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Articles by U. A. Muller
Total Records ( 3 ) for U. A. Muller
  A. Dost , S. Hofer , A. Herbst , R. Stachow , E. Schober , U. A. Muller and R. W. Holl
  Not available
  T. Neumann , A. Samann , S. Lodes , B. Kastner , S. Franke , M. Kiehntopf , C. Hemmelmann , T. Lehmann , U. A. Muller , G. Hein and G. Wolf
  Aim  There are conflicting data regarding the risk of osteoporosis in patients with Type 1 diabetes. We investigated an association between diabetes, bone mineral density and prevalent fractures.

Methods  A single-centre, cross-sectional study of men and pre-menopausal women with Type 1 diabetes (n = 128) and a matched control group (n = 77) was conducted. The primary outcome measure was bone mineral density and secondary measures were markers of bone metabolism and prevalent fractures.

Results  Hip and total body bone mineral densities were significantly lower in women with diabetes compared with control subjects. In men, no difference in bone mineral density was found. A multivariate regression analysis in women with diabetes revealed higher BMI as the strongest predictor of higher total hip, femoral neck and total body bone mineral density, whereas previous fractures were inversely associated with total hip bone mineral density and C-terminal telopeptide of type I collagen with total body bone mineral density. Poor long-term glycaemic control was not associated with low bone mineral density. Fracture frequency was higher in patients with diabetes compared with control subjects (1.64 vs. 0.62 per 100 patient-years; P < 0.05). In a multivariable model, long-term HbA1c control was associated with increased clinical fracture prevalence (OR 1.92; 95% CI 1.09-2.75) in those with diabetes.

Conclusions  Type 1 diabetes contributes to low bone mineral density in women. Previous fractures and low BMI were strong predictors of impaired bone mineral density and should therefore be considered in risk estimation. Fractures are more frequent in Type 1 diabetes. Long-term hyperglycaemia may account for impaired bone strength, independently from bone mineral density.

  L. Baz , N. Muller , E. Beluchin , C. Kloos , T. Lehmann , G. Wolf and U. A. Muller
  Aim  To assess the relationship between social status and quality of diabetes care in a tertiary care centre in Germany.

Methods  Social status was assessed in 940 consecutive patients in a university outpatient department by a questionnaire. The assessment comprised three components: education, highest professional position and household net income (total score 3-21). Quality of diabetes care was measured by HbA1c, blood pressure and BMI. The influence of social status on quality measures was analysed at entry and last visit by fitting linear mixed models.

Results  At the entry visit, patients with lower social status had a higher HbA1c compared with patients with higher status (0.06% per each point of social score difference). After a mean follow- up of 6.0 years (Type 2 diabetes) and 9.4 years (Type 1 diabetes) no significant differences in HbA1c could be found. However, difference in BMI (−0.41 kg/m2 per each point of social score) persisted at last observation. Blood pressure was only negligibly affected by the care programme.

Conclusions  Low social status is associated with worse quality of diabetes care at entry in a tertiary care centre. The differences in HbA1c disappeared after treatment and structured education, whereas the difference in BMI persisted. There was no significant influence of social status or treatment on blood pressure.

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