bluuebunny/crossref_metadata_2025 huggingface dataset:
480-P: Serum Uric Acid–to–Creatinine Ratio Is an Independent Risk Factor of Sudomotor Dysfunction in Patients with Type 2 Diabetes
Authors: PENG JIE , CHEN XUEYAN , XU HUAN , TANG XIAOYUN , SHUI XING , YAN JINHUA , XU WEN , YAO BIN , DENG HONGRONG , YANG XUBIN
Published: June 2024

Object: This study aimed to explore the relationship between serum uric acid to creatinine ratio (UCR) and sudomotor function in patients with T2DM.

Methods: Serum uric acid and serum creatinine were measured with an automated biochemistry analyzer. UCR was calculated. Sudomotor function was assessed through electrochemical skin conductance (ESC) measurements conducted with the SUDOSCAN device.

Results: A total of 781 patients with T2DM were enrolled (59% male, 55.09±13.23 years). Patients were further divided into three groups based on the mean ESC of the hand and foot (MEHF): the group with sudomotor severe dysfunction (SDF group, MEHF< 40μS), the sudomotor moderate dysfunction group (MDF group, 40μS≤ MEHF≤ 60μS), and the group with normal sudomotor function (NSF group, MEHF > 60μS). Compared with the NSF group, level of UCR of patients in MDF group and SDF group was significantly lower (P < 0.0001) (Table 1). Spearman correlation analysis showed that the MEHF was negatively correlated with UCR (r = -0.144, P<0.0001). After dividing UCR into tertiles, multivariate logistic regression analysis demonstrated that participants in the lowest UCR group had a significantly higher risk of sudomotor dysfunction by 67.2% than those in the highest group (OR = 1.672, 95%CI 1.171-2.387, P =0.005).

Conclusion: UCR is an independent risk factor of sudomotor dysfunction in patients with T2DM.

Disclosure

J. Peng: None. X. Chen: None. H. Xu: None. X. Tang: None. X. Shui: None. J. Yan: None. W. Xu: None. B. Yao: None. H. Deng: None. X. Yang: None.
502-P: Significant Inverse Association between Self-Reported Fast Walking and Incident Severe Diabetic Microvascular Complications Including Retinopathy and Initiation of Dialysis
Authors: YAMAMOTO MASAHIKO , FUJIHARA KAZUYA , HASEBE HIRUMA , YAGUCHI YUTA , ISHIGURO HAJIME , MATSUBAYASHI YASUHIRO , YAMADA TAKAHO , KODAMA SATORU , SONE HIROHITO
Published: June 2024

Background & Objective: Whether fast walking is inversely associated with the incidence of severe diabetic retinopathy (DR) and/or diabetic macular edema (DME) or initiation of dialysis remains unknown. We aimed to explore the association between self-reported fast walking and the incidence of these outcomes.

Methods: Japanese with type 2 diabetes were enrolled. Severe DR and DME were defined as vision-threatening treatment-required diabetic eye diseases (TRDED). TRDED and initiation of dialysis were identified according to claims using ICD-10 codes and medical procedures. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of TRDED and initiation of dialysis were calculated by Cox proportional hazards models using a nationwide database.

Results: Of 11,594 persons, 298 developed TRDED (4.9/1000 person-years) during the study period (mean 5.2y) and 82 of 14,695 participants required initiation of dialysis (1.0/1000 person-years, mean 5.4y). Multivariate Cox analysis demonstrated that self-reported fast walking was inversely associated with both TRDED and initiation of dialysis after adjustment for covariates. HRs for incident TRDED and initiation of dialysis in persons reporting fast walking was 0.67 (95%CI, 0.52-0.86) and 0.54 (0.33-0.88), respectively, compared with those reporting slow-to-average walking. This inverse association was unchanged after additional adjustment for physical activity (HR0.67 [0.52, 0.87] for TRDED and 0.59[0.35, 0.98] for initiation of dialysis).

Conclusions: This information can be a valuable aid to prevent severe microvascular complications because maintaining walking speed is an inexpensive and almost universally applicable tool, although further interventional studies are required to prove this hypothesis derived from the current observational study.

Disclosure

M. Yamamoto: None. K. Fujihara: None. H. Hasebe: None. Y. Yaguchi: None. H. Ishiguro: None. Y. Matsubayashi: None. T. Yamada: None. S. Kodama: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.

Funding

The Japan Society for the Promotion of Science (JSPS) KAKENHI Grant (JP21K11569 and JP22K1621)
503-P: The Effect of Ten-Year Multifactorial Intervention on Risk Factors for Diabetic Retinopathy in Patients with Type 2 Diabetes in the Beijing Community
Authors: LIAN ZHANG XUE , YUAN YUAN SHEN
Published: June 2024

Objective: To investigate factors affecting diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) after 10-year interventions in the Beijing community.

Methods: 1,759 patients with T2DM in the Beijing community from August 2008 to July 2009 were enrolled. All patients received 10-year intervention and underwent regular fundus examination during the follow-up. The patients were divided into three groups. Patients without DR during the follow-up were named as the NDR group; Progression from normal fundus to DR during the follow-up was named as the PD-DR group; and those with a diagnosis of DR at both baseline and at the end of follow-up were named as the DR group.

Results: At baseline, comparison of age, the duration of diabetes mellitus, educational attainment, economic level, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose and HbAlc levels among the 3 groups showed significant differences (P<0.05). At the end of follow-up, when compared with the NDR group, the levels of FPG and HbAlc, proportion of all-cause death, cardiovascular events(CVD) were higher in the PD-DR group and DR group (P<0.05), History of diabetic nephropathy, FPG, HbAlc and total cholesterol were independent risk factors for DR at baseline, and the risk factors of DR changed to FPG and HbAlc at the end of follow-up.

Conclusion: After 10-year of strict control of blood glucose, blood pressure and lipid profiles in T2DM in the community, the risk factors for the development of DR changed. Long-term multi-factorial intervention could effectively reduce the risk factors for DR.

Disclosure

X. Zhang: None. S. Yuan: None.

Funding

Capital Medical Development Foundation of China (2007-1035), Beijing Municipal Science &Technology Commission (Z151100004015021)
51-PUB: Assessment the Effect of Therapeutic Education on Nutritional Habits among Pregnant Women with Gestational Diabetes
Authors: SALZBERG SUSANA , GROUP EDUGEST
Published: June 2024

Background: Maternal obesity elevates the risk of gestational diabetes (GD) andimpacts perinatal outcomes, stemming from excessive caloric intake and unhealthynutrient habits.

Objective: To evaluate the effect of therapeutic education on food intake, and itsadequacy to nutritional recommendations in pregnant women with GD.

Methods: GD women who participated in the EDUGEST study were consider to theanalysis. Educational intervention: workshops in-site and on-line, with material speciallydeveloped for the project, reinforced with an individual interview with thenutritionist.Nutriquid-GEST were completed before and after the intervention. A pre-post intervention analysis was carried out, where food intake indicators and theproportion of adequacy to Institute of Medicine recommendations were verified. Theresults are presented as mean ± standard deviation or proportions. Student's tests andchi-squared test were used for comparisons considering significant p<0.05.

Results: Nutritional records of 497 women with GD were analyzed (31.1 ± 6.4 years atthe beginning of pregnancy, BMI 31.8 ± 7 kg/m2, and 28 ± 5 weeks gestational age atthe time of recruitment. PRE intervention: energy intake was 3,633 ± 2,350 Kcal/day, and only 10.9% of the sample recorded consumption as recommended. POSTintervention, a decrease in energy intake was observed (2,0913 ± 881.9 Kcal/day vs.3,633.2 ± 2,350.4 Kcal/day; p=0.000), and a decrease in macro and micronutrientconsumption; without change in the number of servings of fruits and vegetables.Therewas an increase in the percentage of women with an adequate range of energyconsumption (25.4% vs. 10.9%; p=0.000), Carbohydrates (14.5% vs. 8.9%; p=0.006), Lipids (14.5% vs. 9.9%; p=0.026) and Proteins (19.9% vs. 12.3%; p=0.026).

Conclusion: The educational intervention significantly improved the eating behavior ofpregnant women with GD, adopting healthy eating habits throughout pregnancy.

Disclosure

S. Salzberg: Research Support; Eli Lilly and Company.

Funding

World Diabetes Foundation (WDF 19-1724)
517-P: Postprandial Circulating Endocannabinoidome Mediators—Impact of Host's Metabolic Health and Dietary Fatty Acid Profile
Authors: ROCHELEAU TRISTAN , AMZIL LOUBNA , MAYER THOMAS , LEBLANC NADINE , FLAMAND NICOLAS , RAYMOND FRÉDÉRIC , DI MARZO VINCENZO , VEILLEUX ALAIN
Published: June 2024

Introduction & Objective: Food digestion and the activity of the gut microbiota enable the production of several nutrient-derived bioactive metabolites. Notably, lipids can be metabolized into endocannabinoidome (eCBome) mediators, a large family of endocannabinoid and their congeners such as N-acyl-ethanolamines (NAEs) and 2-monoacyl-glycerols (2-MAGs) involved in numerous aspects of energy homeostasis. Our objective is to decipher the short-term and postprandial kinetics of dietary fatty acid incorporation into circulating eCBome mediators in individuals living with visceral obesity and type 2 diabetes (T2D).

Methods: The METAc trial consists of a fixed sequence of standardized meals divided in three periods: a) a 3-day run-in control diet, b) a 2-day UFA-rich diet, and c) a 2-day SFA-rich diet. Fasting and postprandial (45-480 min) circulating levels of NAEs and 2-MAGs were measured by LC-MS/MS and analyzed using longitudinal mixed linear models.

Results: Men and postmenopausal women aged 45 to 65 (n=51) were recruited into the following groups: lean, visceral obesity and T2D. Circulating levels of 2-MAGs derived from oleic acid and omega‑3 PUFAs were increased following the 2-day UFA-rich diet (+25 to 120%). Interestingly, circulating levels of all 2-MAGs were rapidly increased along with digestion (+40 to 220%). In contrast, circulating levels of NAEs were decreased throughout the postprandial periods (−40 to 80%). The magnitude of the postprandial response of most NAE and 2-MAG congeners was influenced by the fatty acid profile of the previous meal. In addition, the eCBome profile was impacted by the obesity and T2D status of the host.

Conclusion: This study supports the hypothesis that dietary lipids are rapidly metabolized and incorporated into circulating 2-MAGs. Dietary lipid intake, obesity and diabetes status as well as gut microbiota activity emerge as crucial regulators of the fasting and postprandial circulating eCBome tone.

Disclosure

T. Rocheleau: None. L. Amzil: None. T. Mayer: None. N. Leblanc: None. N. Flamand: None. F. Raymond: None. V. Di Marzo: None. A. Veilleux: None.
55-OR: Diabetes Distress among Persons Living with Latent Autoimmune Diabetes of Adults in the Canadian Cohort BETTER—A Cross-Sectional Study
Authors: NEHME MAYA , ISSA MOHAMAD , BRAZEAU ANNE-SOPHIE , LEROUX CATHERINE , HAAG SARAH , ROY-FLEMING AMÉLIE , TALEB NADINE
Published: June 2024

Introduction: Latent autoimmune diabetes of adults (LADA) is known for a slowly progressive autoimmune destruction of beta-cells compared to type 1 diabetes while sharing clinical features with type 2 diabetes. Diabetes distress has not been assessed specifically in persons living with LADA (PwLADA) to address potential gaps in their care.

Objective: Assess diabetes distress experienced by PwLADA and compare it to persons living with type 1 diabetes (PwT1D).

Methods: Cross-sectional analysis of Diabetes Distress Scale DDS-17 filled online in the Canadian BETTER registry; Data was analyzed for 2877 participants; 266 (9%) LADA and 2611 (91%) T1D. A total distress score was calculated then items were organized and scored under four categories: emotional burden, physician distress, regimen distress and interpersonal distress. Scores were classified as low, moderate or high distress, mean item score ≥ 3 as “high distress”; chi-square was used for comparison with T1D.

Results: PwLADA vs PwT1D were 50 ± 13 y.o. vs 40 ± 16 y.o (p<0.001); 67% vs. 64% females (p 0.4); diabetes duration 10 ± 9 vs. 22 ± 15 years (p<0.001). Over half PwLADA experienced high (21%) or moderate (35%) distress according to the total distress score. Peak scores (high & moderate) were detected for emotional burden (51% & 31%); followed by interpersonal distress (19% & 27%), regimen distress (20% & 26%) and physician distress (17% &13%). Scores for all categories were comparable to those reported by PwT1D. We explored factors that could modulate distress level among PwLADA including hypoglycemia, use of technology and HbA1c. Significant differences were detected for higher regimen distress among those with severe hypoglycemia in past year (56% vs 18%, p=0.02) and those with A1c >75 mmol/mol (53% vs 11%, p<0.001).

Conclusion: Diabetes distress is highly prevalent among PwLADA, especially the emotional burden similar to PwT1D. Further research is warranted to design adequate interventions.

Disclosure

M. Nehme: None. M. Issa: None. A. Brazeau: Other Relationship; Dexcom, Inc. Research Support; Canadian Institutes of Health Research, Juvenile Diabetes Research Foundation (JDRF), Diabète québec, Fonds de recherche du Québec en Santé. C. Leroux: None. S. Haag: Other Relationship; Omnipod. A. Roy-Fleming: None. N. Taleb: Other Relationship; Dexcom, Inc. Consultant; Viatris Inc. Other Relationship; Novo Nordisk.

Funding

Funding form the CED-CHUM centre d'Expertise en DiabFte at the Centre de recherche de l'UniversitT de MontrTal
55-PUB: Prevalence and Patterns of Multimorbidity among Elderly Aged 65 and above in the Hainan Island
Authors: ZHU XUELI , GENG YIFAN , YI NING
Published: June 2024

Introduction: Studying multimorbidities in the elderly is vital for improving their health outcomes and quality of life. This study aims to determine the prevalence and patterns of multimorbidity among elderly aged 65 and above living in the Hainan Island.

Methods: This is a cross-sectional study included a total of 1,025,831 participants based on a survey of chronic diseases in the elderly aged 65 and above. Nine chronic disease variables (Hypertension, Diabetes, CHD, Cerebral apoplexy, COPD, Chronic kidney disease, Tumor, Immune defect and Sever disability) were included in the study. Chi-square test and trend chi-square test were used to assess the differences in the prevalence of morbidity and multimorbidity by genders and age. Gephi was used for visualizing the network patterns of associative multimorbidities. Condensation cluster analysis was performed on the multimorbidity network matrix using UCINET.

Results: At least one chronic diseases and two chronic diseases coexisted in 71.28% and 30.54% participants. There is a greater prevalence in women than in men (53.8% vs 46.2%, P < 0.001). The most common combinations of two multimorbidities were hypertension & diabetes (7.78%), hypertension & stroke (2.21%), and hypertension & server disability (2.18%). Condensation cluster analysis revealed that the combined model of multimorbidity could be divided into 3 clusters (Hypertension + Diabetes, CHD + Cerebral apoplexy + COPD + Immune defect + Tumor + Sever disability and Chronic kidney disease ).

Conclusion: Our findings suggest that an integrated strategy of prevention, treatment and management should be developed to target different disease clusters.

Keywords: Multimorbidity; Elderly; Network analysis; Condensed subgroup

Disclosure

X. Zhu: None. Y. Geng: None. N. Yi: None.

Funding

Advanced Talents of Hainan (820RC649)
591-P: Basic Knowledge about Diabetes Mellitus among Nurses in University Hospital of Split
Authors: MAJSTOROVIC HELENA , VLADISLAVIC SILVIJA , MARENDIC MARIO , MILICEVIC MILARDOVIC TANJA , KOKIC MALES VISNJA
Published: June 2024

Objective: The research of basic knowledge about DM was carried out in order to determine the quality of care for patients with diabetes.

Respondents and Methods: The research was conducted among 194 nurses/technicians of the University Hospital of Split. A survey questionnaire (Table 1) was used as a research instrument, which consisted of general data and factors affecting DM, and examination of basic knowledge about DM. The questionnaire consisted 9 questions and lasted 20 minutes, with the presence of the examiner, without any literature or mobile phones.

Results: To the question about the most common cause of death of patients with diabetes, the respondents answered with only 47.94% correct answers. A higher level of knowledge was shown in questions related to HbA1c (87.63%) and the reference value of HbA1c (68.56%). The lowest level of knowledge was observed in terms of the knowledge about the use of insulin (23.71%) and oral hypoglycaemics (35.05%). A higher percentage (55.67%) gave the correct answer to the question about the application of insulin. A statistical analysis of only the correct answers within individual clinics was also processed.

Conclusion: There is an insufficient level of basic knowledge about the use of insulin therapy, the characteristics of oral antidiabetic drugs and patient education about proper nutrition among nurses.

Disclosure

H. Majstorovic: None. S. Vladislavic: None. M. Marendic: None. T. Milicevic Milardovic: Consultant; Abbott. Advisory Panel; AstraZeneca, Boehringer-Ingelheim. Consultant; Novo Nordisk. V. Kokic Males: None.
597-P: Wearable Device Use and Physical Activity among Individuals with Diabetes—The 2022 Health Information National Trends Survey
Authors: LEE MINJUNG , NAM SOOHYUN
Published: June 2024

Introduction & Objective: Wearable devices have demonstrated potential in encouraging physical activity (PA) in the general population. This study is to investigate sociodemographic factors linked to the use of wearable devices and assess the influence of the wearable device use on PA among adults with diabetes.

Methods: Data were extracted from the Health Information National Trend Survey 6, covering from March to November 2022. The study included 1,020 adults with diabetes (the survey did not specify the diabetes types). PA levels were self-reported, and logistic regression was employed to examine factors associated with the use of wearable devices and the achievement of a weekly 150-minute moderate-intensity PA (MPA).

Results: About 57% were female, with a mean age of 62.9 years (SD=13.4) (Non-Hispanic White, 47.7 %; Non-Hispanic Black, 22.3%; Hispanic 21.4%). About 25% reported using wearable devices, and 27% engaged in ≥ 150 minutes of MPA per week. Hispanic respondents exhibited significantly higher wearable device use than Non-Hispanic White respondents (OR 1.73, 95% CI, 1.12-2.67). Individuals with an annual household income ≥ $75,000 (OR 4.23, 95% CI, 2.34-7.63) were 4.23 times more likely to use wearable devices; however, household income levels were not significantly associated with MPA. Females (OR 0.60, 95% CI, 0.43-0.82) and individuals with a body mass index ≥ 30kg/m2 (OR 0.54, 95% CI, 0.40-0.74) were less likely to achieve 150 minutes of MPA per week. Importantly, those utilizing wearable devices were 1.72 times more likely to report ≥ 150 minutes of MPA per week (OR 1.72, 95% CI, 1.21-2.43).

Conclusion: The use of wearable devices may have potential to enhance PA among individuals with diabetes. Future efforts promoting PA should take into account the socioeconomic factors linked to wearable adoption. Also, strategies that ensure the equitable adoption of wearable devices should be explored and discussed for individuals with diabetes.

Disclosure

M. Lee: None. S. Nam: None.

Funding

This study is supported by NIH/NIDDK (5R01DK132069).
604-P: Different Exercise Exposures May Protect against Developmental Programming of MASLD in Male Mice?
Authors: CANTIO EVAN , REGINELLI ELEANORE , HINRICHS HOLLY M. , YOUNG MONICA , THOMPSON MICHAEL
Published: June 2024

Introduction: Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is a chronic liver disease that affects up to a fourth of the adults in the US. Maternal obesogenic diet exposure (MODE) programs worse MASLD in offspring. The beneficial effects of exercise on metabolic disease are well defined. We hypothesized that offspring exercise would mitigate the developmental programming effects of MODE.

Methods: To determine the effect of offspring exercise, male offspring from dams fed chow or High Fat Fructose and Cholesterol (HFFC) diet underwent voluntary exercise. The three exercise conditions include voluntary exercise on a wheel for 3 weeks before (pre exercise) feeding a MASLD-inducing diet, exercise from 3 weeks before and during MASLD-diet feeding (continuous exercise) and sedentary conditions. Body weight and liver weights were measured. Histologic analysis and qPCR was performed to assess disease severity.

Results: Exercise before and during HFFC feeding decreased body weight and liver weight to body weight ratio. Preliminary results show a reduction in steatosis and inflammation in offspring with continued exercise during HFFC feeding. Both pre-exercise alone and continued exercise during HFFC feeding show a trend toward attenuating the increase in fibrosis observed in MODE offspring.

Conclusion: Preliminary data support that exercise may attenuate developmentally programmed worsening of MASLD by MODE. Continual exercise appears to have a greater benefit than pre-exercise alone.

Disclosure

E. Cantio: None. E. Reginelli: None. H.M. Hinrichs: None. M. Young: None. M. Thompson: None.

Funding

National Institute of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health (1R25DK113652)
625-P: Association between Vitamin D Status and Thyroid Function in Individuals with Type 2 Diabetes Mellitus
Authors: WANG XINGCHUN , HUANG YUEYE , QU SHEN
Published: June 2024

Background: More studies have revealed role of vitamin D(VD) in chronic diseases. Our study aimed to investigate its association with thyroid function in Type 2 Diabetes Mellitus(T2DM).

Methods: 730 patients with T2DM were enrolled. Thyroid and VD levels were measured. Patients were divided into lower VD and higher VD groups according to the median. Thyroid function was compared between groups and their association was investigated.

Results: BMI, TCH, TG and FFA were significantly higher in higher VD group than lower VD group (all P<0.05). FT3 was significantly higher while TT4 and TSH were significantly higher in higher VD group than lower VD group (4.45±0.93 vs. 4.95±1.52 pmol/l, P<0.001; 104.84±21.17 vs. 99.99±23.64 nmol/l, P=0.008; 2.88±7.03 vs. 2.06±1.72 mU/l, P=0.046). VD was significantly negatively associated with BMI, HGB, LDL-C and FFA (r=-0.093, P=0.016; r=-0.082, P=0.036; r= -0.099, P=0.011; r= -0.125; P=0.001). VD were significantly positively FT3 and FT4 and negatively associated with TSH (r=0.248, P<0.001; r=0.086, P=0.025; r=-0.080, P=0.033). Adjusted for height, BMI, HGB, TCH, TG, FFA and LDL, FT3 and FT4 were still significantly positive while TSH was still significantly negatively associated with VD (r=0.227, P<0.001; r=0.089, P=0.030; r=-0.081, P=0.049). Liner Regression analysis also showed that VD was significantly associated with FT3 and negatively with TSH (β=4.144, P<0.001; β= -0.412, P=0.020). Logistic regression analysis showed that VD was a protective factor for SCH (OR: 0.987, 95%CI:0.974-0.999, P=0.035) and even adjusted for BMI, FBG, FINS, TCH and HDL (OR: 0.986, 95%CI:0.974-0.999, P=0.041). T2DM patients with SCH had lower VD levels than those without SCH(46.45±4.76 vs. 45.40±5.84nmol/l, P=0.029).

In conclusion, there was a negative relationship between VD and thyroid function in patients with T2DM. T2DM patients with SCH had lower VD levels.

Disclosure

X. Wang: None. Y. Huang: None. S. Qu: None.
64-OR: Continuous Glucose Monitoring among Pregnant Individuals with Glucose Intolerance
Authors: GORDON RACHEL D. , GRASCH JENNIFER , NANDAM NEEHARIKA , WU JIQIANG , SCHNEIDER PATRICK , GABBE STEVEN G. , LANDON MARK B. , COSTANTINE MAGED , VENKATESH KARTIK , BUSCHUR ELIZABETH
Published: June 2024

Introduction & Objective: Glucose intolerance is common in pregnancy but incompletely characterized. We used continuous glucose monitor (CGM)-derived metrics to assess dysglycemia amongst pregnant individuals with a varying levels of glucose intolerance.

Methods: In this prospective observational study, pregnant individuals between 24-32 weeks gestation with no history of pregestational diabetes wore blinded CGM for up to 10 days. Participants were separated into four cohorts: normal 1-hour glucose challenge test (GCT), abnormal GCT and normal 3-hour oral glucose tolerance test (OGTT), abnormal GCT and 1 abnormal value on OGTT, and GDM by Carpenter-Coustan criteria. We calculated summary statistics and tested between-group differences with one-way ANOVA pair-wise comparisons with the prespecified primary outcome of time in range (TIR) within the pregnancy-specific goal of 63-140 mg/dL. We used one-way ANOVA and post-hoc tests for secondary outcomes of average glucose, time hyperglycemic, and coefficient of variation.

Results: Among 71 pregnant individuals at a mean gestational age of 29 weeks, the mean CGM use was 7.6 days. The mean time in range for the normal GCT cohort was 96.6% (95% CI 94.9-97.8%), for failed GCT/normal OGTT was 92.0% (95% CI 89.6-96%), for failed GCT/1 abnormal OGTT value was 91.8% (95% CI 83.7-95.7%), and for GDM was 92.6% (95% CI 83.9-97.9%). Normal GCT TIR was significantly different from failed GCT and 1 abnormal OGTT (p=0.04) and GDM (p= 0.04); no other pairwise comparisons of TIR were significantly different. There were no significant between-group differences for average glucose (p= 0.31), time hyperglycemic (p= 0.17), and coefficient of variation (p= 0.10).

Conclusion: Pregnant individuals with 1 abnormal OGTT value had similar TIR as those with a diagnosis of GDM. Further research is needed to determine if these individuals have clinically significant dysglycemia associated with adverse pregnancy outcomes that requires monitoring and intervention.

Disclosure

R.D. Gordon: None. J. Grasch: None. N. Nandam: Other Relationship; American Journal of Managed Care. J. Wu: None. P. Schneider: None. S.G. Gabbe: None. M.B. Landon: None. M. Costantine: None. K. Venkatesh: None. E. Buschur: Research Support; Dexcom, Inc.
647-P: Outcomes Associated with the Medicare Diabetes Prevention Program
Authors: GAO DE , ELY ELIZABETH , LANDAU ERIN O.
Published: June 2024

Introduction & Objective: The National Diabetes Prevention Program lifestyle change program (LCP) is an evidence-based behavior change intervention to prevent or delay type 2 diabetes among adults at high risk for type 2 diabetes. In 2018, the Centers for Medicare & Medicaid Services (CMS) began approving Centers for Disease Control and Prevention (CDC)-recognized organizations to deliver the Medicare Diabetes Prevention Program (MDPP) to eligible Medicare enrollees with prediabetes.

Methods: This study compares outcomes for adults aged 65+ enrolled in the LCP in approved MDPP suppliers to those of adults aged 65+ enrolled in non-suppliers. The analysis used data submitted to CDC by organizations delivering the LCP from 23,579 participants who had the opportunity to complete the program on or before 08/31/2023 (n=2,324 MDPP; n=21,255 non-MDPP).

Results: Among MDPP participants, 62.0% met the 5% programmatic weight loss goal, compared to 55.0% of non-MDPP participants (p<.001). Among female MDPP participants, 60.6% (n=1,034) met the goal, compared to 54.3% (n=8,680) of non-MDPP female participants (p<.001). Among male MDPP participants, 66.4% (n=395) met the goal, compared to 57.1% (n=2,944) of non-MDPP male participants (p<.001). Overall, mean weight loss among MDPP participants was 7.0% (SD=5.7) and 6.3% (SD=6.0) for non-MDPP participants. Across all race and ethnicity groups, at least 50% of MDPP participants met the 5% weight loss goal, ranging from 50.0% to 66.7%. MDPP participants attended a mean of 19 (SD=7.7) of the minimum required 22 sessions, while non-MDPP participants attended a mean of 17 (SD=10.7).

Conclusion: While Medicare-age adults enrolled in the LCP are meeting programmatic weight loss goals, those enrolled in the MDPP are doing so at a higher rate. MDPP participants are also attending more sessions on average than non-MDPP participants. Scaling the MDPP so that more Medicare beneficiaries have access to the LCP may help in lowering the risk of developing type 2 diabetes among this population.

Disclosure

D. Gao: None. E. Ely: None. E.O. Landau: None.
65-OR: Continuous Glucose Monitoring Metrics and Suboptimal Pregnancy Outcomes in Women with Gestational Diabetes—Secondary Analysis of the DiGest Trial
Authors: KUSINSKI LAURA C. , JONES DANIELLE , ATTA NOORIA , TURNER ELIZABETH , OUDE GRIEP LINDA M. , RENNIE KIRSTEN L. , DE LUCIA ROLFE EMANUELLA , MURPHY HELEN R. , TAYLOR ROY , MEEK CLAIRE L.
Published: June 2024

Background: Continuous glucose monitoring (CGM) is increasingly used in gestational diabetes but the optimal metrics and targets in this population are undefined. We assessed if CGM metrics were associated with pregnancy outcomes in gestational diabetes.

Methods: 432 women with gestational diabetes (BMI >25 kg/m2) received a dietary intervention (DiGest trial; ISRCTN; 37866), with masked CGM (Dexcom G6) at 29 (n=332) and 36wks (n=225) respectively. We used logistic regression, adjusted for trial arm, to assess the associations between standardized CGM metrics and pregnancy outcomes, including preeclampsia, preterm delivery, large-for-gestational-age (LGA), admission to the neonatal intensive care unit (NICU) and neonatal hypoglycemia. Time in range (TIR) was defined using 63-120 mg/dl.

Results: At 29wks, mean glucose, TIR and time-above-range (TAR) were significantly associated with multiple outcomes, including pre-eclampsia, LGA, NICU admission and neonatal hypoglycemia (table 1). TIR and TAR recalculated using range 63-140mg/dl (3.5-7.8 mmol/l) performed similarly. Glucose SD at 29 and 36wks was significantly associated with LGA. Time-below-range at 36wks was associated with neonatal hypoglycemia (table 1).

Conclusions: CGM metrics are strong predictors of multiple relevant pregnancy outcomes in gestational diabetes.

Disclosure

L.C. Kusinski: None. D. Jones: None. N. Atta: None. E. Turner: None. L.M. Oude Griep: None. K.L. Rennie: None. E. De Lucia Rolfe: None. H.R. Murphy: Advisory Panel; Medtronic. Research Support; Abbott, Dexcom, Inc. Speaker's Bureau; Ypsomed AG, Eli Lilly and Company, Dexcom, Inc. R. Taylor: Advisory Panel; Fast800. C.L. Meek: Research Support; Dexcom, Inc.

Funding

Diabetes UK 17/0005712EFSD - NNF NNF19SA058974
651-P: Group Matching Preferences for Emerging Adults with Type 1 Diabetes
Authors: RODRIGUEZ GONZALES BRUNO , ALLEN NANCY A. , IACOB ELI , BLANCHETTE JULIA E. , MARIE MORAITIS ANN , SHAH NAZEEN , LITCHMAN MICHELLE L.
Published: June 2024

Introduction & Objective: D-COPES (Diabetes - Connecting Online Peers to Enhance Support) is a social support intervention that matches emerging adults (EA) into small groups led by a trained peer connector (PC) who engage virtually over 12 weeks. The purpose of this pilot was to evaluate the process for matching EA to PC.

Methods: Pre-intervention, EA and PC completed a matching survey consisting of diabetes and personal characteristics and priority matching preferences. The research team manually matched EA to PC across three separate cohorts. Cohort 1 matched on characteristics and preferences. Cohort 2 matched on availability, then characteristics and preferences. Cohort 3 matched on availability, EA’s prioritization rating of their preferred PC, then characteristics and preferences. Post-intervention, a subset of EA from each cohort were interviewed about group matching satisfaction.

Results: A total of 83 EA were part of the intervention group. EA were primarily female (59%), non-Hispanic (90.4%), and white (91.6%) and 33.7% identified as a sexual gender minority. The three cohorts had 20, 36, and 27 EA respectively that were matched into 14 groups. EA most frequently endorsed the following matching preferences for demographic and diabetes characteristics: similar age (67.5%), similar life stage (50.6%), gender (24.1%), use of continuous glucose monitoring (65.1%), insulin pump use (49.4%), cooks at home (33.7%), and moderate-high endurance exercise (32.5%). Interviewed EA (n=14) reported matching well to their PC and group. EA preferred similarities in personal characteristics over diabetes characteristics. Only one EA requested a group change, reporting a mismatch with the PC. No differences were found between cohorts with attendance or retention and matching on availability or rating of the PC.

Conclusion: These results suggest prioritizing EA to PC matching on personal characteristics to support successful group matches. Processes to automate matching are needed to support larger studies.

Disclosure

B. Rodriguez Gonzales: None. N.A. Allen: Research Support; Dexcom, Inc. Consultant; Diathrive Health. E. Iacob: None. J.E. Blanchette: Speaker's Bureau; Insulet Corporation. Board Member; Juvenile Diabetes Research Foundation (JDRF). Research Support; American Heart Association, Association of Diabetes Care & Education Specialists, National Institute of Diabetes and Digestive and Kidney Diseases, Leona M. and Harry B. Helmsley Charitable Trust. Advisory Panel; LifeScan Diabetes Institute. Consultant; WellDoc. Advisory Panel; Cardinal Health/Edgepark. A. Moraitis: None. N. Shah: None. M.L. Litchman: Research Support; American Diabetes Association, Association of Diabetes Care & Education Specialists, Dexcom, Inc. Other Relationship; Association of Diabetes Care & Education Specialists. Research Support; National Institutes of Health.

Funding

Franklin S. Ivory and Rachael C. Ivory Foundation
66-OR: Using Continuous Glucose Monitoring to Identify Neonatal Hypoglycemia following Gestational Diabetes—The DiGest Newborn Study
Authors: JONES DANIELLE , THOMSON LYNN , KUSINSKI LAURA C. , BEARDSALL KATHRYN , MEEK CLAIRE L.
Published: June 2024

Introduction: Offspring exposed to intrauterine hyperglycemia are at risk of neonatal hypoglycemia (NH) and associated neurocognitive dysfunction in later life. As prevalence of gestational diabetes increases, early identification and treatment of NH is crucial to avoid long-term sequelae. We assessed the efficacy of current perinatal guidelines to identify NH using continuous glucose monitoring (CGM) in neonates.

Methods: Pregnant women with gestational diabetes from the DiGest trial (ISRCTN; 37866) were recruited to wear a masked Dexcom G6 CGM device intrapartum. Masked CGM was also sited on the infant thigh within 4 hours of life. NH was defined as glucose <47 mg/dL (2.6 mmol/L), with a target glucose range of 47-180 mg/dL (2.6-10.0 mmol/L).

Results: 13 mother-infant dyads with paired data were included in this analysis. Maternal characteristics were: white (62%), mean (SD) age 32.3 (5.8) years, mean (SD) booking BMI 32.1 (4.8) kg/m2 and Caesarean section delivery (69%) at mean (SD) 38.9 (0.6) weeks gestation. Neonates (69% male, Apgars >9) wore CGM for mean (SD) 3.9 (1.9) days with mean percent time below range (TBR) 2.8 (5.6)%, and a mean (SD) glucose 91.8 (19.8) mg/dL (5.1 (1.1) mmol/L). CGM identified periods of suspected NH which were not detected clinically with standard monitoring and were identified after the first 24 hours of life, outside of typical monitoring periods. CGM was well tolerated by mothers and neonates.

Conclusions: CGM may offer novel opportunities to improve the identification of NH following gestational diabetes.

Disclosure

D. Jones: None. L. Thomson: None. L.C. Kusinski: None. K. Beardsall: None. C.L. Meek: Research Support; Dexcom, Inc.
660-P: Participant Retention in the National Diabetes Prevention Program Lifestyle Change Program
Authors: ELY ELIZABETH , CARSTENSEN BENDIX
Published: June 2024

Introduction & Objective: Since 2012, the Centers for Disease Control and Prevention (CDC) has recognized organizations, through the Diabetes Prevention Recognition Program, that deliver the National Diabetes Prevention Program lifestyle change program (LCP) and achieve specific metrics. Organizations enroll adults at high risk for type 2 diabetes and submit data to CDC for evaluation.

Methods: Because data have shown that retention is key to achieving outcomes that reduce risk of type 2 diabetes, we used a Cox model to compute hazard ratios (HR) of early dropout and survival curves for being retained in the program using data from 403,392 adults who enrolled 1/1/2012-8/31/2022. The model included sex, race/ethnicity, and age, and time in the program was censored at day 274. The racial/ethnic groups American Indian/Alaska Native, Asian/Asian American, Native Hawaiian/other Pacific Islander, and Multiracial were combined due to small numbers (5.3% of total). Analysis was limited to in-person and online programs.

Results: We saw no difference in dropout rates for men vs. women in in-person programs across racial/ethnic groups; for online programs, the men to women HRs were between 1.08 and 1.17. Among men in in-person programs who reported race/ethnicity, the largest HR was found for those who identified as Hispanic/Latino vs. White (1.46). Regarding men in online programs, this was the only comparison where a racial/ethnic difference was seen (1.04). Dropout rates for women in in-person programs were different between all racial/ethnic groups except those who identified as Other vs. White. The largest HR was for those who identified as Hispanic/Latino vs. White (1.29). Women in online programs who identified as Black/African American or Other had lower rates than White women, both with HRs of 0.98.

Conclusion: As we strive to retain participants in the LCP to maximize reducing risk of type 2 diabetes, our data predicting retention for different populations may allow for more focused coaching.

Disclosure

E. Ely: None. B. Carstensen: Stock/Shareholder; Novo Nordisk.
662-P: Type 1 Diabetes (T1D) Medical Providers' Perceptions of a Video to Bring Awareness to Diabetes Stigmatizing Language
Authors: JOINER KEVIN , AGAPIOU ALEXANDRA , ELJAHMI SARAH A. , PIATT GRETCHEN
Published: June 2024

Introduction & Objective: Language guidelines state that when medical providers use certain language in encounters with adults with type 1 diabetes (T1D), they contribute to diabetes stigma and other language might be preferred. A team at the University of Michigan created a video in consultation with a leader of the language matters movement, which shows the difference between a clinical encounter when diabetes stigmatizing language is used and the same clinical encounter when preferred language is used. The purpose was to explore the acceptability of this video in a sample of medical providers who care for adults with T1D.

Methods: Nurse practitioners, physicians, and physician assistants were invited to participate using snowball sampling. Participants (n=16; 56% aged 30-39 yrs., 94% female, 56% non-Hispanic White, 56% physicians) viewed the video, and were interviewed via Zoom. The transcriptions were analyzed using a qualitative descriptive approach.

Results: Four themes emerged from the data: (1) the juxtaposition of the diabetes stigmatizing language and the preferred language aligns with values of empathy and respect, (2) the language used by medical providers is central to building and maintaining therapeutic relationships, (3) medical providers play an outsized role in determining the culture of outpatient settings, and (4) systemic issues (e.g., time constraints) exacerbate and provoke the use of diabetes stigmatizing language. The majority indicated that the video brings awareness to diabetes stigmatizing language (87%), that they planned to make a personal practice change after viewing the video (69%), and that raising awareness about diabetes stigmatizing language among medical providers is important (100%).

Conclusion: The results suggest that the video brings awareness to diabetes stigmatizing language among medical providers who provide care for adults with T1D. Future research to pilot the video as part of an intervention is warranted.

Disclosure

K. Joiner: None. A. Agapiou: None. S.A. Eljahmi: None. G. Piatt: None.
676-P: Associations between Individual Characteristics and Diabetes Self-Care among Black and White Women
Authors: BURCH ASHLEY , JACOBS MOLLY M.
Published: June 2024

Introduction & Objective: Evidence-based guidelines recommend several practices to facilitate diabetes management. This study explored the association between individual characteristics and diabetes care behaviors among Black and White women.

Methods: Cross sectional data from the 2018-2022 Behavioral Risk Factor Surveillance System were pooled yielding a sample of 149,706 women with diabetes. Logistic regression models evaluated the association between individual level characteristics and the likelihood of having an annual healthcare visit, taking a diabetes education course, and checking feet at least once a day.

Results: White women living in an urban area and currently employed were less likely to have an annual healthcare visit within the last year. For Black women, being employed was associated with not having taken a diabetes education course. A daily diabetes-related self-care behavior, checking feet for sores or irritations, was less likely among Black women who were high school graduates and White women with a higher income and those who were employed.

Conclusion: Results suggest that employment may be a barrier to diabetes management among both Black and White women. Offering virtual diabetes education courses and opportunities for annual visits outside of traditional office hours could benefit women with diabetes who are members of the workforce.

Disclosure

A. Burch: None. M.M. Jacobs: None.
685-P: Digital Platform Users Taking GLP-1 and Managing Diabetes Adapt Lifestyle Behavior Change over Twelve Months
Authors: HERSHCOVITZ YIFAT , BREUER ASHER INBAR , MANEJWALA OMAR
Published: June 2024

Glucagon-like peptide 1 (GLP-1) agonists improve blood glucose (BG) in adults with type 2 diabetes (T2D) along with diet and exercise modifications. Dario, a digital health platform, may assist in supporting these users with needed lifestyle changes. This study followed behavior change in users utilizing a new “medication cabinet” feature for medication logging and were identified as existing GLP-1 users, versus non-GLP-1 users. The purpose of the study was to investigate monthly activities over twelve months of using a digital platform in GLP-1 users versus non-GLP-1 Metformin users. A retrospective data analysis was performed on early users of “medication cabinet” with T2D and prediabetes who measured their Blood glucose (BG) at months 1,3,6,9,12. The GLP-1 group included users who reported taking GLP-1 and non-GLP-1 group reported taking metformin. A piecewise mixed effects model was applied to follow monthly average BG and lifestyle digital activities (logging meal/reference, carbohydrate intake and calories burned). A cohort of 107 users was evaluated: GLP-1 (N=35) and non GLP-1 users (N=72). The groups were statistically equivalent in baseline average BG (150 vs. 152 mg/dL) and monthly average BG measurements (31.3 vs 30.5). GLP-1 users showed significant reduction in BG at months 1-5 (p=0.02) maintained throughout the year. GLP-1 and non-GLP-1 users both demonstrated a statistically significant increase in lifestyle activities during their first three months (p<0.001, p=0.02 respectively) maintained for a year. Moreover, mixed-effects model revealed a statistically significant increase in monthly average weight measurements over the year among GLP-1 users (p<0.001). Lifestyle monitoring components in a metabolic digital disease management solution have the potential to drive behavior change and enhance clinical care among users taking GLP-1 medications. These lifestyle changes may be important in driving outcomes in users taking GLP-1 medications.

Disclosure

Y. Hershcovitz: Employee; DarioHealth Corp. I. Breuer Asher: None. O. Manejwala: Employee; DarioHealth Corp. Stock/Shareholder; DarioHealth Corp.
686-P: Prevalence and Determinants of Diabetes Distress in Type 2 Diabetes Patients in India—A Cross-Sectional Study
Authors: TRIPATHI PRAMOD , KADAM NIDHI S. , SHARMA BABY , KULKARNI POURNIMA , DAS BISWAS MAYURIKA , GANLA MALHAR H. , HIREMATH MAMATA , SABOO BANSHI D.
Published: June 2024

Background: Research suggests a mutual relationship between type 2 diabetes (T2D) and mental health concerns. It is estimated that one in ten individuals with T2D experience severe distress.

Aim: To examine the prevalence and determinants of diabetes distress in T2D patients in India.

Materials and Methods: This cross-sectional study included patients enrolled in a one-year online diabetes management program conducted at the Freedom from Diabetes Clinic in Pune, India, between June 2023 and November 2023. Data on the medical history, anthropometry, and biochemical parameters were collected. The combined type 2 Diabetes Distress Assessment System (T2-DDAS) was used to assess diabetes distress. Regression analysis was used to identify the predictors of diabetes distress.

Results: This cross-sectional study included 144 patients with T2D (14 pre-diabetes) (49.3% female). The mean age, duration of diabetes, and HbA1c were 50.9±10.8 years, 8.1±7.1 years, and 8.3±1.9%, respectively. The prevalence of diabetes distress (score => 2) was 62.5%. Of the patients with diabetes distress, 72.2% reported multiple elevated sources, with long-term health (70.1%) and management demands (70.8%) being the top two sources. Regression analysis revealed that a longer duration of diabetes (>5 years), a family history of diabetes, and comorbid hypertension were predictors of diabetes distress.

Conclusion: The study revealed a high prevalence of diabetes distress at 62.5%, with factors like longer diabetes duration, family history, and hypertension as predictors. Targeted interventions addressing psychological well-being in T2D patients, especially those with specific risk factors, are needed to improve health outcomes and manage diabetes-related distress.

Keywords: Diabetes Distress; Type 2 Diabetes; Mental health; India; cross-sectional study

Disclosure

P. Tripathi: None. N.S. Kadam: None. B. Sharma: None. P. Kulkarni: None. M. Das Biswas: None. M.H. Ganla: None. M. Hiremath: None. B.D. Saboo: None.