an animal model, we evaluated calcium homeostasis before pregnancy and during gestation and lactation in non-insulindependent (NIDD) diabetic rat mothers and their neonates (NeoDM). Plasma glucose, calcium (Ca), magnesium (Mg), phosphate (Pi), and immunoreactive parathyroid hormone (iPTH) were measured in the NIDD rats and controls before pregnancy, during the first, second, and third gestational week, and during lactation 12, 24, 48 and 72 h postpartum. The same measurements were performed on NeoDM and controls 12, 24, 48, and 72 h after birth. In the mothers, plasma calcitonin was assayed before pregnancy and at 72 h postpartum. Higher plasma glucose values before pregnancy (216 +/- 9 mg/dl vs 126 +/- 4) and during the second (105 +/- 5 vs 73 +/- 6) and third (114 +/- 8 vs 91 +/- 3) gestational week were observed in diabetic mothers when compared to controls. Glucose values decreased during the second and third gestational week in both groups compared to pregestational values. Plasma Ca, Mg, and Pi were similar in both groups during gestation and lactation except for the third gestational week when plasma Mg was lower in the diabetic mothers (P less than 0.05). Plasma iPTH rose to similar values in both groups during pregnancy. During lactation, plasma iPTH levels were higher and plasma calcitonin levels were lower compared to controls (P less than .05, P less than 0.01, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Biochemical and Biophysical Research Communications, 1972

Specffic insulin receptors from human lymphocytes in culture have been prepared using the nonioni... more Specffic insulin receptors from human lymphocytes in culture have been prepared using the nonionic detergent NP-40. Receptors were solubilized from intact cells and from crude plasma membrane fractions. Insulin receptors prepared in this manner retain many of the characteristics of the receptors studied in intact cells. We have recently demonstrated the presence of specific insulin receptors in human circulating cells (1). The insulin receptors in isolated peripheral lymphocytes displayed characteristics very similar to those studied in fat cells and liver membranes of rats (2,3,4). Several reports have appeared on the isolation and characterization of solubilized insulin receptors from fat cells and liver from rats, providing evidence that these receptors are localized in the plasma membrane fraction of these tissues (5,6,7). The presence of receptors on cultured human lymphocytes and the availability of large numbers of these cells make it possible to study insulin receptors in tissue of human origin. This report describes the isolation of a solubilized insulin receptor from cultured human lymphocytes using the nonionic detergent NP-40. MATERIALS AND METHODS Cultured lymphocytes (RPM1 4265) were grown under conditions previously Copyright 0 19 72 by Academic Press, Inc. 870 A# rights of reproduction in any form reserved.

resents the quintessential scientist, ed-ucator, trailblazer, and type of leader most people aspi... more resents the quintessential scientist, ed-ucator, trailblazer, and type of leader most people aspire to become. The breadth and depth of his contributions to the scientific and medical community in the area of diabetes are unparalleled, while his passion has pushed him to un-precedented heights in American medi-cine. His original research as a young investigator at the National Institute of Diabetes and Digestive and Kidney Dis-eases at the National Institutes of Health (NIH) has greatly contributed to our un-derstanding of insulin receptor binding and function. This factor advanced the understanding of the mechanism of in-sulin resistance and the role of hyper-insulinemia in obesity and type 2 diabetes. These observations have be-come the pathophysiologic hallmarks of both diseases.

Ethnicity & disease, 2006

Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite p... more Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite previous downward trends, which have not persisted, CHD mortality remains higher in African Americans than in Whites. Among African American and White adolescents and adults are trends of increased physical inactivity, smoking, and obesity. Approximately 47 million Americans have metabolic syndrome, a constellation of obesity, hypertension, dyslipidemia, and insulin resistance leading to diabetes. Despite a lower prevalence of metabolic syndrome, African Americans are more insulin resistant than Whites at similar degrees of adiposity, have higher blood pressures, and among women, have more obesity. Since African Americans tend to be diagnosed later and have more risk factors, which confers greater than additive risks, we propose the term "African American multiple-risk patient (AAMRP)." The AAMRP poses clinical and public health challenges for healthcare providers. We provide cl...

Ethnicity & disease, 2006

Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite p... more Coronary heart disease (CHD) is the second leading cause of death in the United States. Despite previous downward trends, which have not persisted, CHD mortality remains higher in African Americans than in Whites. Among African American and White adolescents and adults are trends of increased physical inactivity, smoking, and obesity. Approximately 47 million Americans have metabolic syndrome, a constellation of obesity, hypertension, dyslipidemia, and insulin resistance leading to diabetes. Despite a lower prevalence of metabolic syndrome, African Americans are more insulin resistant than Whites at similar degrees of adiposity, have higher blood pressures, and among women, have more obesity. Since African Americans tend to be diagnosed later and have more risk factors, which confers greater than additive risks, we propose the term "African American multiple-risk patient (AAMRP)." The AAMRP poses clinical and public health challenges for healthcare providers. We provide cl...

Diabetes Technology & Therapeutics, 2021

Journal of Biological Chemistry, 1973

Journal of Biological Chemistry, 1974

The interaction of human growth hormone with human lymphocytes from an established culture (IM-9)... more The interaction of human growth hormone with human lymphocytes from an established culture (IM-9) was studied using lz51-human growth hormone. The binding of l*51human growth hormone was rapid; with human growth hormone at 0.1 no a steady state was observed in 90 min at 30".

Journal of Biological Chemistry, 1974

The interaction of human growth hormone with human lymphocytes from an established culture (IM-9)... more The interaction of human growth hormone with human lymphocytes from an established culture (IM-9) was studied using lz51-human growth hormone. The binding of l*51human growth hormone was rapid; with human growth hormone at 0.1 no a steady state was observed in 90 min at 30".

US Endocrinology, 2016

Type 2 diabetes has been definitively characterized as one of the most physiologically complex an... more Type 2 diabetes has been definitively characterized as one of the most physiologically complex and heterogeneous metabolic known diseases. The extraordinary depth of knowledge that has been achieved regarding the pathophysiology has helped to stimulate an explosive array of therapeutic regimens and monitoring tools for improving outcomes in this disease. Indeed, the clinical narrative about ‘control’ of diabetes has shifted markedly in the last two years, away from a focus on glucose-mediated vascular complications to defining diabetes control as cardiovascular risk reduction and end organ protection. The new tools for management coupled with new pathophysiologic insights have brought a tide of good news for the millions of people living with type 2 diabetes.

Diabetes technology & therapeutics, 2017

Diabetes care, Aug 1, 2016

Diabetes care, 2016

The current classification system presents challenges to the diagnosis and treatment of patients ... more The current classification system presents challenges to the diagnosis and treatment of patients with diabetes mellitus (DM), in part due to its conflicting and confounding definitions of type 1 DM, type 2 DM, and latent autoimmune diabetes of adults (LADA). The current schema also lacks a foundation that readily incorporates advances in our understanding of the disease and its treatment. For appropriate and coherent therapy, we propose an alternate classification system. The β-cell-centric classification of DM is a new approach that obviates the inherent and unintended confusions of the current system. The β-cell-centric model presupposes that all DM originates from a final common denominator-the abnormal pancreatic β-cell. It recognizes that interactions between genetically predisposed β-cells with a number of factors, including insulin resistance (IR), susceptibility to environmental influences, and immune dysregulation/inflammation, lead to the range of hyperglycemic phenotypes ...

European journal of applied physiology, 2015

Exercise-induced muscle damage and lowered glycogen are common during heavy training periods, and... more Exercise-induced muscle damage and lowered glycogen are common during heavy training periods, and may prolong recovery. We examined the effects of lowered glycogen on cardiorespiratory, metabolic and perceptual responses to downhill running. Twelve men performed two downhill runs (-12 % gradient, 12.1 ± 1.1 km h(-1)) separated by 6 weeks, under normal (NORM) and reduced glycogen (RED) conditions in a crossover design. For RED, participants performed exhaustive cycling at 60 % [Formula: see text]O2max power (95 ± 13 min) in the evening, and the next morning completed a downhill run comprising of five stages of 8 min running, with 2 min recovery (1 % gradient, 8 km h(-1)) between each stage. Expired gas, heart rate, rating of perceived exertion (RPE) and blood lactate (bLa) and glucose were measured for each stage. Blood glucose (P < 0.05) and respiratory exchange ratio (P < 0.01) were lower in RED, than NORM, throughout the downhill run. RED demonstrated higher bLa until stage ...

Journal of Electromyography and Kinesiology, 2015

The aim of this study was to examine the effect of low muscle glycogen on the neuromuscular respo... more The aim of this study was to examine the effect of low muscle glycogen on the neuromuscular responses to maximal eccentric contractions. Fourteen healthy men (22±3 yr) performed single-leg cycling (20 min at ~75% maximal oxygen uptake (VO 2max); eight 90 s sprints at a 1:1 work-to-rest ratio (5% decrements from 90 to 55% VO 2max); and ~85% VO 2max until exhaustion) the evening before 100 eccentric knee extensions (1.57 rad•s-1) with reduced (RED) and normal glycogen (NORM). Neuromuscular responses were measured during and up to 48 h after with maximal voluntary and involuntary (twitch, 20 Hz and 50 Hz) isometric contractions. During eccentric contractions, peak torque decreased (RED:-16.1±2.5%; NORM:-6.2±5.1%) and EMG frequency increased according to muscle length. EMG activity decreased for RED only. After eccentric contractions, maximal isometric force was reduced up to 24 h for NORM (-13.5±5.8%) and 48 h for RED (-7.4±10.9%). Twelve hours after eccentric contractions, twitch force and the 20:50 Hz ratio were decreased for RED but not for NORM. Immediate involuntary with prolonged voluntary force loss suggests that reduced glycogen is associated with increased susceptibility to mild muscle-damaging eccentric exercise with contributions of peripheral and central mechanisms to be different during recovery.

American family physician, Jan 15, 2003

Cardiovascular disease is responsible for 65 percent of deaths in persons with type 2 diabetes. H... more Cardiovascular disease is responsible for 65 percent of deaths in persons with type 2 diabetes. However, awareness of cardiovascular disease risk factors among patients with diabetes remains low, resulting in missed opportunities to lower risks for coronary events and strokes. The National Diabetes Education Program has begun a campaign to increase patient participation in risk-reduction practice s by promoting the "ABCs" of diabetes care: A(1c) level, Blood pressure, and Cholesterol level. By increasing patient awareness of the link between diabetes and heart disease, family physicians can encourage patients to take medications (including aspirin), stop smoking, lower blood pressure, and lower cholesterol and blood glucose levels.

Risk Management and Healthcare Policy, 2009

This investigation evaluated the role of obesity in health status and behaviors for weight manage... more This investigation evaluated the role of obesity in health status and behaviors for weight management and exercise among individuals with type 2 diabetes mellitus (T2DM) or cardiometabolic risk factors. Methods: Self-reported health status, exercise behaviors, and weight management were assessed in the SHIELD study for respondents with T2DM or high risk (HR) for diabetes (ie, Ն3 of the following: abdominal obesity, body mass index [BMI] Ն28 kg/m 2 , self-reported diagnosis of dyslipidemia, hypertension, or history of cardiovascular disease). Respondents were stratifi ed into three BMI categories: Ͻ25 kg/m 2 (underweight or normal weight), 25.0−29.9 kg/m 2 (overweight), and Ն30 kg/m 2 (obese), with comparisons made using analysis of variance. Comparisons between T2DM and HR were made using chi-square tests. Results: T2DM (n = 3,918) and HR (n = 5,464) groups were similar for age (mean = 59 years), race (Ն85% white), and obesity. Overweight (31%) or obese T2DM (18%) respondents were signifi cantly less likely to report excellent health compared with overweight or obese HR respondents (42% and 30%, respectively), p Ͻ 0.001. There were no differences between T2DM and HR groups for exercise behaviors. More obese respondents (20% T2DM, 21% HR) were "contemplating exercising", and fewer (21%−23%) were currently "exercising regularly" compared with overweight and normal weight respondents, p Ͻ 0.001. More obese respondents (78% T2DM, 83% HR) attempted weight management than normal (28%−35%) or overweight (57%−61%) respondents, p Ͻ 0.001. Conclusions: Obesity was negatively associated with self-perception of current health, exercising regularly, and weight maintenance for those with or at risk for diabetes.