bluuebunny/crossref_metadata_2025 huggingface dataset:
32-LB: Oral Care Behaviors among the U.S. Population with Diabetes
Authors: ZHANG YUQING , LEVEILLE SUZANNE , BERGER KIMBERLY , CAMHI SARAH M. , SHI LING
Published: June 2023

Diabetes self-care skills are necessary to control glucose in people with diabetes (PWD). The ADA recommends self-care behaviors including healthy eating, being active, monitoring, taking medication, consulting diabetes care professionals, and reducing risk for complications. Oral self-care is an important but often overlooked aspect of reducing risk in diabetes self-care. This study examined the relationship between diabetes self-care and oral care behaviors. Using NHANES 2011-2016, we analyzed data from 1,585 dentate adults (≥ 30yrs) with self-reported diabetes. Oral self-care was measured by use of preventive dental care in the past year and flossing frequency (never, 1-6day/week, daily). Descriptive analyses compared people reporting good diabetes self-care (score 4-7, summary score of 7 self-care recommendations) and those with poor diabetes self-care (score 0-3), an approximate median split. Sample weights were applied to derive US population estimates. Multivariable and multinomial logistic regression was performed adjusting for age, gender, race, education, income and health insurance. Among the US PWD, 35% report daily flossing and 29% report never flossing; 48% reported a preventive dental visit in the past year. PWD who performed good diabetes self-care were 47% more likely to report using preventive dental care compared to those with poor diabetes self-care (AOR=1.47, 95%CI 1.18-1.84), and they were 38% more likely to be flossing daily (AOR=1.38, 95%CI 1.07-1.79). PWD who practice good diabetes self-care are more likely to also engage in good oral self-care. However, the association cannot be attributed to diabetes self-management education because until 2023, the ADA standards for diabetes self-management did not address oral health practices or dental care. Continued efforts are needed to incorporate oral self-care practices into diabetes self-care education. Further research is warranted to determine possible disparities in diabetes self-management and oral care.

Disclosure

Y. Zhang: None. S. Leveille: None. K. Berger: None. S. M. Camhi: None. L. Shi: None.
321-OR: Differential Associations of Obesity and Metabolic Syndrome with Polyneuropathy in Early Type 2 Diabetes and Normal Glucose Tolerance
Authors: SIPOLA GUNDEGA , STROM ALEXANDER , BOMBRICH MARIA , WAGNER ROBERT , ZIEGLER DAN , RODEN MICHAEL , BÖNHOF GIDON J. ,   GDS GROUP
Published: June 2023

There is increasing evidence for a role of the metabolic syndrome (MetS) during development of distal sensorimotor polyneuropathy (DSPN). We hypothesized that MetS components are differentially associated with measures of DSPN in individuals with normal glucose tolerance (NGT) and early type 2 diabetes (T2D). Electrophysiological and quantitative sensory testing was performed in 180 participants with NGT and 355 with recent-onset T2D (known diabetes duration <1 year) matched for age from the German Diabetes Study (NGT/T2D [mean±SD]: age: 43.9±14.0/45.1±7.7 years; sex: 61/65% male; BMI: 26.8±5.0/32.3±6.5 kg/m²; HbA1c: 5.2±0.3/6.5±1.0%). Intraepidermal nerve fiber density (IENFD) was assessed in 218 individuals (NGT/T2D: n=117/101). Subsets of participants were followed for 5 years (NGT/T2D: n=48/53). MetS was defined according to International Diabetes Federation (2006) and DSPN according to Toronto consensus criteria (2011). After adjustment for age, sex, height, smoking and HbA1c, a lower IENFD was associated with higher weight (β=-0.306), number of MetS components (NMetSC; β=-0.222) and presence of central obesity (β=-0.292), while higher malleolar vibration perception threshold was associated with weight (β=0.219) in NGT (P<0.05), but not in T2D. Median motor nerve conduction velocity and sural sensory nerve action potential were inversely associated with weight (β=-0.182/-0.286), NMetSC (β=-0.127/-0.128), presence of central obesity (β=-0.163/-0.165), and MetS (β=-0.169/-0.203) in T2D (P<0.05). Higher weight predicted the presence of DSPN at 5 years (β=0.652, P=0.001) in NGT, while increasing NMetSC and MetS prevalence predicted a decline in IENFD over 5 years (β=-0.533/-0.388, P=0.001/0.013) in T2D. This suggests that obesity indices can predict DSPN over 5 years in NGT, while MetS and its components are differentially associated with measures of DSPN in early, well-controlled type 2 diabetes compared with NGT.

Disclosure

G.Sipola: None. A.Strom: None. M.Bombrich: None. R.Wagner: Advisory Panel; Daiichi Sankyo, Speaker's Bureau; Novo Nordisk, Sanofi. D.Ziegler: None. M.Roden: Advisory Panel; Eli Lilly and Company, Consultant; TARGET PharmaSolutions, Inc., Research Support; Boehringer-Ingelheim, Novo Nordisk, Novartis, Sanofi. G.J.Bönhof: None. Gds group: n/a.

Funding

German Federal Ministry of Health; Ministry of Innovation, Science, Research and Technology of the state North Rhine-Westphalia; German Federal Ministry of Education and Research
330-OR: Healthy Eating Index Correlates with Better Glycemic Control among People with Type 1 Diabetes
Authors: GILLINGHAM MELANIE B. , MARAK CHASE , CALHOUN PETER , NEUBIG KARISSA E. , PATTON SUSANA R. , CASTLE JESSICA R. , JACOBS PETER G. , GAL ROBIN L. , MARTIN CORBY K. ,   T1DEXI STUDY GROUP
Published: June 2023

The amount and type of food consumed impacts glycemic response and insulin needs of people with type 1 diabetes (T1D). Day to day variation in types of foods consumed or diet quality may acutely impact glycemic levels and insulin needs within an individual with T1D. As part of the Type 1 Diabetes Exercise Initiative (T1Dexi), we examined the impact of overall daily diet quality on glycemic control. Diet quality was assessed by the Healthy Eating Index-2015 (HEI) where a score of 100 indicates highest quality diet characterized by intake of more vegetables, fruits, and whole grains and less intake of saturated fat and added sugar. Dietary intake was captured on up to 12 different days per participant during the one-month study via food photography with the T1Dexi app. Food photos were analyzed for nutrient intake by the Remote Food Photography Method. Mean HEI score for all participants was 57, similar to the general US population. Each day of dietary intake was classified as low (HEI≤57) or high (HEI>57) within a participant and only participants with at least two low and two high HEI days were included in the analysis. CGM and insulin metrics were compared using a linear mixed effect model with a random subject effect. Participants (n=223) were 19-68 years (37±14 years), 76% identified as female, had a mean HbA1C of 6.6±0.7 and a mean body mass index of 25.1±3.6. On high HEI days (mean score: 66±4), total time in range (70-180 mg/dl) was greater (77.2±14% vs 75.7±14% p=0.01), while time above 180 mg/dl (19±14% vs 21±15%, p=0.01) and mean glucose (143±22 vs 145±22 mg/dl, p=0.02) were lower compared to low HEI days (mean score: 47±5). Total daily insulin dose was lower on high HEI days (0.52±0.18 vs 0.54±0.18 U/kg/day p=0.01). Higher diet quality correlates with improved glycemia and lowered insulin needs during that 24-hour period of time within an individual T1D participant but the impact of diet quality was smaller than the impact of exercise and represents an incremental improvement among well-controlled subjects.

Disclosure

M.B.Gillingham: None. T1dexi study group: n/a. C.Marak: None. P.Calhoun: None. K.E.Neubig: None. S.R.Patton: None. J.R.Castle: Advisory Panel; Novo Nordisk, Zealand Pharma A/S, Research Support; Dexcom, Inc., Stock/Shareholder; Pacific Diabetes Technologies. P.G.Jacobs: Board Member; Pacific Diabetes Technologies, Other Relationship; Pacific Diabetes Technologies, Research Support; Dexcom, Inc. R.L.Gal: None. C.K.Martin: Board Member; EHE Health, Wondr Health, Other Relationship; ABGIL, Research Support; Pack Health, Evidation Health, Lilly, WW International, Inc.

Funding

The Leona M. and Harry B. Helmsley Charitable Trust; Verily Life Sciences; Dexcom, Inc.
397-P: Epigenetic Regulation of the Chemokine CXCL2 in Acute Kidney Injury in Diabetes
Authors: NAGARJUN BATCHU SRI , GANESH YERRA VEERA , HONG YUQING , PLANT PAMELA , LIU YOUAN , ADVANI ANDREW
Published: June 2023

People with diabetes are much more likely to develop acute kidney injury (AKI) than people who do not have diabetes. Here we took a reverse translational approach to identify factors that increase the risk of AKI in diabetes. Aged diabetic high fat diet-fed (DM-HFD) mice and nondiabetic controls were randomized to sham or bilateral renal ischemia reperfusion injury (IRI) surgery, with phenotyping performed 24h later. DM-HFD mice with IRI had increased plasma BUN and creatinine and increased tubule injury in comparison to either nondiabetic mice with IRI or DM-HFD mice that underwent sham surgery. NanoString nCounter analysis of AKI kidneys revealed that 47 of 248 inflammatory genes were differentially expressed in the kidneys of DM-HFD IRI mice in comparison to nondiabetic mice with IRI. The top hit was the chemokine Cxcl2, which was upregulated 2429-fold compared with sham-operated nondiabetic mice and 92-fold compared with nondiabetic mice with IRI. Urine CXCL2 excretion was increased >200-fold in DM-HFD IRI mice. By RNAscope in situ hybridization, Cxcl2 was observed to be upregulated in DM-HFD IRI kidneys, being localized primarily to infiltrating inflammatory cells, but also expressed in glomeruli and scattered tubule epithelial cells. Stimulation of bone marrow-derived macrophages (BMDMs) with lipopolysaccharide caused release of CXCL2 into the culture medium, with a significant increase in CXCL2 secretion by BMDMs from mice with myeloid cell deletion of the histone demethylase KDM6A (LysMCre+Kdma6fl/ymice). In summary, augmented AKI in aged diabetic high fat diet-fed mice is accompanied by upregulation of the myeloid cell chemoattractant CXCL2, which itself is under the influence of the histone demethylating enzyme KDM6A. The findings provide insights into the molecular causes of worsened AKI in diabetes and they illustrate that, like chronic kidney disease in diabetes, AKI processes in diabetes are also under epigenetic regulation.

Disclosure

S. Batchu: None. V. Yerra: None. Y. Hong: None. P. Plant: None. Y. Liu: None. A. Advani: None.

Funding

Canadian Institutes of Health Research (PJT166083 to A.A.)
502-P: Correlation of Periodontal Inflamed Surface Area and Clinical Attachment Loss with Glycemic Status, Serum IL6, and Serum Lipoprotein(a) in Subjects Having Type 2 Diabetes Mellitus With and Without Diabetic Retinopathy
Authors: JAMAL T P NUSREEN , R CHANDNI , VADAKKEKUTTICAL ROSAMMA J.
Published: June 2023

Background: The two-way relationship between periodontitis and type 2 diabetes mellitus (T2D) is well established. An inflammatory link exists between diabetic retinopathy (DR) and periodontitis. This study was undertaken to compare the prevalence, extent and severity of periodontitis, to correlate clinical attachment level (CAL) and periodontal inflamed surface area (PISA) with glycemic status, serum IL-6 and lipoprotein a [Lp (a)] in T2D subjects with and without DR.

Method: This cross-sectional study comprised 40 T2D subjects with DR and 40 T2D subjects without DR. All were assessed for periodontal parameters (BOP, PPD, CAL, OHI-S Index, PI Index and PISA) and systemic parameters (HbA1c, FBG, PPBG, FLP, serum IL-6 and serum Lp (a)).

Results: The Proportion, Extent and severity of periodontitis and PISA were higher in T2D with DR compared to T2D without DR. T2D with DR subjects had a mean of 69% sites with gingival bleeding and 40% in T2D without DR. HbA1c was positively correlated with CAL (r = 0.123, p=0.001) and PISA (r = 0.154, p=< 0.001) in T2D with DR. A positive correlation was found between PISA and IL6 (Pearson correlation coefficient 0.651, p < 0.0001); PISA and Lp (a) (Pearson correlation coefficient 0.59, p < 0.001); CAL and IL6 (Pearson correlation coefficient 0.527, p < 0.0001) and CAL and Lp (a) (Pearson correlation coefficient 0.631, p < 0.001). Serum IL-6 and Lp (a) are higher in retinopathy patients with periodontitis than those without periodontitis.

Conclusion: Despite both groups having poor glycemic control and comparable plaque scores, the periodontal and inflammatory parameters were higher in the DR group compared to T2D without the DR. The presence of diabetic retinopathy may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of diabetic retinopathy. Support: Ophthalmology faculty

Disclosure

N.Jamal t p: None. C.R: None. R.J.Vadakkekuttical: None.
684-P: Momentary, Daily, and Long-Term Impacts of Diabetes on Daily Activities—The Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D) Study
Authors: PYATAK ELIZABETH , SPRUIJT-METZ DONNA , LEE PEY-JIUAN , SCHNEIDER STEFAN , PETERS ANNE L. , CRANDALL JILL P. , AGARWAL SHIVANI , JIN HAOMIAO , HOOGENDOORN CLAIRE J. , CRESPO-RAMOS GLADYS , HERNANDEZ RAYMOND , PHAM LOREE T. , GONZALEZ JEFFREY S.
Published: June 2023

Introduction: While it is widely recognized that T1D can interfere with daily activities, the extent and impact of these disruptions are poorly understood. Using FEEL-T1D study data, we examined how T1D interfered with daily activities, and the association between activity disruptions, illness intrusiveness, and diabetes-related quality of life (DQoL).

Methods: FEEL-T1D prompted 14 days of surveys via smartphone at 3-hr intervals 5-6x/day. At each survey, participants indicated what activity they were doing, their activity performance and satisfaction, and whether/how T1D interfered with the activity. At end-of-day, they noted activities they could not do due to T1D. At study end, participants completed the T1D and Life (T1DAL) measure of DQoL and Adapted Illness Intrusiveness Rating Scale (AIIRS). Descriptive statistics and multilevel regressions were used to identify daily activity disruptions and their associations with DQoL and illness intrusiveness.

Results: Overall, 190 participants (40±14 yrs old, 54% female, 29% White, 40% Hispanic/Latinx, 31% other) completed 14,387 momentary surveys, of which 12.1% indicated activity disruptions, most often personal care (16.1% disrupted), sleep (14.6%), and housework/errands (13.4%). Participants were unable to do desired activities due to T1D on 8.2% of days, most often housework/errands (3.8% of days), work/school, personal care, and leisure (2.6% for each). Performance and satisfaction were poorer for disrupted vs. non-disrupted activities (p<.0001). Those with more activity disruptions had greater illness intrusiveness (p<.0001) and lower DQoL (p<.0001).

Discussion: T1D-related activity disruptions are common and associated with poorer activity performance/satisfaction, more illness intrusiveness, and lower DQoL. Validating the impact of T1D on daily activities, and seeking strategies to minimize this impact, may improve QoL for adults with T1D.

Disclosure

E.Pyatak: Research Support; Abbott Diabetes. G.Crespo-ramos: None. R.Hernandez: None. L.T.Pham: None. J.S.Gonzalez: Consultant; Virta Health Corp. D.Spruijt-metz: None. P.Lee: None. S.Schneider: None. A.L.Peters: Advisory Panel; Abbott Diabetes, Medscape, Novo Nordisk, Vertex Pharmaceuticals Incorporated, Zealand Pharma A/S, Research Support; Abbott Diabetes, Dexcom, Inc., Insulet Corporation, Stock/Shareholder; Omada Health, Inc., Livongo. J.P.Crandall: Research Support; Abbott Diabetes. S.Agarwal: Advisory Panel; Medtronic, Consultant; Beta Bionics, Inc., Research Support; Abbott Diabetes, Dexcom, Inc. H.Jin: None. C.J.Hoogendoorn: None.

Funding

National Institutes of Health (1R01DK121298)
698-P: Interoperability as an Important Factor for Achieving the Full Potential of a Digital Diabetes Logbook
Authors: KULZER BERNHARD , HERMANNS NORBERT , VESPER IRIS , SCHAEFER VANESSA L. , SILBERMANN STEPHAN , KOBER JOHANNA , FINKE-GROENE KATHARINA , ROOS TIMM , BINGOL EZGI , EHRMANN DOMINIC
Published: June 2023

A randomized controlled trial (RCT) has demonstrated the efficacy of a digital diabetes logbook (mySugr) in reducing diabetes distress compared to a control group without such an app. In a sub-group analysis, we analyzed whether those who have paired their glucose meter (glucose values were directly imported into the app) benefit differently than those who manually entered their glucose values. A total of 282 people were randomized to the intervention group using the app for 3 months (2:1 randomization; age: 51.2±14.6 years; 13.1% type 1, 66.7% type 2, 20.2% gestational diabetes). The per protocol population within the intervention group consisted of 232 participants who completed the 3-month follow-up and have used the app on ≥10% of the study days. Analysis of covariance was conducted with diabetes distress at the 3-month follow-up at dependent variable and connected glucose meter (yes/no) as independent variable, controlled for diabetes distress at baseline. Diabetes distress was measured with the Problem Areas in Diabetes (PAID) questionnaire. Within the per protocol population, 134 participants of the intervention group (57.8%) have used a connected glucose meter. Participants with a connected meter had significantly less diabetes distress at follow-up compared to participants who manually entered their glucose values (16.9±1.05 vs. 20.5±1.2, p = 0.027). There was no significant difference in demographic characteristics between the two groups. Participants with a connected meter had significantly more meal logs (3.3±2.2 vs. 2.0±1.2, p = 0.01) on days they have used the app. Overall, the digital diabetes logbook was able to reduce diabetes distress over a 3-month period. This reduction in diabetes distress was more pronounced in participants who used an interoperable glucose meter that automatically transferred glucose data into the app. Interestingly, there seems to be an increased interaction with the app regarding logging of meals in participants with a connected meter.

Disclosure

B.Kulzer: Advisory Panel; Berlin-Chemie AG, Abbott Diabetes, Bayer Inc., Dexcom, Inc., Novo Nordisk, Insulet Corporation, embecta, Research Support; Sanofi, Roche Diabetes Care. D.Ehrmann: Advisory Panel; Roche Diabetes Care, mySugr, Dexcom, Inc., Speaker's Bureau; Berlin-Chemie AG, Dexcom, Inc. N.Hermanns: Advisory Panel; Insulet Corporation, Research Support; Sanofi-Aventis Deutschland GmbH, Roche Diagnostics, Becton, Dickinson and Company, Speaker's Bureau; Dexcom, Inc., Berlin-Chemie AG. I.Vesper: None. V.L.Schaefer: Employee; Roche Diabetes Care. S.Silbermann: Employee; Roche Diabetes Care. J.Kober: Employee; mySugr. K.Finke-groene: None. T.Roos: None. E.Bingol: Employee; Roche Diabetes Care.

Funding

Roche Diabetes Care GmbH (DC000097)
774-P: Weight-Independent Effects of CT-868, a Signaling Biased Dual GLP-1/GIP Receptor Modulator, on Glucose Homeostasis in Overweight and Obese Adults with Type 2 Diabetes
Authors: CHAKRAVARTHY MANU , HERNANDEZ MOISES , ELLIOTT MICHAEL , MACIAS ALEJANDRA , HANSEN STIG K. , HOMPESCH MARCUS
Published: June 2023

GLP-1 and GIP can deliver complementary pharmacology when combined. CT-868 (CT) is a biased dual GLP-1 and GIP receptor modulator that exhibits no arrestin coupling or receptor internalization at either receptor. Its effects on insulin (INS) secretion via graded glucose infusion (GGI), glucose (GLUC) homeostasis in response to a mixed meal tolerance test (MMTT), gastric emptying (GE), and food intake (FI) were investigated in a randomized, double-blind crossover study in 20 overweight and obese adults with T2D split into 2 groups: CT vs placebo (PL), n=7 and CT vs PL vs liraglutide (LI), n = 13, the latter as a fixed 3rd period. Mean age and BMI were 52.2 years and 32.7 kg/m2 with 55% males. Treatments were administered for 4 days to minimize weight loss with 14 days washout between periods. GGI data showed robust INS secretion for CT-868 vs PL [change in ISR/GLUC at GIRmax (pmol/kg/min): CT 1.1 (0.1), PL 0.1 (0.2), LI 1.0 (0.3)]. MMTT based GLUC iAUC0-240 was significantly reduced for CT vs PL [72(46) vs 392(48)mmol/L*min] and numerically lower vs. LI [187(55) mmol/L*min] accompanied by significantly decreased INS iAUC0-240 vs both PL and LI: CT 1178(846), PL 5833(873), LI 4613(1253) mU/L*min. As both CT and LI had similar delayed GE vs PL, the reduced GLUC and INS excursion seen with CT suggests improved INS sensitivity or enhanced INS independent GLUC disposal. CT demonstrated minimal suppression of glucagon during MMTT vs LI that showed glucagon lowering. FI was lower for CT vs PL accompanied by reduction in hunger and appetite as assessed by VAS. There were no significant body weight changes in any treatment period. GI side effects were mostly mild and transient. This data supports a robust weight-independent effect of CT-868 (vs unbiased liraglutide) on glucose disposal with minimal suppression of glucagon. Further delineation of CT-868's longer term effects in overweight and obese patients with both T2D and T1D is underway.

Disclosure

M.Chakravarthy: Employee; Carmot Therapeutics, Inc. M.Hernandez: None. M.Elliott: Employee; Carmot Therapeutics, Inc. A.Macias: None. S.K.Hansen: Board Member; Carmot Therapeutics, Inc. M.Hompesch: Board Member; ProSciento, Consultant; Wiley-Blackwell, Employee; ProSciento, Stock/Shareholder; ProSciento.
849-P: Antidiabetic Effects of TLC-3595, a Selective ACC2 Inhibitor, in ZDF Rats
Authors: VIJAYAKUMAR ARCHANA , MURAKAMI EISUKE , HUSS RYAN S. , SRODA NATALIE , SHIMAZAKI ATSUYUKI , KASHIWAGI YUTO , MYERS ROBERT P. , SUBRAMANIAN MANI , SHULMAN GERALD I.
Published: June 2023

Background: TLC-3595 is a potent (IC50=14nM), selective, small molecule, allosteric inhibitor of acetyl-CoA carboxylase 2 (ACC2). TLC-3595 provides a novel therapeutic approach for type 2 diabetes (T2D), via reduction in intramyocellular lipid (IMCL) content, that is complementary to approved therapies. Reduced IMCL strongly correlates with insulin sensitivity (IS). Here, we demonstrate antidiabetic effects of TLC-3595 in Zucker Diabetic Fatty (ZDF) rats.

Methods: IMCL was measured by 1H-MRS. T2D progression and IS by hyperinsulinemic-euglycemic clamp were assessed in 30% diet-restricted ZDF rats treated with TLC-3595 (1.67, 5, or 15mg/kg) or pioglitazone (Pio, 0.75mg/kg) daily for 5-12 weeks.

Results: TLC-3595 or an analog caused rapid and sustained IMCL reduction (~50%) in lean and dysmetabolic rodents. TLC-3595 enhanced systemic fatty acid oxidation (increased plasma beta-hydroxybutyrate) and reduced cardiac lipid in ZDF rats. TLC-3595 dose-dependently delayed β-cell failure in ZDF rats and was non-inferior to Pio for reductions in hyperglycemia (15-25% lower glucose AUC) and HbA1c (0.6-1.6% vs. vehicle) (Fig A, B). TLC-3595 improved IS and increased clamp glucose infusion rate by 29%, (Fig C).

Conclusion: TLC-3595 reduced IMCL, improved IS, and delayed T2D progression comparable to Pio in ZDF rats. These data provide strong rationale for evaluation of TLC-3595 to treat insulin resistance and T2D.

Disclosure

A. Vijayakumar: Employee; OrsoBio Inc, Gilead Sciences, Inc. E. Murakami: Employee; OrsoBio. R.S. Huss: Employee; OrsoBio, Inc. Stock/Shareholder; OrsoBio, Inc. N. Sroda: None. A. Shimazaki: Employee; Shionogi & Co. Ltd. Y. Kashiwagi: Employee; Shionogi & Co. Ltd. R.P. Myers: Employee; OrsoBio, Inc. Stock/Shareholder; OrsoBio, Inc. M. Subramanian: Other Relationship; OrsoBio Inc. G.I. Shulman: Other Relationship; AstraZeneca, Merck & Co., Inc., Janssen Research & Development, LLC. Consultant; Novo Nordisk. Other Relationship; iMetabolic Biopharma Corporation, Maze Therapeutics, 89bio, Inc. Consultant; DiCerna Pharmaceuticals, Inc. Other Relationship; Equator Therapeutics, Inc., Generian Pharmaceuticals. Stock/Shareholder; Levels Health, Inc. Other Relationship; Fortress Biotech, Inc. Consultant; Bayer Consumer Care AG, Kriya Therapeutics, Arrowhead Pharmaceuticals, Inc., ESPERION Therapeutics, Inc. Other Relationship; OrsoBio, Aro Biotherapeutics Company.
877-P: Effects of SGLT2 Inhibitors on Gut Microbiota in Japanese Patients with Type 2 Diabetes
Authors: KUSUNOKI MASATAKA , HISANO FUMIYA , MATSUDA SHIN-ICHI , MIYATA TETSURO
Published: June 2023

SGLT2 inhibitors (SGLT2is) promote urinary glucose excretion, thereby lowering blood glucose. In addition, SGLT2is have been reported to reduce body weight. However, the mechanism underlying the reduction in the body weight induced by SGLT2i remains to be elucidated. In this study, we investigated the effects of SGLT2is on the gut microbiota. A total of 36 Japanese patients with type 2 diabetes received SGLT2is for 3 months, and the prevalences of balance-regulating bacteria (12 types), which regulate the balance of the gut microbiota to maintain health, and balance-disturbing bacteria (6 types), which disturb the balance of the gut microbiota to cause disease, in the feces of the patients before and after 3 months of SGLT2i treatment were determined. Furthermore, the prevalences of short-chain fatty acid-producing bacteria (6 types), which are thought to be involved in body weight gain and weight loss, were also analyzed individually. The SGLT2i treatment was associated with a significant increase of the overall prevalence of the 12 types of balance-regulating bacteria. In addition, significant increases in the prevalences of the short-chain fatty acid-producing bacteria among the balance-regulating bacteria were also observed. However, the SGLT2i treatment had no effect on the balance-disturbing bacteria. Individual analyses of the balance-regulating bacteria revealed that the SGLT2i treatment was associated with a significant increase in the prevalence of Ruminococci, which are balance-regulating bacteria classified as short-chain fatty acid-producing bacteria. In conclusion, SGLT2i treatment was associated with an overall increase in the prevalence of balance-regulating bacteria. Among the balance-regulating bacteria, the prevalences of short-chain fatty acid-producing bacteria increased. Since short-chain fatty acids have been reported to prevent obesity, these results suggest that SGLT2is might induce body weight reduction via their actions on the gut microbiota.

Disclosure

M.Kusunoki: Research Support; Taisho Pharmaceutical Holdings Co., Ltd., Ono Pharmaceutical Co., Ltd., Daiichi Sankyo, Kaken Pharmaceutical Co., Ltd., Eli Lilly Japan K.K. F.Hisano: None. S.Matsuda: None. T.Miyata: None.
879-P: Cardiorenal Outcomes Associated with the Use of Dapagliflozin Compared with DPP-4 Inhibitors as Add-on Treatment in Uncontrolled DM2 Patients with Failure to Previous Treatment—A Retrospective, Real-Life Evaluation in México
Authors: ESPINOZA-PERALTA DIEGO , HERNANDEZ-ALARCON JIMENA , LOPEZ IRLANDA N. , CETINA-CANTO JOSE , BÚRQUEZ-GONZÁLEZ MARIA E. , PAUL PEDRO V. , BUSTAMANTE GUADALUPE A. , CARLOS GARNICA CUELLAR JUAN , MIRELES-ZAVALA LEONOR G. , JUAREZ-COMBONI SONIA C. , RODRÍGUEZ ARELI M.
Published: June 2023

Mexico is one of the three countries in Region of Americas with the highest prevalence (14.4%) of DM. We conducted a retrospective study in Mexico and compare Dapagliflozin effect in cardio-renal outcomes and metabolic control compared to DPP4-inhibitors (DPP4i) as added-on therapy in T2DM patients with failure to previous medications.

Objectives: Compare proportion of patients achieving HbA1c below 7%, first appearance of eGFR below 60 ml/min, renal replacement therapy, heart failure hospitalization and death by the end of the 156-week observation period from index date.

Inclusion Criteria: T2DM subjects ≥18 years old with failure to any previous antidiabetic medication and HbA1c% ≥7 that started Dapa or DPP4i as add-on to other antidiabetic drugs from August 2014 to December 2019.

Statistical Methods and Analysis: A propensity score matching model (nearest neighbor algorithm) was used.

Results: Of 1800 subjects, 267 met statistical matching criteria. There were no differences in basal characteristics of age, SBP, Creatinine Clearance, but DAPA group had higher basal HbA1c (8.54±1.45 vs 8.16±1.43, p<0.01). Patients in Dapa compared to DPP4i achieved A1c ≤7% in 49.8% vs 20% (p<0.01) by week 156. Creatinine clearance between groups favored DAPA after week 52 (76.07±18.52 vs 86.40±21.27, p<0.01), and persisted through week 156 (68.19±19.4 vs 88.45±19.73, p<0.01). By week 52, Incidental CKD was present in 5.8% of Dapa group and in 14.8% of DPP4i group, p=0.013 (OR 0.607, 95% IC 0.409-0.901), and by week 156 6.5% DAPA vs 27.6% DPP4i, p<0.01 (OR 0.275, 95% IC 0.191-396). There were no differences in HF hospitalizations.

Conclusion: In patients with uncontrolled T2DM who have failed to previous antidiabetic therapies, the add-on of dapagliflozin significantly provides reductions of HbA1c, microalbuminuria and reduces the risk of CKD compared to DPP4i add-on.

Disclosure

D.Espinoza-peralta: None. S.C.Juarez-comboni: Employee; AstraZeneca. A.M.Rodríguez: Employee; AstraZeneca. J.Hernandez-alarcon: None. I.N.Lopez: None. J.Cetina-canto: None. M.E.Búrquez-gonzález: None. P.V.Paul: None. G.A.Bustamante: None. J.Garnica cuellar: None. L.G.Mireles-zavala: None.
891-P: SGLT2 Inhibitors Use and Diabetic Ketoacidosis in the Inpatient Setting
Authors: ZANKAR SARAH , ARNAOUT AMEL
Published: June 2023

Background: Current guidelines recommend SGLT2 inhibitors in patients with cardiovascular disease, chronic kidney disease and/or heart failure. Studies have demonstrated early initiation of SGLT2i in stable hospitalized patients to be safe and associated with benefits such as reduced hospitalization. However, SGLT2i are known to lower the threshold for developing diabetic ketoacidosis (DKA) and reported rates with real world use are higher than those seen in randomized controlled trials. There are limited studies evaluating the safe use of SGLT2i in the real world inpatient setting.

Aim: The primary aim of this study is to determine the incidence of DKA in patients with diabetes admitted to hospital and started or continued on an SGLT2i. A secondary aim is to determine risk factors to inpatient SGLT2i associated acidosis and make recommendations for safe initiation in hospital.

Methods: A retrospective chart review was performed on patients with diabetes admitted to a tertiary hospital with anion-gap metabolic acidosis (AGMA) between January 2020-June 2020 (prior to SGLTi being available on hospital formulary) compared to between January 2021-June 2021 (post-formulary). Patients were included if they were started or continued on an SGLT2i during their admission or were on an SGLT2i < 72h prior to admission.

Results: 159 patient charts met our inclusion criteria, with 43.4% (n=69) admitted prior to SGLT2i being available on hospital formulary and 56.6% (n=90) admitted post-formulary. There was a 12.2% (n=11) increase in patients with AGMA with SGLT2i being available on hospital formulary. 41.0% of patients were above the age of 70, and common issues during admission were infection (66.7%), acute kidney injury (44.0%), surgery (23.3%), and/or confusion (23.9%).

Conclusion: Increased use of SGLT2i in hospital resulted in an increase in incidence of inpatient DKA in older patients admitted with infection, AKI, surgery and/or confusion.

Disclosure

S.Zankar: None. A.Arnaout: None.
Use of Real-World Data in Population Science to Improve the Prevention and Care of Diabetes-Related Outcomes
Authors: Gregg Edward W. , Patorno Elisabetta , Karter Andrew J. , Mehta Roopa , Huang Elbert S. , White Martin , Patel Chirag J. , McElvaine Allison T. , Cefalu William T. , Selby Joseph , Riddle Matthew C. , Khunti Kamlesh
Published: June 2023

The past decade of population research for diabetes has seen a dramatic proliferation of the use of real-world data (RWD) and real-world evidence (RWE) generation from non-research settings, including both health and non-health sources, to influence decisions related to optimal diabetes care. A common attribute of these new data is that they were not collected for research purposes yet have the potential to enrich the information around the characteristics of individuals, risk factors, interventions, and health effects. This has expanded the role of subdisciplines like comparative effectiveness research and precision medicine, new quasi-experimental study designs, new research platforms like distributed data networks, and new analytic approaches for clinical prediction of prognosis or treatment response. The result of these developments is a greater potential to progress diabetes treatment and prevention through the increasing range of populations, interventions, outcomes, and settings that can be efficiently examined. However, this proliferation also carries an increased threat of bias and misleading findings. The level of evidence that may be derived from RWD is ultimately a function of the data quality and the rigorous application of study design and analysis. This report reviews the current landscape and applications of RWD in clinical effectiveness and population health research for diabetes and summarizes opportunities and best practices in the conduct, reporting, and dissemination of RWD to optimize its value and limit its drawbacks.
THE ROLE OF MOBILE APPS IN DESTINATION MARKETING AND BRANDING
Authors:   Babeş-Bolyai University, Cluj-Napoca, Faculty of Political, Administrative and Communication Sciences, BENEDEK István , SZÖLLŐSI Tamás ,   National University of Public Service, Budapest, Hungary, Public Administration Doctoral School
Published: June 2023

Since the turn of the millennium, mobile applications have played an increasingly mportant role in destination marketing and branding. Official destination apps are specific media channels designed to communicate the unique characteristics of a destination and influence visitors’ perceptions of the place. To date, no prior research has been carried out to analyse the use of destination mobile apps in Romania. The current paper tries to fill in this gap in the literature and provide an analysis of destination mobile apps of Romanian counties using a revised framework based on literature review and earlier studies.
THE STRANGER AMONG US IN COMICS FROM CUTEZĂTORII MAGAZINE. CONSTRUCTING CHILDREN’S POLITICAL IDENTITIES THROUGH INTERACTION WITH THE OTHER IN COMMUNIST ROMANIA
Authors:   Babeș-Bolyai University: Cluj-Napoca, ILOVAN Oana-Ramona
Published: June 2023

A product of popular culture, comics are in tune with the societal context that created them. This article aims to present the hegemonic narrative, reading and messages of comics for communist pioneers in Cutezătorii [The Daring Ones] Magazine. To do so, the research material considered is made up of two comics focused on Otherness and Romanians’ relationships with state institutions close to the political factor. Qualitative content analysis was performed on both text and images. Findings uncovered a partial view of communist Romania and of the workings of propaganda, because, beside their entertainment value, these comics can be read as political texts or statements. These comics show how the political elite perceived those who wanted to leave Romania (illegally) and those who, of foreign origin, visited this country. Both comics series glorify the collaboration with the Militia, the State Security, and their surveillance methods (through technology and responsible employees and citizens). Communist pioneers are plain clothes detectives who help these institutions to gather their information, catch criminals, and keep the society under control. Because cultural representations impacted the Romanian society in multiple ways during the totalitarian communist rule, a critical reconsidering of cultural products of the past is necessary in order to better understand the present.
Dynamic algorithm to boost the synergy between biogas plants and photovoltaic plants
Authors: C. Roldán-Blay  , D. Dasí-Crespo  , C. Roldán-Porta  , G. Escrivá-Escrivá  , E. Quiles-Cucarella
Published: June 2023

This research work proposes an efficient management algorithm for the integration of a biogas and photovoltaic plant for self-consumption. The algorithm is based on the optimization of production and energy use in the plants to meet demand at a reduced cost. The algorithm has been validated using models and simulations, using real data from experimental trials, and comparing the results with simple, non-adaptive control strategies. The results obtained show that the synergy between biogas production and solar energy generation is a promising strategy to increase efficiency and sustainability of electricity production. The algorithm has the potential to overcome technical and economic challenges and is a valuable tool for medium-sized installations. Furthermore, the study found that the algorithm can reduce the cost of electricity by up to 5% on average and even more under certain conditions. Additionally, this research highlights the need for further studies to develop advanced algorithms that are adaptable to different scenarios and weather conditions.
Impact of electric vehicles fast frequency regulation and charging strategies on grid frequency stability
Authors: A. Ordono  , F.J Asensio  , J.I. San Martín  , M. González-Pérez  , J.A. Cortajarena
Published: June 2023

With the gradual reduction of grid inertia, system sensitivity to load unbalances is increasing, compromising frequency stability. To face this problem, faster frequency regulation resources are required. In this context, vehicle-to-grid (V2G) is one of the concepts that is suggested for this purpose. When electric vehicles (EVs) are parked, their batteries can be used as distributed energy storage systems (EESs), injecting and absorbing power faster than conventional generation units (CGUs). The goal of this paper is to analyse the impact of fast frequency regulation of EVs in a small-scale grid, under sudden load variations. In this paper, the effect of charging strategies (CSs) is addressed, as they have a direct impact on the magnitude of the EV fleet regulation. In this way, different CSs can be used to achieve symmetrical up and down regulation, or to maximize one of them. The effect of the EV fleet dynamics in the frequency transient is also studied. The speed of response, and hence, the frequency transient, are influenced by these dynamics. The focus of the analysis will be the communication delay between the EV fleet and the central controller.
Evaluation of the Potential of Ethyl Esterification Reaction Catalyzed by Enzyme to Improve the Quality of Bio-Oil
Authors: Cândida Luiza Simonato  , Aline Gonçalves  , Bruno Eduardo Piske  , Luana Marcele Chiarell  , Vanderleia Botton  , Laércio Ender  , Vinicyus Rodolfo Wiggers
Published: June 2023

Biomass has been investigated in recent years as an alternative source for fuel production. The use of triglyceride biomass is highlighted and, from the thermal cracking process, solid, liquid and gaseous products with energetic potential are generated. The liquid product, called bio-oil, has characteristics similar those of fossil fuels. Its composition is mainly based on hydrocarbons and carboxylic acids, and the second group generates a limiting characteristic in its processing, refining and use as fuel, increasing the acidity of bio-oil. In this work, bio-oil produced from commercial soybean oil was used in a thermal cracking process at 525ºC. The objective was to carry out ethyl esterification reactions via enzymatic catalysis in order to reduce the acidity index of the crude bio-oil. All reactions were carried out at 40ºC to avoid enzyme deactivation and different conditions of type and amount of catalyst, alcohol mass ratio and reaction time were evaluated. The best result was obtained after 6 hours of reaction with 60% acidity reduction, using Novozym 435 lipase as a catalyst at a concentration of 5% in relation to the substrate mass and 1:3 mass ratio.
Technical versus socio-economic and environmental criteria in power transmission projects
Authors: N. Naval  , J.M Yusta
Published: June 2023

In recent years, the efforts of countries to reach agreements on the development of cross-border electricity interconnection have intensified because they optimize energy resources and constitute the most significant instantaneous support for the security and continuity of electricity supply. In addition, interconnections play a key role in the integration of electricity markets. However, the planning of European electricity infrastructures constitutes complex analyses due to the large number of factors involved. This article applies a multicriteria methodology for the evaluation and prioritization of cross-border interconnection projects with the simulation of different scenarios, in total 12 scenarios, to study the effect of changes in the selected criteria on the results obtained. To test the defined methodology, the variation in the weight of different criteria in the assessment of a new cross-border electrical interconnection project between Spain and France is studied. It was verified that the tool is coherent and that the analysis developed improves the understanding of such large and complex projects and can facilitate the prioritization of project portfolios with a clear and explicit method.
DSUALMH- A new high-resolution dataset for NILM
Authors: C. Rodriguez-Navarro  , A. Alcayde  , V. Isanbaev  , L. Castro-Santos  , A. Filgueira-Vizoso  , F.G.  Montoya
Published: June 2023

The optimisation of energy consumption requires a reasonably accurate measurement, so an appropriate and advanced monitoring system of the relevant electrical variables in the electrical installations is of paramount importance. In this context, interoperable and highly configurable devices play a crucial role. A clear example is the OpenZMeter (OZM) which is an open source, open hardware, multi-purpose precision smart meter that can measure a wide range of electrical variables at a high sampling rate and provide processed data on power quality. The aim of this work is to show the use and possible applications of the new high sampling frequency data provided by the OZM device, which are much richer and more accurate than those obtained with other low-cost electrical meters. For this purpose, the opensource tool NILMTK has been used and adapted. Likewise, the use of two of the best known and most widely used algorithms such as Combinatorial Optimisation (CO) and the Factorial Hidden Markov Model (FHMM) has been considered, analysing the results obtained in the experimental study and offering a detailed comparison of the performance of the two different disaggregation algorithms using metrics for the different cases, as well as the incorporation of transients, and the comparison with other public Datasets
A Benchmark and Validation Guide for the Hungarian Implementation of the Common European Requirements for Electricity Generators
Authors: Dr. Istvan Vokony  , Kristóf Juhász  , Márk Somogyi
Published: June 2023

In the Hungarian electricity system, as well as in other European countries, the share of renewable based production is increasing. These power generating modules do not contain rotating masses like those of traditional synchronous power generating modules which creates new challenges on the electric grid with respect to system stability and frequency control. The distribution system operators (DSOs) of the different countries need to cope with this problem and set frequency, voltage thresholds and robustness requirements for the electricity generating power plants. This project aims to create specific requirements for the Hungarian generators considering the former implementations of other countries (UK, Germany, Denmark and Finland). The different requirements of these foreign areas are introduced in a benchmark study, which is the first essential part of the whole project. Such implementations are only partially defined for Hungary; therefore, in some cases it is necessary to use the implementations of other foreign countries which have similar grid characteristics and are dealing with the same control and operation challenges. Another important milestone of this work besides the benchmark study is to present a validation guide for the Hungarian transmission system operator (TSO) that can be sent directly to the operators of electric power generating modules with six different types. These guides contain compliance tests for the power plants to examine whether they meet the requirements of grid connection or not.
One Network for Europe – Scalability and Replicability in View of Harmonised Electricity Markets
Authors: I. Vokony  , G. M. Péter  , P. Sőrés  , B. Hartmann
Published: June 2023

Renewable energy production is mentioned by many as one of the key factors in mitigating the effects of climate change. However, there may be several downsides to the spread of renewables, such as their impact on the balance of the electricity system and on receiving networks. The project OneNet (One Network for Europe) is funded through the EU’s eighth Framework Programme Horizon 2020. It is titled “TSO – DSO (TransmissionDistribution System Operator) Consumer: Large-scale demonstrations of innovative grid services through demand response, storage and small-scale (Renewable Energy Source) generation” and responds to the call “Building a low-carbon, climate resilient future”. While the electrical grid is moving from being a fully centralized to a highly decentralized system, grid operators must adapt to this changing environment and adjust their current business model to accommodate faster reactions and adaptive flexibility. This is an unprecedented challenge requiring an unprecedented solution. Thus, the two major associations of grid operators in Europe, the European Network of Transmission System Operators for Electricity (ENTSO-E) and European Distribution System Operators (EDSO), have activated their members to establish a unique consortium.
Single -Phase Hybrid Converter With Series Voltage Compensation On The DC Bar Applied to Micro grids
Authors:   Department of Electrical Engineering Triangulo Mineiro Federal University. Brazil, Mattos D. , Rodrigues D. , Albertini M.R. , Bernardelli C. , Moura A. , Mendonça M.V. , Rosentino A.J. , Rimoldi de Lima R. , Rezende P.H. ,   Department of Electrical Engineering of University of Uberlandia. Brazil, Lima G. , Rezende J.O. ,   Department of Electrical Engineering of Federal Institute of Goais. Brazil
Published: June 2023

This work presents the development of computer simulation of a topological structure of singlephase hybrid converter that aims to impose sinusoidal input current and the supply of a DC bus with regulated voltage using the voltage series compensation. With the increase in distributed generation by the use of DC renewable energy sources by microgrids, the characteristics of the structure proposed to make it an excellent alternative for applications involving the compensation of voltage fluctuations due to to the intermittence of microgeneration systems.
A First Approach on the Impact of Distributed Generation and Fault Impedance on Studies on domain of frequency of Voltage Sags
Authors: A. C. L. Ramos  , A. J. Batista  , R. C. Leborgne  , E. G. Domingues  , W. P. Calixto
Published: June 2023

An analysis of the distributed generation (DG) and fault impedance on studies of voltage sags caused by system faults is presented on domain of frequency. The simulation of 62 case studies of phase-to-ground faults on 13.8, 69, 138 and 230 kV transmission lines were performed and the voltage of a 380 V sensitive industrial busbar client was monitored. These lines are part of the electrical system of the city of Goiania, Brazil. For each case study, different fault positions and impedance fault were simulated by considering different DG levels connected to the consumer busbar. Long-term simulation scenarios were obtained by the Monte Carlo method and analyzed based on their cumulative distribution functions and probability density curves of voltage sags. This is one major contribution of this work.