bluuebunny/crossref_metadata_2025 huggingface dataset:
907-P: The Effect of Imeglimin on Glycemic Management in Japanese Patients with Type 2 Diabetes
Authors: MATSUHASHI YUKI , ABE TAKAHIRO , FUJITA TOMOYUKI , CHIKAZAWA SHINJI , FUJITA YUKIHIRO
Published: June 2024

Background: Imeglimin exerts hypoglycemic actions by stimulating insulin secretion in a glucose concentration-dependent manner and by improving insulin resistance. We evaluated the effects of imeglimin on glycemic management, insulin secretion, body weight(BW) and composition in Japanese patients with type 2 diabetes.

Subjects and Methods: Patients with inadequate glycemic control(HbA1c >7.0%), treated with diet/exercise or oral antidiabetic drugs(OADs) in our outpatient clinic, were eligible. Height, BW and composition were measured and body mass index(BMI) was calculated. Diabetic complications were assessed. HbA1c(A1c), fasting plasma glucose(FPG), and C-peptide(CPR) were measured. CPR-to-glucose ratio(CPR[ng/ml] / glucose[mg/dl] x100: CPR-index) was calculated. Imeglimin 2000mg was administrated without changing the treatment. The change in A1c(ΔA1c), BW, liver function and other items after administration(6 months) were examined with paired t-test, simple and multiple regression analysis. Patients were classified into 4 groups by BMI and CPR-index before imeglimin administration, ΔA1c was evaluated with ANOVA. Data was expressed as mean±SD.

Results: Background of 32 patients(17 male) were as follows: age 60.8±11.9yo, BMI 26.3±5.1kg/m2. OADs(number) were DPP-4i(27), SGLT2i(24), metformin(22), AGi(7) and glinides(4)(overlapped). A1c was significantly decreased(7.5±0.6→6.9±0.7%, p<0.05). FPG and ALT were also decreased, and CPR-index was increased significantly. BW, BMI and body fat mass(BFM) were decreased, but lean body mass was not changed significantly. Simple regression analysis showed that ΔA1c was significantly correlated with AST and ALT, but not with A1c, BMI, CPR-index and other measured items. Noteworthy A1c was significantly decreased in BMI<32 and CPR-index >0.8 group(ΔA1c -0.7±0.3%, p<0.05 vs other 3 groups).

Conclusions: Imeglimin increased insulin secretion, decreased BW and BFM, improved liver function and glycemic management.

Disclosure

Y. Matsuhashi: None. T. Abe: None. T. Fujita: None. S. Chikazawa: None. Y. Fujita: None.
912-P: Kidney and Cardiovascular Effectiveness of SGLT2 Inhibitors Compared with GLP-1 Receptor Agonists in Patients with Type 2 Diabetes
Authors: EDMONSTON DANIEL , MULDER HILLARY , LYDON ELIZABETH , CHISWELL KAREN , LAMPRON ZACHARY , SHAY CHRISTINA M. , MARSOLO KEITH , BOSWORTH HAYDEN B. , PAGIDIPATI NEHA
Published: June 2024

Introduction & Objective: In placebo-controlled trials, SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP1RA) improve kidney and cardiovascular outcomes. However, direct comparisons are lacking.

Methods: We analyzed EHR data from 20 US health systems that contribute to PCORnet. Using propensity scores and overlap weighting, we compared kidney and cardiovascular outcomes for initiators of SGLT2i and GLP1RA with type 2 diabetes between 2015-2020. The primary kidney outcome was a composite of 40% eGFR decline, incident ESKD, or all-cause mortality over 2 years or until censoring. We also examined cardiovascular and safety outcomes.

Results: Over a median of 1.2 years, risk for the primary outcome did not differ between the 35,004 SGLT2i and 47,268 GLP1RA initiators, though SGLT2i initiation was associated with lower risk of 40% eGFR decline (Table). Risks for mortality, cardiovascular outcomes, and most safety outcomes did not differ between groups, though genital mycotic infections were more common for SGLT2i initiators. Results were similar in patients with and without CKD.

Conclusion: In a large, real-world population with type 2 diabetes, risk for a composite kidney outcome, all-cause mortality, or cardiovascular outcomes was similar between initiators of SGLT2i and GLP1RA, though SGLT2i initiation was associated with a lower risk of 40% eGFR decline.

Disclosure

D. Edmonston: None. H. Mulder: None. E. Lydon: None. K. Chiswell: None. Z. Lampron: None. C.M. Shay: Employee; Boehringer-Ingelheim. K. Marsolo: Research Support; Boehringer-Ingelheim, Amgen Inc., Bayer Inc., Bristol-Myers Squibb Company, Novartis Pharmaceuticals Corporation, Seqirus, Genentech, Inc., Pfizer Inc. H.B. Bosworth: Research Support; BeBetter Therapeutics, Boehringer-Ingelheim, Improved Patient Outcomes, ESPERION Therapeutics, Inc., Novo Nordisk, Otsuka America Pharmaceutical, Inc., Sanofi, National Institutes of Health, Veterans Administration, elton john foundation. N. Pagidipati: Research Support; Alnylam Pharmaceuticals, Inc., Amgen Inc., Eli Lilly and Company. Consultant; ESPERION Therapeutics, Inc., AstraZeneca. Research Support; Boehringer-Ingelheim, Novartis AG, Novo Nordisk. Consultant; CRISPR Therapeutics. Research Support; Bayer Inc., Merck & Co., Inc. Consultant; Merck & Co., Inc., Boehringer-Ingelheim, Novo Nordisk, Bayer Inc., Novartis Pharmaceuticals Corporation. Other Relationship; Janssen Pharmaceuticals, Inc., Novartis Pharmaceuticals Corporation.

Funding

Boehringer Ingelheim
913-P: Risk of Dementia in Diabetes Patients Aged Less than 70 Years Initiating Sodium–Glucose Cotransporter-2 Inhibitor vs. Dipeptidyl-Peptidase-4 Inhibitor
Authors: SHIN ANNA , KYUNG KOO BO , LEE JUN-YOUNG , HA KANG EUN
Published: June 2024

Objective: To compare the risk of dementia associated with sodium glucose co-transporter 2 inhibitor (SGLT2i) versus dipeptidyl peptidase 4 inhibitor (DPP4i) among relatively young patients with type 2 diabetes (T2DM) patients.

Methods: We conducted a population-based cohort study using 2010-2021 Korea National Health Insurance Service database on T2DM patients aged ≥40 and ≤70 years initiating SGLT2i versus DPP4i. The primary outcome was new onset dementia based on diagnosis codes. Secondary outcomes were dementia requiring medications, individual types of dementia, genital infection (positive control), and osteoarthritis encounter (negative control). We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Fine-Gray models adjusting for competing risk of death, after a 1:1 ratio propensity-score (PS) matching for >110 potential baseline confounders. Subgroup analyses were done by age, sex, concurrent metformin use, and baseline cardiovascular risk.

Results: 110,885 PS-matched pairs of SGLT2i and DPP4i initiators were included. The mean follow-up time (standard deviation) were 670 days (650) with 1,172 new cases of dementia. The incidence rate was 0.22 in SGLT2i initiators and 0.35 in DPP4i initiators per 100 person-years, with the corresponding HR (95% CI) of 0.65 (0.57-0.73) for dementia, 0.57 (0.49-0.67) for dementia with medications, 0.63 (95% CI 0.55-0.72) for Alzheimer dementia, and 0.53 (95% CI 0.36-0.77) for vascular dementia. We observed a 2.45 times risk of genital infection with SGLT2i and near-null association for osteoarthritis encounter. The benefits were consistent across subgroups, and after accounting for lag times, but greater beyond than within 2 years of treatment.

Conclusion: Among patients with T2DM, SGLT2i may reduce the risk of dementia.

Disclosure

A. Shin: None. B. Koo: None. J. Lee: None. E. Kang: None.

Funding

This study was supported by the grant from the Korea Health Industry Development Institute (KHIDI)-AZ Diabetes Research Program (#08-2022-0261).
932-P: Clinical Efficacy, Safety, and Tolerability of Single-Pill Combination of Dapagliflozin and Linagliptin in Uncontrolled Indian Type 2 Diabetes Mellitus Patients—A Randomized Double-Blind Study
Authors: AHMAD JAMAL , GHOSH SAYAN , KUMTHEKAR PRASHANT P. , UPADHYAY MIHIR R. , SONAWANE KUNAL S. , KHALSE MANEESHA , PATEL KAMLESH
Published: June 2024

Introduction: While Dapagliflozin and Linagliptin are known for robust glycaemic efficacy T2DM patients when used individually, although it remained unknown whether their combined use is associated with further improved efficacy, safety and tolerability in Indian scenario.

Objective: To determine whether Dapagliflozin 10mg-Linagliptin 5mg (group 1) is associated with an improved glycemia compared with Linagliptin (group 2) alone in uncontrolled on metformin monotherapy.

Method: In a Phase 3, randomized, double blind, active-controlled, double dummy study, a total of 232 T2DM patients on stable dose of metformin were randomized to a group 1 and 2 for 16 weeks. The endpoints included were mean change in glycemic and metabolic parameters. Statistical analysis was conducted using SAS 9.4.

Results: At baseline, mean (SD) for age, weight, BMI was 46.5 (10.52) years, 62.17 (7.57) kg and 23.76 (2.61) kg/m2. At end of 16 weeks, mean reductions in HbA1c (±SE) in group 1 was -1.36 ±0.05 % with difference in mean (SE) -0.44 (95% CI -0.59 to -0.29) %, in FPG -25.90 (1.23) %, 2-hr PPG -52.41 (2.29)% was reported from baseline. About 49% subjects achieved therapeutic glycaemic response in group 1 compared to 26% of group 2 and modest weight reduction from baseline was observed (LSM (SE) -1.34 (0.07) kg in group 1 with mean difference of -0.93 (0.1) kg. AEs reported were twelve in group 1 and ten in group 2, which were mild-moderate in nature.

Conclusion: Dapagliflozin-Linagliptin combination provided superior glycemic control with good tolerability and safety profile in Indian T2DM patients uncontrolled on metformin monotherapy.

Disclosure

J. Ahmad: None. S. Ghosh: None. P.P. Kumthekar: None. M.R. Upadhyay: None. K.S. Sonawane: None. M. Khalse: Employee; Lupin Limited. K. Patel: None.
935-P: Cardiovascular and Mortality Outcomes with SGLT2 Inhibitors in Patients with Atrial Fibrillation and Type 2 Diabetes
Authors: HUN KIM SO , CHO YONGIN , HEA SEO DA , KIM YOUNGJOON , PARK MINAE , JU SUH YOUNG , SHIN SUNG-HEE
Published: June 2024

Introduction & Objective: Sodium glucose cotransporter 2 (SGLT2) inhibitors have shown clinical benefits in patients with heart failure (HF), chronic kindey disease and type 2 diabetes(T2DM). However, limited data exist on their effects on clinical outcomes in patients with AF and T2DM.

Methods: We conducted a retrospective cohort study using the National Health Insurance Service database of Korea. A total of 4,771 patients with T2DM and AF who were newly prescribed SGLT2 inhibitors or DPP4 inhibitors were selected and matched by propensity score in a 1:2 ratio. The effect of SGLT2 inhibitors on the composite outcome of either HF hospitalization or death compared with DPP4 inhibitors were examined. Consistency of the drug effect on the primary outcome in subgroups and the effect of SGLT2 inhibitor according to follow-up period after the time of initiation were analyzed.

Results: Over a median follow-up of 31 months, SGLT2 inhibitors showed a lower risk of hospitalizations for HF or death compared to use of DPP4 inhibitors (HR 0.61; 95% CI 0.44-0.85; P=0.004). SGLT2 inhibitor use was also associated with a lower risk of mortality (HR 0.61; 95% CI 0.39-0.94; P=0.025). SGLT2 inhibitors were associated with a lower risk of HF hospitalization or mortality regardless of prior ASCVD or HF history. Patients with SGLT2 inhibitors demonstrated a significantly lower risk of primary outcome from 90 days after initiating the drug to the third year, as compared with those with DPP4 inhibitors (P<0.05).

Conclusion: In a nationwide cohort of patients with T2DM and AF, SGLT2 inhibitors showed a lower risk of mortality compared to DPP4 inhibitors. This may support the use of SGLT2 inhibitors as the first-line antidiabetic medication in patients with T2DM and AF to prevent adverse outcomes.

Disclosure

S. Kim: None. Y. Cho: None. D. Seo: None. Y. Kim: None. M. Park: None. Y. Suh: None. S. Shin: None.

Funding

Inha University
949-P: Android Artificial Pancreas System Use among Patients with Type 1 Diabetes Mellitus in China—A Real-World Study
Authors: LEI MENGYUN , LING PING , NI YING , ZENG XIFENG , YANG DAIZHI , DENG HONGRONG , YANG XUBIN , XU WEN , YAN JINHUA
Published: June 2024

Objective: The real-world study aimed to investigate the current status of Android artificial pancreas system (APS) use among patients with type 1 diabetes mellitus (T1DM) in China, where market-approved commercial APS is unavailable.

Methods: The healthcare providers of China’s largest online T1DM community (TTQ) helped build up AndroidAPS using a compatible insulin pump, real-time continuous glucose monitoring (CGM), and a heuristic-based algorithm. Patients with T1DM who used AndroidAPS for at least 3 months between January 2020 and July 2023 were included. The baseline data and main glycemic metrics during the last 3 months after using AndroidAPS were collected.

Results: We included 191 patients (56 non-adults and 135 adults) with a median age of 24.80 (15.83, 32.74) yrs, T1DM duration of 6.01(1.63,8.58) yrs, and body mass index (BMI) of 20.74(18.51,22.34) kg/m2. The duration of APS use was 153(114.00,206.00) days. After using AndroidAPS, HbA1c was decreased from 7.1(6.4,8.5) % to 6.3(5.6,6.8) % (p<0.001). The median 24-hour time in range (TIR,70-180mg/dL), time above range (TAR,>180mg/dL), time below range (TBR, <70mg/dL), TBR(<54mg/dL), and glucose management indicator were 81.40(71.99,87.10) %, 13.55(7.20,22.37) %, 4.06(2.63,6.28) %, 0.42(0.20,0.87) %, and 6.45(6.09,6.78) %, respectively. The median overnight TIR, TAR, TBR (<70mg/dL), and TBR(<54mg/dL) were 85.42(77.87,91.87) %, 8.00(3.45,16.52) %, 3.82(2.00,6.44) %, and 0.39(0.11,0.95) %, respectively. A total of 155 patients achieved the recommended TIR of 70%, and 66 achieved TIR, TAR, and TBR targets simultaneously. Multiple linear regression revealed age (β=0.285, p<0.01) and duration of APS use (β=-0.167, p<0.05) as determinants of 24-hour TIR after adjusting gender, duration, BMI, and baseline HbA1c (R2=0.13, p<0.01).

Conclusion: Our study confirmed the efficacy and safety of AndroidAPS on glycemic control among Chinese patients with T1DM, especially at nighttime.

Disclosure

M. Lei: None. P. Ling: None. Y. Ni: None. X. Zeng: None. D. Yang: None. H. Deng: None. X. Yang: None. W. Xu: None. J. Yan: None.

Funding

the Science and Technology Planning Project of Guangzhou (202102010154) and the Diabetes Mellitus Research Fund Program from Shanghai Medical and Health Development Foundation (DMRFP_II_14 from SHMHDF)
952-P: What Happens When People Don’t Bolus for Extended Periods of Time while Using the t:slim X2 with Control-IQ Technology?
Authors: POLIN MIRANDA , JOHNSON ANDREW K. , MESSER LAUREL H. , PINSKER JORDAN E. , CONSTANTIN ALEXANDRA
Published: June 2024

Objective: The t:slim X2 with Control-IQ technology (CIQ) predicts future hyperglycemia and delivers automatic correction boluses to help improve time-in-range (TIR, 70-180 mg/dl). This is thought to help improve glycemia when users do not initiate boluses for meals. The purpose of this analysis is to determine glycemic results in users who do not bolus for prolonged periods of time.

Methods: Data were analyzed from the Tandem Diabetes Care t:connect database for CIQ users from January 2020 to December 2023. Users were included for analysis if they had a minimum of 7/ 14/ 30/ 182 days without a carbohydrate bolus and ≤ 1 manual bolus. Time in range (TIR) and time-below-range (TBR, <70 mg/dl) were analyzed on days without bolusing compared to days with user-initiated boluses.

Results: Out of 291,769 CIQ users, 28,790 (10% users) had used the system for 7+ consecutive days without bolusing. The average number of days without boluses was 61 per user. There were a total of 1,728,304 days without boluses in the database. 27,688 users had periods of 7-13 consecutive days without user-initiated boluses. 11,127 users had periods of 14-29 consecutive days without user-initiated boluses. 3,813 users had periods of 30-181 consecutive days without user-initiated boluses. And 102 users had periods of more than 6 months of consecutive days without user-initiated boluses. On days without boluses, median TIR was 62% (IQR 50-74%) in all four groups, whereas median TIR for days with boluses was 57%-60% (IQR 46-70%). The TBR was less than 0.6% for both days without boluses and days with boluses.

Conclusion: Users of Control-IQ technology who do not bolus for extended periods of time have slightly higher TIR on days when they do not bolus compared to days when they take manual boluses, with no increase in hypoglycemia. This is likely due to myriad reasons, including that the CIQ system can attenuate hyperglycemia enough to be acceptable for a subset of users who struggle with consistent bolusing.

Disclosure

M. Polin: Employee; Tandem Diabetes Care, Inc. A.K. Johnson: Employee; Tandem Diabetes Care, Inc. L.H. Messer: Employee; Tandem Diabetes Care, Inc. J.E. Pinsker: Employee; Tandem Diabetes Care, Inc. A. Constantin: Employee; Tandem Diabetes Care, Inc.

Funding

Tandem Diabetes Care
961-P: Significant Reduction in Real-World Nighttime Burden with the MiniMed 780G System (MM780G)
Authors: SHIN JOHN , DAI ZHENG , MATHEW NATHAN SATHIYANATHAN NAVEEN , VIGERSKY ROBERT A. , MCVEAN JENNIFER
Published: June 2024

Introduction: Nighttime burdens of T1D include responding to CGM-generated alerts and delivering manual boluses which interrupt sleep. First-generation automated insulin delivery (AID) systems without autocorrection (e.g., MM670G/770G) have improved overnight glycemic outcomes, but sleep interruptions may still be common. The ability of the MM780G with frequent (every 5-min) autocorrections to decrease nighttime burden, versus the MM770G, was evaluated.

Methods: Nighttime (12AM-6AM) glycemic control, alarms/alerts, and insulin delivery were evaluated in 8019 U.S. MM780G system users (≥7 years) who transitioned from the MM770G and had ≥14 nights on both systems, in addition to those who used recommended settings (RS, a glucose target of 100mg/dL with active insulin time of 2 hours for 95% of the time).

Results: In all MM780G users and those who used RS, alerts decreased 45% and 55%, respectively (Table). Nights with manual boluses decreased to 3.8% and 2.1% and uninterrupted sleep increased by 30 and 36 minutes per night, respectively, compared to the MM770G. All MM780G users and those using RS received 16.4% and 18.2% of their overnight insulin as autocorrections.

Conclusion: MM780G system users have fewer overnight sleep interruptions and better glycemic control due to frequent autocorrections.

Disclosure

J. Shin: None. Z. Dai: Employee; Medtronic. N. Sathiyanathan: None. R.A. Vigersky: Employee; Medtronic. J. McVean: Employee; Medtronic.
963-P: Is Using an Automated Insulin Delivery System Associated with a Higher Physical Activity Frequency? A BETTER Registry Analysis
Authors: WU ZEKAI , YARDLEY JANE E. , CHAHAL TAMANNA , GUÉDET CAPUCINE , MESSIER VIRGINIE , GROU CAROLINE , BOUDREAU VALERIE , BRAZEAU ANNE-SOPHIE , RABASA-LHORET RÉMI
Published: June 2024

Introduction & Objective: To explore the association between using an automated insulin delivery (AID) system and physical activity (PA) frequency among people with type 1 diabetes (T1D).

Methods: Cross-sectional study using the Canadian BETTER T1D registry. Inclusion criteria: T1D; aged ≥ 18 y/o; reported PA with a validated questionnaire (Canadian Community Health Survey). “PA” includes organized or unorganized sports, fitness or recreational PA lasting ≥ 10 consecutive minutes; “moderate to vigorous PA” is PA that makes participants sweat at least a little and breathe harder. Regression models (with and without adjustment for imbalanced variables - sex, age, T1D duration) were used to compare PA frequency among treatment options, with pairwise comparison between the AID group and each of the other groups.

Results: Among 1213 participants, the AID group and pump+continuous glucose monitoring (CGM) group had a similar frequency of PA and moderate to vigorous PA, but these levels were higher in the AID group than those of injections+CGM and no-CGM groups (Table).

Conclusion: In real-world settings, compared with injections+CGM or No-CGM, AID users within the BETTER T1D registry have a higher frequency of PA and moderate to vigorous PA. However, these frequencies are similar between AID and pump+CGM users.

Disclosure

Z. Wu: None. J.E. Yardley: Speaker's Bureau; Dexcom, Inc. Research Support; LifeScan Diabetes Institute. T. Chahal: None. C. Guédet: None. V. Messier: None. C. Grou: None. V. Boudreau: 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. R. Rabasa-Lhoret: Other Relationship; Abbott, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Dexcom, Inc. Research Support; Diabetes Canada. Other Relationship; Eli Lilly and Company. Research Support; Cystic Fibrosis Canada, Canadian Institutes of Health Research, FFRD - Fondation Francophone pour la Recherche du Diabète. Other Relationship; Janssen Pharmaceuticals, Inc. Research Support; Juvenile Diabetes Research Foundation (JDRF). Other Relationship; Novo Nordisk, GlaxoSmithKline plc. Consultant; HLS Therapeutics Inc., Insulet Corporation. Speaker's Bureau; CPD Networks. Other Relationship; Medtronic. Consultant; Pfizer Inc. Speaker's Bureau; Tandem Diabetes Care, Inc. Other Relationship; Sanofi. Speaker's Bureau; Vertex Pharmaceuticals Incorporated. Research Support; SFD - Société Francophone du Diabète.

Funding

Canadian Institutes of Health Research (JT1-157204) and Juvenile Diabetes Research Foundation (4-SRA-2018-651-Q-R)
971-P: "Take a Chance on Me"—A Trial of Automated Insulin Delivery in Those Who Historically Declined Pump Therapy
Authors: IBRAHIM CHRISTINE
Published: June 2024

Introduction & Objective: In Ontario, Canada there are strict guidelines for those with type 1 diabetes (T1D) to qualify for insulin pump therapy. This often excludes those with significant glycemic variability, mixed adherence and difficulties with carbohydrate counting. However, with automated insulin delivery (AID), there are less managerial steps, making insulin-pump management easier, with improved results given algorithmic insulin modifications. Given this, this historically ignored population, would be most ideal for AID access.

Methods: This qualitative and quantitative trial identified four patients with historically difficult to manage diabetes and placed them on a nine-week trial of Dexcom G6 sensor, and six weeks on Tandem Control-IQ. They were given a pre- and post-survey and followed every 2 weeks to evaluate time in range (TIR), hypoglycemia, and assess quality of life.

Results: There were N=4 patients, 2 male, duration of diabetes 2-20 years, HbA1c (9.5-11%), pre-trial TIR 20-50%, pre-trial hypoglycemia <1%. Post-trial, A1c (7.3-8.6%), end-trial TIR 46-67%, and post-trial hypoglycemia <2%. Post-survey, comments included “Having the ability to feel more ‘normal’ having access to my sugars all the time without having to finger prick or scan⋯” “I didn’t have to think too much other than carb counting⋯” “Being able to have insulin all the time without giving a needle is great.”

Conclusion: This study demonstrates that the advancement in AID should enable a policy change to allow ubiquitous usage to those with T1D for best standard of care.

Disclosure

C. Ibrahim: None.
985-P: Association of CGM Data Interpretation by Health Care Providers with Glycemic Control for Patients with Type 2 Diabetes
Authors: HANNAH KATIA , NEMLEKAR POORVA , NORMAN GREGORY J.
Published: June 2024

This study examined the association between change in A1c and CGM data interpretation by health care providers (HCPs) among people with T2D using a personal CGM, stratified by insulin therapy. US administrative claims data for this retrospective analysis were from Optum’s deidentified Clinformatics® Database. Commercially insured people with T2D using any personal CGM with evidence of CGM data interpretation (billing code 95251) between 1/1/2020 and 12/31/2021 (index = earliest observed billing claim) were identified. Those with evidence of professional CGM use (billing code 95250), prior CGM data interpretation, and pregnancy were excluded. Cohorts were stratified by insulin and non-insulin therapy. A1c change was assessed 12 months pre- and post-index date. A total of 2,099 individuals (mean age=54 (SD=10.1) years, 55% male) met inclusion criteria. Across stratified cohorts, two groups were defined as ‘CGM + data interpretation’ and ‘CGM without data interpretation’. Independent of insulin therapy, use of data interpretation by HCPs was associated with a greater decrease in A1c among people with T2D using a personal CGM (Table). These results suggest a significant benefit from incorporation of CGM data interpretation by HCPs. Integration of CGM data interpretation may facilitate collaborative care plan development between patient and HCP.

Disclosure

K. Hannah: Employee; Dexcom, Inc. P. Nemlekar: Employee; Dexcom, Inc. G.J. Norman: Employee; Dexcom, Inc.
987-P: iCan CGM System—Performance Evaluation of a New CGM System with an Innovative Sensor Technology
Authors: JI LINONG , FLACKE FRANK , GAO FEI , YU YUANYUAN , ZHENG JIYUN , GAO AO , FEI JIANGFENG
Published: June 2024

Introduction and Objectives: The iCan CGM system, developed by Sinocare Meditech Inc. is equipped with an innovative sensor technology. Data presented here are from a multicenter study which assessed accuracy of the iCan CGM system; conducted in China according to international standards and which resulted in regulatory submission. The iCan CGM system received regulatory clearance 2023 in People’s Republic of China and EU for a wear time of 15 days.

Methods: The study had a single arm, prospective multicenter design and evaluated the iCan CGM system in one of 2 subgroups. There were 60 patients with T1D and T2D aged ≥18yrs enrolled into this subgroup and at days 2, 7-9 and 15 the performance of the device was assessed by comparison to YSI readings. The data were analyzed according to generally accepted procedures.

Results: For per protocol set (PPS) the surveillance error grid analysis shows 100% of the data pairs in the none to slightly lower/higher degree of risk zones (none 94.12% (95%CI: 86.96% - 100%), slightly lower 5.76% (95%CI: 0% - 12.86%), slightly higher 0.12% (95%CI: 0% - 1.15%). Also, the Clarke error grid confirms this high correlation with the reference method with 99.22% (95%CI: 98.67% - 99.58%) in Zones A+B. The full analysis set (FAS) analysis shows a MARD 8.88% (95%CI: 7.98% - 9.77%) which is similar the previously reported MARD of 8.71% (95%CI: 7.86 - 9.55%) from the PPS analysis, and stays below a MARD of 8% for the complete wear life. The average wear life was estimated to 14.76 (1.26) days. There were no SAEs, devices related AEs and no skin related AEs reported during the study.

Conclusion: The iCan CGM system, becoming available on the worldwide markets, demonstrated in a multicenter trial overall accuracy performance on par with established devices, high EGA correlation as well as single digit MARD throughout 15 days, in combination with an outstanding sensor wear life. (NCT0599575)

Disclosure

L. Ji: None. F. Flacke: Consultant; BOYDSense SAS, Sinocare Meditech Inc., embecta. F. Gao: Employee; Sinocare Inc. Y. Yu: Employee; Sinocare Inc. J. Zheng: Employee; Sinocare Inc. A. Gao: Employee; Sinocare Inc. J. Fei: Employee; Sinocare Inc.
991-P: Use of a Mobile Diabetes Self-Management Application Is Associated with Increased Blood Glucose Monitoring Frequency and Improved Glycemic Control
Authors: ULMER BRIAN , RUCH BERNHARD , REPETTO ENRICO
Published: June 2024

Introduction and Objectives: While recommended blood glucose monitoring (BGM) frequency varies by therapy and individual circumstances, many people with type 2 diabetes (T2D) may not follow suggested monitoring guidelines. Given recent advancements in blood glucose monitoring technology, we studied the impact of connecting a BG meter to a mobile diabetes self-management app (mySugr®) on testing frequency and glycemic control.

Methods: We performed a retrospective analysis of 103,400 mySugr app users in the United States with self-reported T2D who were enrolled between January, 2018 and November, 2023 and calculated the change in BG testing frequency and mean BG per 30-day period in the 180 days following glucometer connection to mySugr to the 30-day period prior to connection. We also analyzed the impact of BG logging frequency on the change in glycemic control.

Results: Following enrollment in the app, users increased the frequency of BG testing from a baseline of 19.87 logs (95% CI 19.61-20.15) in the 30-day period prior to mySugr connection to 52.38 BG logs (52.02-52.74) in days 0-30 following connection and 32.57 logs (32.27-32.86) at 150-180 days. Mean BG was 175.87 mg/dL (175.43-176.36) at baseline and 143.99 mg/dL (143.62 - 144.38) at 180 days following connection to mySugr. Users who logged greater than 30 logs between 150 and 180 days after registration had a greater reduction of mean BG (-20.44 mg/dL [-19.70 - -21.22]) than those with 30 or fewer logs (-18.35 mg/dL [-17.78 - -18.95]).

Conclusion: Following glucometer connection to the mySugr app, users recorded significantly more BG logs up to 180 days following connection. Use of the mySugr app was associated with a significant reduction in mean BG, and users who recorded > 30 logs/30 days achieved a greater reduction in mean BG vs. those who recorded <= 30 logs/30 days.

Disclosure

B. Ulmer: Employee; Roche Diabetes Care. B. Ruch: Employee; Roche Diabetes Care. E. Repetto: Employee; Roche Diabetes Care.
998-P: Real-World Evidence for Computerized Insulin Dose Adjustment Algorithms (CIDAAs) in the Effective Use of Continuous Glucose Monitoring (CGM) by Primary Care Clinicians (PCCs)
Authors: DAVIDSON MAYER B. , DAVIDSON JOSH
Published: June 2024

Introduction & Objective: PCCs are challenged using insulin because of time constraints and experience. Mellitus Health has developed FDA-cleared CIDDAs that enabled PCCs to effectively lower A1C levels by 1.5-2.0% over 3-6 months in poorly controlled, insulin-requiring patients who provided remote glucose readings to HIPAA approved cloud-based CDAAs that analyzed them and sent dose change recommendations to PCCs. Inconvenience and discomfort limit glucose fingerstick tests, barriers which CGM overcome. This study examined the ability of these CIDAAs to help PCCs effectively utilize CGM in similar patients.

Methods: A clinical pharmacist used a Free Style Libre Pro in 23 patients and an NP used a Dexcom reader in 13 patients, both in real world situations. Since A1C levels were not scheduled at specific times, the outcomes were changes in average glucose (AG) levels and calculated eA1Cs between the 1st and last reports sent to the PCC who could accept or modify the dose adjustment recommendations. The new doses served as the basis for the next report.

Results: A mean of 159 reports were issued over a mean of 113 days. Initial and final insulin regimens were basal alone, 15 and 12, basal/bolus, 20 and 23, and 1 short-acting alone in both. Baseline AGs (mg/dL ± SD) fell from 230 ± 68 to 196 ± 56 and eA1Cs (% ± SD) from 9.6 ± 2.4 to 8.4 ± 1.9 (P <0.001 by paired t tests). The PCCs accepted 56% of the recommended changes. Percents of glucose values <70 mg/dL were <2.0% and not significantly different between 1st and last reports signifying the safety of these CIDAAs. The total doses of insulin increased by 43%.

Conclusions: If a higher % of recommendations had been accepted, there may have been greater decreases. CIDAAs can facilitate and educate PCCs in the effective use of CGM.

Disclosure

M.B. Davidson: Other Relationship; Mellitus Health. J. Davidson: Employee; Mellitus Health.
Patient-reported outcomes after minimally invasive sacro-iliac joint surgery: a cohort study based on the Swedish Spine Registry
Authors: Randers Engelke Marie , Kibsgård Thomas Johan , Stuge Britt , Westberg Andreas , Sigmundsson Freyr Gauti , Joelson Anders , Gerdhem Paul
Published: June 2024

Background and purpose: There is conflicting evidence regarding treatment outcomes after minimally invasive sacroiliac joint fusion for long-lasting severe sacroiliac joint pain. The primary aim of our cohort study was to investigate change in patient-reported outcome measures (PROMs) after minimally invasive sacroiliac joint surgery in daily practice in the Swedish Spine Registry. Secondary aims were to explore the proportion of patients reaching a patient acceptable symptom score (PASS) and the minimal clinically important difference (MCID) for pain scores, physical function, and health-related quality of life outcomes; furthermore, to evaluate self-reported satisfaction, walking distance, and changes in proportions of patients on full sick leave/disability leave and report complications and reoperations.Methods: Data from the Swedish Spine Registry was collected for patients with first-time sacroiliac joint fusion, aged 21 to 70 years, with PROMs available preoperatively, at 1 or 2 years after last surgery. PROMs included Oswestry Disability Index (ODI), Numeric Rating Scale (NRS) for low back pain (LBP) and leg pain, and EQ-VAS, in addition to demographic variables. We calculated mean change from pre- to postoperative and the proportion of patients achieving MCID and PASS.Results: 68 patients had available pre- and postoperative data, with a mean age of 45 years (range 25–70) and 59 (87%) were female. At follow-up the mean reduction was 2.3 NRS points (95% confidence interval [CI] 1.6–2.9; P < 0.001) for LBP and 14.8 points (CI 10.6–18.9; P < 0.001) for ODI. EQ-VAS improved by 22 points (CI 15.4–30.3, P < 0.001) at follow-up. Approximately half of the patients achieved MCID and PASS for pain (MCID NRS LBP: 38/65 [59%] and PASS NRS LBP: 32/66 [49%]) and physical function (MCID ODI: 27/67 [40%] and PASS ODI: 24/67 [36%]). The odds for increasing the patient’s walking distance to over 1 km at follow-up were 3.5 (CI 1.8–7.0; P < 0.0001), and of getting off full sick leave or full disability leave was 0.57 (CI 0.4–0.8; P = 0.001). In the first 3 months after surgery 3 complications were reported, and in the follow-up period 2 reoperations.Conclusion: We found moderate treatment outcomes after minimally invasive sacroiliac joint fusion when applied in daily practice with moderate pain relief and small improvements in physical function.
Hauntings in Twenty-First Century Fiction
Authors:   , Brewster Victoria
Published: June 2024

There has been a proliferation in the first quarter of the twenty-first century of fiction that features haunting – be they traditional ghost stories or stories that feature other kinds of haunting. The reasons for this are identified as particular to the rapid changes and global upheavals of the political, economical, and technological situation of the times. These factors complicate for the reader, and for individuals more broadly, what is real and what can be trusted. While ghost stories have always encouraged mistrust in the reader towards the narrator, contemporary haunted fiction upends the stability of place and time, as well as narrative voice. In examining this concept, this thesis develops the work of late twentieth century theorists such as Jacques Derrida and Jean Baudrillard, who both theorised the ephemerality of reality: Derrida with his essays on hauntology, and Baudrillard with his work on simulacra and simulation. These haunted texts are also peculiar in that they destabilise the notion of who and what haunts. This thesis argues that contemporary haunted fiction revises the notion of who haunts and who is haunted by moving agency away from those who traditionally control the narrative (the heteronormative, patriarchal, colonial subject), and towards voices previously unheard and/or suppressed. This builds on Jeffrey Andrew Weinstock’s work on Object Oriented Ontology in the Gothic, as the identity of the haunted subject and haunting object becomes fluid. This thesis researches texts largely new to literary examination, focusing on popular and award-winning contemporary fiction to truly reflect the stories that are desired for consumption by the ‘average reader today’ (with acknowledgement this is a construct), but also the stories publishers believe should be told. The methodology uses close textual analysis, building on Gothic and horror theory of the twentieth century, as well as personal correspondence with the authors for perspectives on authorial intention and the state of the text before publishing/editorial intervention.
Formulasi Castile Soap Berbasis Virgin Coconut Oil (VCO) dan Minyak Zaitun Sebagai Bahan Pembuatan Sabun Cair
Authors: Dewi Luthfi Kurnia , Cahyani Chandrawati , Nurhadianty Vivi , Sarosa Aji Hendra , Zari Anne Dian Pavita , Wahyuningtyas Lusia Emiliana , Aulia Isnaini Rahmi Nur
Published: June 2024

Salah satu jenis sabun cair berbahan alami yang bersifat biodegradable dan aman adalah castile soap. Castile soap dibuat melalui reaksi saponifikasi minyak nabati dan alkali (KOH). Minyak nabati yang digunakan yaitu Virgin Coconut Oil (VCO) dan minyak zaitun. Kandungan asam laurat pada VCO dan asam oleat pada minyak zaitun menghasilkan produk sabun yang lembut, aman dan bersifat antibakteri. Tujuan penelitian ini adalah kajian pengaruh penambahan VCO dan minyak zaitun dalam pembuatan castile soap terhadap kualitas sabun cair yang dihasilkan dan kajian formula sabun cair kualitas terbaik. Pada penelitian ini, penambahan Virgin Coconut Oil (VCO) dan minyak zaitun dilakukan dengan memvariasikan jumlah masing-masing minyak yang ditambahkan sebesar 0%, 40%, 50%, 60%, 100% (% massa minyak / massa castile soap). Reaksi saponifikasi dilakukan selama 4 jam pada suhu 70oC. Pengujian mutu sabun cair terdiri dari uji mutu fisikokimia sesuai dengan SNI Sabun Mandi Cair 06-4085-1996 meliputi nilai pH dan bobot jenis dan uji organoleptik terhadap warna, aroma, kekentalan, jumlah busa yang terbentuk, kesan dan reaksi setelah pemakaian pada 50 responden. Hasil penelitian menunjukan bahwa formula sabun cair berbasis VCO dan minyak zaitun dengan penambahan essential oil (rosehip oil, lemon oil, dan lemongrass oil) yang memenuhi SNI 06-4086-1996 dan disukai responden terdapat pada sabun cair dengan variasi 60% VCO dan 40% minyak zaitun dengan konsentrasi lemon oil 1% karena sabun cair dengan formula tersebut memiliki pH 10 dan massa jenis 1,0209 g/ml dimana sabun cair tersebut memiliki karakteristik lembut, aman, dan bersifat antibakteri.
Cyclic Silicon Organic Copolymers: Synthesis and Investigation. Review
Authors:   Ivane Javakhishvili’ Tbilisi State University, Department of Macromolecular Chemistry, I. Chavchavadze Ave., 1, Tbilisi 0179, Georgia, Tatrishvili Tamara ,   Institute of Macromolecular Chemistry and Polymeric Materials, Ivane Javakhishvili Tbilisi State University, University Street, 13, Tbilisi 0186, Georgia, Mukbaniani Omar
Published: June 2024

This paper considers the synthesis and investigation of cyclic silicon-organic polymers with mono- and polycyclic fragments in the side chain. For obtaining monocyclic polymers, the hydrosilylation reaction of 1-hydro-3-vinylhexamethylcyclotetrasiloxane was used. The reaction was conducted in a CCl4 solution at 75°C in the presence of Speier’s catalyst (H2PtCl6  6H2O) to produce a viscous-flow at room temperature polymer. The polymers were studied by NMR spectroscopy. Poly(carbosiloxane) with cyclic fragments in the methyl-siloxane backbone was synthesized by the hydride polyaddition of divinylorganocyclosiloxane with dihydrodimethylsiloxane. A semi-quantitative assessment conducted using NMR spectroscopy revealed the ratio of isomeric 1,3- and 1,5-cyclic structures as 1:1. X-ray diffraction studies indicated that copolymers are single-phase amorphous systems. Also, in the review, synthesis and studies of carbosiloxane copolymers containing flexible dimethylsiloxane and decaorganotricyclodecasiloxane fragments in the backbone are discussed. Hydride polyaddition of divinyl-containing compounds was carried out for -dihydridedimethylsiloxanes of various lengths. The synthesized copolymers were characterized by the X-ray diffraction method and TGA.
Unlocking Sustainability: A Comprehensive Review of Up-Recycling Biomass Waste into Biochar for Environmental Solutions
Authors:   Wroclaw University of Science and Technology, Department of Chemistry, Wybrzeże S. Wyspiańskiego 27, 50-370 Wrocław, Poland, Pstrowska Katarzyna , Łużny Rafał ,   Wroclaw University of Science and Technology, Department of Chemistry, Wybrzeże S. Wyspiańskiego 27, 50-370 Wrocław, Poland, Fałtynowicz Hanna ,   Wroclaw University of Science and Technology, Department of Chemistry, Wybrzeże S. Wyspiańskiego 27, 50-370 Wrocław, Poland, Jaroszewska Karolina ,   Wroclaw University of Science and Technology, Department of Chemistry, Wybrzeże S. Wyspiańskiego 27, 50-370 Wrocław, Poland, Postawa Karol ,   Wroclaw University of Science and Technology, Department of Chemistry, Wybrzeże S. Wyspiańskiego 27, 50-370 Wrocław, Poland, Pyshyev Serhiy ,   Lviv Polytechnic National University, Department of Chemical Technology of Oil and Gas Processing, 12 Bandera st., Lviv, 79013, Ukraine, Witek-Krowiak Anna ,   Wroclaw University of Science and Technology, Department of Chemistry, Wybrzeże S. Wyspiańskiego 27, 50-370 Wrocław, Poland
Published: June 2024

From the perspective of converting waste into valuable products and reducing environmental pollution, the up-recycling of biomass waste into carbon-rich materials is attracting widespread attention. This literature review presents the possibilities of using the solid product of one-stage carbonization (char) of plant-origin waste biomass. Several applications are discussed, including the production of sorbents, energy storage materials, catalyst carriers, and agricultural applications.
Modern Use of Biochar in Various Technologies and Industries. A Review
Authors:   National Technical University “Kharkiv Polytechnic Institute”, 2 Kirpychova St., 61002 Kharkiv, Ukraine, Miroshnichenko Denis , Zhylina Maryna ,   Riga Technical University, Faculty of Materials Science and Applied Chemistry, Institute of General Chemical Engineering, Rudolfs Cimdins Riga Biomaterials Innovations and Development Centre,   Pulka St., 1007, Riga, Latvia 3 Institute of Agricultural Resources and Economics, Stende Research Centre, „Dizzemes‟, Dizstende, Libagu parish, Talsu County, 3258, Latvia, Shmeltser Kateryna ,   State University of Economics and Technology, 2, Vyzvolenya Square, 50005 Kriviy Rih, Ukraine
Published: June 2024

The article analyzes the use of biochar in various industries and the national economy (as a sorbent, fuel, reducing agent in the metallurgical industry, a component of coal coke blends, biocomposites, modification of explosives, fertilizers, etc.) It is noted that the direction of use depends on the quality and characteristics of biochar (size, physical properties, chemical composition), which are determined by the nature of the raw material, its chemical composition and carbonization temperature.
Characteristics and Applications of Waste Tire Pyrolysis Products: A Review
Authors:   Lviv Polytechnic National University, 12 Bandera St., 79013 Lviv, Ukraine, Pyshye Serhiy , Lypko Yurii ,   Lviv Polytechnic National University, 12 Bandera St., 79013 Lviv, Ukraine, Demchuk Yuriy ,   Lviv Polytechnic National University, 12 Bandera St., 79013 Lviv, Ukraine,   Danylo Halytsky Lviv National Medical University, 69 Pekarska St., 79010 Lviv, Ukraine, Kukhar Oleh ,   Lviv Polytechnic National University, 12 Bandera St., 79013 Lviv, Ukraine, Korchak Bohdan ,   Lviv Polytechnic National University, 12 Bandera St., 79013 Lviv, Ukraine, Pochapska Iryna ,   Lviv Polytechnic National University, 12 Bandera St., 79013 Lviv, Ukraine, Zhytnetskyi Ihor ,   National University of Food Technologies, 68 Volodymyrska St., 01601 Kyiv, Ukraine
Published: June 2024

The review considers the environmental problem of generation, accumulation and utilization of waste tires in Ukraine and the world. It is established that waste tires can serve as a valuable raw material for obtaining fuel components and technical/individual chemicals for further industrial processing. One of the promising methods for the rational utilization of waste tires may be their pyrolysis. The pyrolysis process of waste tires produces gaseous, liquid and solid carbonized residue. At the same time, there is no ideal universal technology for the use of waste tire pyrolysis products without preliminary treatment/purification methods. The main characteristics, processing methods and applications of products obtained from the pyrolysis of waste tires are briefly considered.
METHOD OF MEASURING PSRR FOR LINEAR VOLTAGE REGULATORS
Authors:   Lviv Politecnic National University, Lastovetskyi Oleh , Likhnovskyi Ihor ,   Lviv Politecnic National University
Published: June 2024

The article describes a method for measuring the power supply rejection ratio and its characteristics. A simulation of the measurement in the LTspice program considering a linear voltage regulator as an example, with varying output capacitance is studied.
PENTINGNYA MAHASISWA PRODI KEWIRAUSAHAAN UNIVERSITAS MEGAREZKY MAKASSAR DALAM MEMAHAMI PERILAKU ORGANISASI BISNIS
Authors: Bine Enjelin , Jannah Mifta , Madai Hengky
Published: June 2024

This research was conducted with the aim of analyze and exploring the extent to which entrepreneurship study program students understand the importance of studying organizational behavior and how students can apply their understanding in the future to the importance of understanding organizational behavior in the future. The method used in this research is a qualitative method. The results of this research confirm the importance of students understance and studyng organizational behavior. Organizational behavior is a behavior or way of someone in an organizational group. In a business, organizational behavior is very necessary, because establishing relationships within an organization, both between individuals and groups, requires behavior. In a company or organization, one important aspect that must be considered is organizational behavior, where a company must know every behavior or characteristic between individuals and groups within the organization.
Isolation And Characterization of Lactobacillus Species From Local Indonesian Cow’s Milk
Authors: Kandou Abigail Sabrina , Sugata Marcelia , Jo Juandy
Published: June 2024

Probiotics are a group of beneficial microorganisms that can improve the health of their host. Lactobacillus species are lactic acid bacteria that have great potential as probiotics, in which cow’s milk is a great source of lactic acid bacteria. In this study, Lactobacillus spp. were isolated from fresh local Indonesian cow’s milk. The methods used to characterize the Lactobacillus spp. were (i) biochemical tests including catalase, hemolytic and sugar fermentation tests; (ii) tolerance tests against salt (NaCl 2%, 4% and 6%), low pH (2, 3, 4, 5, 6 and 7) and temperature (7°C, 37°C and 45°C); and (iii) 16S rRNA sequencing. The isolation yielded 14 isolates matching the criteria of Lactobacillus spp. colony and cell (i.e., Gram positive rods that did not produce endospores and did not have a waxy layer covering its cell wall). Based on subsequent biochemical tests, 5 isolates were suspected as potential probiotic Lactobacillus spp. The 16S rRNA sequencing revealed that the isolate L was Limosilactobacillus fermentum. In conclusion, this study demonstrated that local cow’s milk could be used to isolate Lactobacillus spp.
Güterbahn zwischen Wunsch und Wirklichkeit
Authors: Kortschak Bernd H.
Published: June 2024

In politischen Sonntagsreden wird regelmäßig die Verlagerung des Güterverkehrs von der Straße auf die Schiene propagiert. Die Umwandlung zur DB AG hat die Bahn in ihrer Wettbewerbsfähigkeit nur geschwächt – sowohl von der EU-Rechtssetzung her als auch der deutschen Verkehrspolitik. Sie ist jedoch noch immer die einzig darstellbare E-Mobility-Alternative für den Güterverkehr, die es zu retten gilt, bevor es zu spät ist.