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Articles by B. Nowotny
Total Records ( 3 ) for B. Nowotny
  B. Nowotny , P. J. Nowotny , K. Strassburger and M. Roden
  Aims  Assessment of insulin sensitivity by dynamic metabolic tests such as the hyperinsulinemic euglycemic clamp critically relies on the reproducible and fast measurement of blood glucose concentrations. Although various instruments have been developed over the last decades, little is known as to the accuracy and comparability. We therefore compared the best new instrument with the former gold standard instruments to measure glucose concentrations in metabolic tests.

Methods  Fasting blood samples of 15 diabetic and 10 healthy subjects were collected into sodium-fluoride tubes, spiked with glucose (0, 2.8, 6.9 and 11.1 mmol/l) and measured either as whole blood (range 3.3-26.3 mmol/l) or following centrifugation as plasma (range 3.9-32.0 mmol/l). Plasma samples were analyzed in the YSI-2300 STAT plus (YSI), EKF Biosen C-Line (EKF) and the reference method, Beckman Glucose analyzer-II (BMG), whole blood samples in EKF instruments with YSI as reference method.

Results  The average deviation of the EKF from the reference, BMG, was 3.0 ± 3.5% without any concentration-dependent variability. Glucose measurements by YSI were in good agreement with that by BMG (plasma) and EKF (plasma and whole blood) up to concentrations of 13.13 mmol/l (0.5 ± 3.7%), but deviation increased to −6.2 ± 3.8% at higher concentrations. Precision (n = 6) was ±2.2% (YSI), ±3.9% (EKF) and ±5.2% (BMG).

Conclusions  The EKF instrument is comparable regarding accuracy and precision to the reference method BMG and can be used in metabolic tests, while the YSI showed a systematic shift at higher glucose concentrations. Based on these results we decided to replace BMG with EKF instrument in metabolic tests.

  J. Genz , B. Haastert , H. Muller , F. Verheyen , D. Cole , W. Rathmann , B. Nowotny , M. Roden , G. Giani , A. Mielck , C. Ohmann and A. Icks
  Aims  To compare the effect of our newly developed online evidence-based patient information vs. standard patient information about sub-threshold elevated blood glucose levels and primary prevention of diabetes on informed patient decision making.

Methods  We invited visitors to the cooperating health insurance company, Techniker Krankenkasse, and the German Diabetes Center websites to take part in a web-based randomized controlled trial. The population after randomization comprised 1120 individuals aged between 40 and 70 years without known diabetes, of whom 558 individuals were randomly assigned to the intervention group receiving evidence-based patient information, and 562 individuals were randomly assigned to the control group receiving standard information from the Internet. The primary endpoint was acquired knowledge of elevated blood glucose level issues and the secondary outcomes were attitude to metabolic testing, intention to undergo metabolic testing, decisional conflict and satisfaction with the information.

Results  Overall, knowledge of elevated glucose level issues and the intention to undergo metabolic testing were high in both groups. Participants who had received evidence-based patient information, however, had significantly higher knowledge scores. The secondary outcomes in the evidence-based patient information subgroup that completed the 2-week follow-up period yielded significantly lower intention to undergo metabolic testing, significantly more critical attitude towards metabolic testing and significantly higher decisional conflict than the control subgroup (n = 466). Satisfaction with the information was not significantly different between both groups.

Conclusions  Evidence-based patient information significantly increased knowledge about elevated glucose levels, but also increased decisional conflict and critical attitude to screening and treatment options. The intention to undergo metabolic screening decreased. Future studies are warranted to assess uptake of metabolic testing and satisfaction with this decision in a broader population of patients with unknown diabetes.

  A. Icks , B. Albers , B. Haastert , S. Pechlivanis , B. Bokhof , U. Slomiany , R. Erbel , K.-H. Jockel , J. Kruse , B. Nowotny , C. Herder , G. Giani and S. Moebus
  Aims  Cross-sectional studies have consistently reported evidence for an association between diabetes and depressive disorders. However, only limited prospective studies have examined this association, reporting conflicting results. In a population-based cohort study, we compared cumulative incidences of diabetes between participants with and without high depressive symptoms.

Method  We analysed the 5-year follow-up data from the German Heinz Nixdorf Recall study of 3547 participants without diabetes at baseline [mean age 58.8 (sd 7.6) years, 47.5% male]. Depressive symptoms were defined using the Centre for Epidemiologic Studies Depression scale (cut point ≥ 17). Diabetes (diagnosed or previously undetected) was identified by self-reported physician-diagnosed diabetes, medication and high blood glucose levels. We estimated 5-year cumulative incidences with 95% confidence intervals and fitted multiple logistic regression models to calculate the odds ratios, adjusted for age, sex, physical activity, smoking, living with or without partner, and educational level.

Results  The cumulative incidence of diabetes was 9.2% (95% CI 6.3-12.8) in participants with high depressive symptoms at baseline and 9.0% (95% CI 8.0-10.0) in participants without these symptoms. The age- and sex-adjusted odds ratio of diabetes in participants with depressive symptoms compared with those without was 1.13 [95% CI 0.77-1.68; fully adjusted 1.11 (95% CI 0.74-1.65)]. These results did not substantially change in several additional sensitivity analyses.

Conclusion  Our study did not show a significantly increased risk of developing diabetes in individuals with high depressive symptoms compared with those without high depressive symptoms during a 5-year follow-up period.

 
 
 
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