bluuebunny/crossref_metadata_2025 huggingface dataset:
Komparasi Term Weighting dan Word Embedding pada Klasifikasi Tweet Pemerintah Daerah
Authors: Pande Made Risky Cahya Dinatha  , Nur Aini Rakhmawati
Published: June 2020

Munculnya media sosial mendorong pemerintah untuk memanfaatkan media sosial sebagai sarana penyebaran informasi. Informasi yang diberikan haruslah bermanfaat bagi masyarakat dalam rangka meningkatkan hubungan government to citizen. Klasifikasi terhadap unggahan media sosial pemerintah daerah dapat dilakukan untuk mengetahui jenis informasi yang diunggah. Penelitian klasifikasi unggahan media sosial pada studi kasus pemerintah daerah di Indonesia telah berhasil dilakukan, tetapi pengolahan teks untuk membangun model klasifikasinya masih dapat dieksplorasi. Metode pengolahan teks yang dibahas di dalam makalah ini adalah term weighting dan word embedding. Tujuan makalah ini adalah membandingkan term weighting term frequency-inverse document frequency, Okapi BM25, dan word embedding doc2vec dalam menghasilkan fitur untuk mengatasi masalah klasifikasi teks pendek. Makalah ini merepresentasikan teks sebagai fitur untuk melakukan klasifikasi, mengetahui kinerja model klasifikasi yang telah menerapkan teknik tersebut, dan membandingkan kinerja setiap model klasifikasi untuk mengetahui metode terbaik di dalam studi kasus klasifikasi unggahan media sosial pemerintah daerah di Indonesia. Terdapat enam kelas untuk mengklasifikasi 1.000 teks pendek dari 91 akun pemda. Pengukuran precision, recall, f-1, macro-average, micro-average, dan AUC dilakukan pada masing-masing model. Hasil menunjukkan bahwa model TF-IDF bersama SVM linear memberikan hasil yang lebih baik dibandingkan logistic regression dengan skor 0,572 dan 0,766 pada pengukuran macro-average recall dan micro-average recall.
TO STUDY PRESCRIPTION PATTERN IN THE MANAGEMENT OF OSTEOARTHRITIS IN TERTIARY CARE HOSPITAL
Authors: LAHAMATE SHRIKANT B , U RAZVI SYED
Published: June 2020

Objective: The leading cause of disability is arthritis among adults worldwide. Osteoarthritis (OA) is the most common form of joint disease and the leading cause of pain in elderly people. The aim of the study was to study the prescription pattern in the management of OA.

Methods: A prospective observational study was conducted in a tertiary care hospital for period of 12 months in collaboration with the department of orthopedics. A total of 630 patients enrolled in the present study with fulfilling inclusion and exclusion criteria. Patients’ data recorded in case report form and analyzed to study the prescription pattern.

Results: A total of 630 cases were enrolled in this study. Osteoarthritis is more common in female i.e. 55% followed by male i.e. 45% of patients. Old age (39.84%) is most common risk factor followed by obesity (29.68%) in OA patient. Most commonly prescribed drug was diclofenac followed by paracetamol. Nonsteroidal anti-inflammatory drugs were most commonly prescribed class of drug, i.e., 92.19%. In this study, combination therapy most commonly prescribed, i.e., 75.4% followed by monotherapy, i.e., 24.6%. Combination therapy in OA patients two drug therapy, i.e., 88.42% followed by three drug therapy, i.e., 10.53%.

Conclusions: The principal aim of drug utilization research is to facilitate the rational use of drugs. The study shows that OA more common in female patient than male patient. The most common disease distribution site was knee in OA patient. Old age was the most common encounter risk factor in OA patient. Combination therapy was most commonly used than single drug therapy.
CURCUMIN PROTECTION AGAINST CADMIUM CHLORIDE-INDUCED BIOCHEMICAL ALTERATIONS IN LUNGS OF SWISS ALBINO MICE
Authors: KUMARI AMRITA , SHARMA SUMAN
Published: June 2020

Objective: The aim of the present study was to investigate the protective effect of curcumin against cadmium chloride (CdCl2)-induced toxicity in lungs of albino mice.

Methods: Albino mice were divided into eight groups and five mice were kept in each group. The experiment was carried out for 15 and 45 days. Group 1 mice were kept as control. Group 2 mice were given an oral dose of 1 mg/kg body weight of cadmium chloride on alternate days. Group 3 mice were administered an oral dose of 1 mg/kg body weight of cadmium chloride on alternate days and 100 mg/kg body weight of curcumin daily. Group 4 mice were received an oral dose of 100 mg/kg body weight of curcumin daily. Autopsies were done on 15 and 45 days post-treatment.

Results: The results of the present study showed a significant decrease in organ weight at both the intervals. Biochemical analysis showed decline in total glycogen, cholesterol, and protein concentration in lung of cadmium chloride-treated mice. Furthermore, the cadmium chloride concentration in cadmium chloride-treated group was increased in comparison to the control group. However, the treatment with curcumin ameliorated cadmium chloride-induced changes in lung tissue as it instigated the antioxidant enzymes remarkably. However, cotreatment of cadmium chloride with curcumin boosted the changes due to cadmium chloride.

Conclusion: Hence, we concluded that curcumin has protective efficacy in the lungs against the cadmium chloride generated toxicity in albino mice.
EFFECT OF SUPPLEMENTATION OF VITAMIN C ON BLOOD GLUCOSE AND GLYCOSYLATED HEMOGLOBIN LEVELS IN EXPERIMENTALLY-INDUCED DIABETIC RABBITS
Authors: P VIJAYAKRISHNA , TS USHASREE , K INDIRA , NAVEEN AVULA , S SHIRISHA
Published: June 2020

Objectives: Diabetes mellitus (DM) is a spectrum of common metabolic disorders, arising from a variety of pathogenic mechanisms resulting in hyperglycemia that causes chronic micro- and macro-vascular complications. Vitamin C is structurally similar to glucose and can replace it in many chemical reactions and thus is effective in the prevention of non-enzymatic glycosylation of proteins. Hence, the present study taken up to see the effect of supplementation of Vitamin C on blood glucose and glycosylated hemoglobin (HbA1c) along with metformin in experimentally-induced diabetic rabbits.

Methods: Twenty-four adult New Zealand white rabbits (1.5–2.5 kg) were divided into four groups, each containing six rabbits. Group 1: Normal control (distilled water); Group 2: Metformin (23.33 mg/kg) is given orally; Group 3: Metformin (23.33 mg/kg) plus Vitamin C 250 mg are given orally; and Group 4: Metformin (23.33 mg/kg) plus Vitamin C 500 mg are given orally. Animals were treated for 30 days. The blood samples were collected on days 0 and 30 from the marginal ear vein of rabbits for the estimation of blood glucose and HbA1c levels.

Results: Statistically analyzed by ANOVA test followed by post hoc Tukey’s test using GraphPad Prism software. Results shown that Vitamin C 500 mg oral supplementation with metformin had very highly significantly reduced HbA1c levels by 40.12% (p = 0.0001***) and blood glucose levels by 49.12% (p = 0.0003***), whereas Vitamin C 250 mg oral supplementation with metformin also significantly reduced HbA1c levels by 25.49% (p = 0.0001***) and blood glucose levels by 42.95% (p = 0.0026**) when compared to metformin alone, which reduced HbA1c levels by 22% (p = 0.0001***) and blood glucose levels by 39.58% (p = 0.0001***).

Conclusion: Oral supplementation of Vitamin C 500 mg/250 mg to the metformin was superior in reducing HbA1c levels and blood glucose levels compared to metformin alone in rabbits. Hence, Vitamin C oral supplementation may be helpful in lowering blood glucose levels and HbA1c levels and improving glycemic control in Type 2 DM.
PENENTUAN KANDUNGAN LOGAM BERAT PADA AIR TANAH DI KECAMATAN KUBU BABUSSALAM, ROKAN HILIR, RIAU
Authors: Putra Arief Yandra , Mairizki Fitri
Published: June 2020

Water is a material that can not be separated from the life activities of living things on earth. One of the water resources that gets the most attention and the most needed is ground water. Ground water is a hydrological cycle that involves several aspects such as bio-geo-physical and socio-cultural. Heavy metals are pollutants that are most often found in water. This heavy metal has a negative impact on humans who use the water and organisms that are in the water. The purpose of this study was to analyze the content of heavy metals contained in ground water in the District of Kubu Babussalam, Rokan Hilir, Riau. Sampling using random sampling technique. Ground water in Kubu Babussalam Subdistrict has been contaminated by heavy metals such as lead (Pb), copper (Cu), iron (Fe), cadmium (Cd) and chromium (Cr). The Pb content contained in ground water ranges from 0,01-0,06 mg/L, Fe ranges from 1,3-2,2 mg/L while the content of the other three metals still very little and were carried under the LOQ value of the measuring instrument used. Based on Permenkes 416/MEN.KES/PER/IX/1990, there was one sample point that had Pb metal content above the quality standard, and there were seven sample points that had Fe metal content above the quality standard.

 
Optimization of the Tensile Properties of Polymeric Matrix Composites Reinforced with Magnetite Particles by Experimental Design
Authors: Lara-González Luis Ángel , Guillermo-Rodríguez Wilmar , Pineda-Triana Yaneth , Peña-Rodríguez Gabriel , Salazar Hugo Felipe
Published: June 2020

A full-factorial 33 experiment was used in this study to determine the optimal values of the tensile properties of three composite materials manufactured based on three polymeric resins: Derakane Momentum epoxy vinyl ester based on bisphenol-A (DM-411), polyester based on terephthalic acid (P115-A), and isophthalic polyester (P2000). Such materials were reinforced with magnetite powders at concentrations of 10, 20, and 30 wt %, and the particle sizes were classified with three sieves: #200 (46–75 μm), #325 (26–45 μm), and #500 (0–25 μm). The compounds were manufactured using the hand lay-up method at room temperature in accordance with ASTM D638-14 for M1-type specimens. A tensile test was conducted on a universal Microtest EM2/300/FR machine at a test speed of 5 ± 25 % mm/min using an Epsilon extensometer calibrated in accordance with the ASTM E83 standard at 20 ± 2 °C. The magnetite powders and compound morphology were studied by Scanning Electron Microscopy. The mechanical properties of the compounds and the optimal response found by Analysis of Variance (ANOVA) and Response Surface Methodology (RSM) are also reported. The best response to the mechanical stimuli occurs with the composite material prepared with the epoxy vinyl ester resin DM-411, a concentration of 29.4 % of magnetite (Fe3O4), a particle size of 58.5 microns, and a 200 sieve.
Dependencia de la sensibilidad en un cristal fotónico unidimensional con el ángulo incidente de la radiación para la detección de célula cancerígenas
Authors: Trujillo-Yague Juan Carlos , Segovia-Chaves Francis
Published: June 2020

En este trabajo calculamos la dependencia de la sensibilidad de cinco células cancerígenas con el ángulo incidente de la radiación en un cristal fotónico unidimensional. El estudio se realizó para dos tipos de polarización: Transversal Eléctrica (TE) y Transversal Magnética (TM). Las muestras de las células se infiltran mediante biopsia líquida dentro de una nano cavidad que funciona como recipiente, y es revestida por nanocompuestos formados por la mezcla de la sílice con nano partículas de plata de tal forma que rompe la periodicidad del cristal fotónico compuesto por capas de SiO2 y aire. Encontramos picos de resonancia en el espectro de transmisión que caracteriza a cada célula infiltrada, por ende, este mecanismo de detección permite que el cristal fotónico funcione como un biosensor. Mediante el método de la matriz de trasferencia, para la polarización TE se observó un incremento de la sensibilidad al aumentar el ángulo incidente. Sin embargo, en la polarización TM no existieron aumentos significativos. Adicionalmente, se varía el espesor de la nano cavidad y el factor de relleno para obtener una mayor optimización. Los resultados revelan un incremento en la sensibilidad al aumentar el espesor de la nanocavidad, mientras que al aumentar el factor de relleno la sensibilidad decrece.
Un método para la evaluación de la accesibilidad y la usabilidad en aplicaciones móviles
Authors: Paniagua L. Andrés , Bedoya R. Diana , Mera Carlos
Published: June 2020

Internet es el mayor medio de difusión de información y el mayor canal de prestación de servicios que existe actualmente. Debido a que el número de sus usuarios se mantiene en constante crecimiento, se debe procurar por la inclusión de aquellas características que velan por el aseguramiento del acceso a la información de toda la población, incluyendo a las personas con necesidades especiales. En este sentido, es necesario asegurar el cumplimiento de los estándares de accesibilidad propuestos por el World Wide Web Consortium (W3C) a través de las Pautas de Accesibilidad de Contenido Web (WCAG) y las Mejores Prácticas de Web Móvil (MWBP). Diferentes autores afirman que, incluso teniendo conocimientos de las falencias de accesibilidad de las aplicaciones existentes, los desarrolladores presentan problemas en su evaluación, al igual que en la valoración de la usabilidad. Si bien existe una guía para realizar dicha evaluación, esta no está completa y los elementos que definen la evaluación aún son incipientes. En este sentido, es importante definir un método que permita evaluar no solo la usabilidad, sino también la accesibilidad de las aplicaciones web y móviles, sobre todo, considerando aquellos usuarios que poseen necesidades especiales. Con base en lo anterior, en este trabajo se propone un método para la evaluación de usabilidad y accesibilidad para aplicaciones móviles, desarrollado en seis fases iterativas, las fases iniciales del método buscan asegurar el cumplimiento de los niveles de accesibilidad deseados según el W3C; seguidamente, se busca el cumplimiento de la usabilidad aplicando las fases restantes del método, obteniendo como resultados mejoras en cada iteración. Al usar el método para evaluar la aplicación “Diccionario de Neologismo”, se evidencia una mayor detección de fallas en la implementación del estándar de W3C y mejoras en las respuestas obtenidas por medio de encuestas de satisfacción.
Curating the Art School – Propositions for developing a collaborative art space in the intersection between art school and community
Authors: Susanne Clausen
Published: June 2020

This exposition presents the ongoing artistic research project ‘Curating the Art School – Propositions for developing a collaborative art space in the intersection between art school and community’ which has driven the creation of a new arts organisation at the University of Reading. I would like to offer an introduction to the research questions, a situational and theoretical background and present some of the artistic and curatorial explorations via photo documentation and links to the project pages as a running visual commentary.

‘Reading International’ was established to develop and test the creation of a liminal space between an art school, a regional arts community and an international contemporary art network. By inviting artists to respond to the specific social and historical framework offered by the art school and the town the project aims to explore how we can imagine the art school in a university as a public arena, which opens its life beyond the academic community and actively engages with a wider public? Could the art school become a catalyst to create a speculative thinking space, erasing hierarchical (and economic) divisions between the educational environment and wider publics? How can we create a space that is less separated from the professional public, where artists collaborate with students and the community to create a dynamic cultural space in a regional environment? I would like to set out these questions at an interim stage of the project as a way to invite further responses and discussion.
Leiomyosarcoma of the upper respiratory tract: A case report and review of literature
Authors: Milic-Perovic Marija , Solajic Nenad , Rakic Nebojsa , Vuckovic-Hardi Lidija
Published: June 2020

Introduction. Leiomyosarcoma is a malignant smooth muscle tumor that is most often found in the gastrointestinal tract, uterus, and retroperitoneum. It is uncommon in the upper respiratory tract. Case report. A 53-year-old woman sought treatment for a 3-month history of nasal obstruction and facial pain. An endoscopic examination revealed a polypoid mass involving the right nasal cavity. The patient was operated on. During surgery, a bulky tumor mass was found, which involved the posterior part of the right inferior concha projecting into the lumen of the epipharynx and upper part of the oropharynx. The lesion was completely excised with adequate margins of uninvolved tissue. Histologic slides stained with hematoxylin and eosin showed interlacing fascicles of atypical spindle-shaped cells. Mitotic figures and bizarre giant cells were frequently observed. Immunohistochemical staining revealed that the tumor was positive for smooth muscle actin and h-caldesmon and negative for S-100. Histological and immunohistochemical features were consistent with leiomyosarcoma. The follow-up was regularly performed by nasal endoscopy and computed tomography, and the disease-free period has been 53 months so far. Conclusion. To the best of our knowledge, this is the longest disease-free period in a patient with leiomyosarcoma of the upper respiratory tract since 1996. This tumor has obscure clinical behavior and prognosis, thus we believe it is necessary to have more published data to determine the best combination of existing therapies, as well as potential new therapies, and enable a longer survival period.
Mathematical procedure for prediction of dental anxiety in children with inherited bleeding disorders
Authors: Vujkov Sanja , Cveticanin Livija , Bajkin Branislav , Blagojevic Duska , Milekic Bojana , Vucinic Predrag
Published: June 2020

Background/Aim. The dental anxiety in children is commonly measured applying the Dental Anxiety Scale (DAS) and the level is statistically treated. However, there are no studies on prediction of development of dental anxiety. The aim of this study was to develop a mathematical procedure for dental anxiety prediction based on the statistical values. Methods. Mathematical relation between the dental anxiety and aging was developed using the interpolation method based on the statistical values. It was supposed that the anxiety level is a polynomial function of the age. The obtained function was tested on the healthy children and those with inherited bleeding disorders. By mathematical fitting procedure using statistical data, the analytical relation for prediction of dental anxiety as a function of aging was developed. Results. According to prediction function, it was found that for healthy population the dental anxiety has the tendency to increase quite slowly or to remain almost constant after the age of 18. In the patients with inherited bleeding disorders, the DAS score would increase even after age of 18. The treatment of the anxiety in children with inherited bleeding disorders is optimal at about the age of 12 when they become aware of their illness. Conclusion. The introduced prediction function gives the tendency of DAS score development which enables timely adequate action in reducing dental anxiety. The predicted DAS score may be used as a control measure of oral health.
1012-P: Study of Insulin Stability Impact on Pump Therapy: Test Model Development
Authors: CHATTARAJ SARNATH , ZHANG GINA , ANSELMO EVAN , FUSSELMAN JENNY (HSI) C.
Published: June 2020

Objective: Develop a test methodology for evaluating the reason for infusion set (IS) failure in persons with diabetes using insulin pump therapy (Continuous Sub-cutaneous Insulin Infusion, CSII). Insulin stability (physical, chemical, and microbiological) and/or the loss of preservatives in the infusate are thought to play significant roles in shortening IS wear time. In-vitro and in-vivo methods were used to assess the cause(s) site inflammation and the loss of preservatives.

Method: Fast-acting insulin (insulin aspart and lispro) were pumped through different infusion sets (>4) under simulated-use conditions. The pumped insulin and non-pumped insulin controls were characterized for physical, chemical, and microbiological properties. The pumped insulin, combined with fibrinogen (an initiator for material foreign body responses), were tested in murine macrophage cell culture for inflammatory responses. The corresponding infusion sets were tested in vivo in a diabetic porcine model to determine IS wear-time.

Result: Pumped insulins in ≥8 insulin/IS combinations met corresponding criteria in USP insulin monographs, indicating no significant chemical changes. Lower preservative content was found to increase insulin aggregates in-vitro/in-vivo. Pro-inflammatory cytokines (MIP-1α, and MCP-1) increased significantly in the inflammatory in-vitro model. The IS wear-time was shortened from 4.9±0.3 days (control) to 1.7±0.3 days (p<0.0001) with lower preservative content (<50% per label claim).

Conclusion: Preliminary findings from in-vitro and in-vivo test model development indicate that macrophage number, the inflammatory response, and device wear time were significantly impacted by loss of preservative and trace aggregates/particles. The new test methodology can further our understanding as to how to improve IS wear time.

Disclosure

S. Chattaraj: Employee; Self; Medtronic. G. Zhang: None. E. Anselmo: Employee; Self; Medtronic. J.C. Fusselman: None.
1037-P: Efficacy and Safety of Fast-Acting Insulin Aspart in Adults with T2D with Different Insulin Requirements
Authors: LANE WENDY , EKELUND MAGNUS , THÓRISDÓTTIR ÓLÖF , JÓDAR ESTEBAN , OVIEDO ALEJANDRA , RATHOR NAVEEN , SENIOR PETER , SESTI GIORGIO , FRANEK EDWARD
Published: June 2020

A previous post-hoc analysis of the 26-week onset 2 trial indicated that with insulin glargine the effect of fast-acting insulin aspart (FA) vs. insulin aspart (IAsp) on PPG increment (meal test) was larger for subjects on high bolus insulin doses in bolus-naïve adults with T2D (duration ≥6 mo). This post-hoc analysis of the 16-week onset 9 trial aimed to confirm this and explore efficacy and safety of FA vs. IAsp, both with insulin degludec, in bolus-experienced adults with T2D (duration ≥10 yrs) by insulin requirement. Participants were divided by meal test bolus dose at baseline: ≤10 U (n=303), 10-20 U (n=518) or >20 U (n=270). Baseline characteristics were similar across subgroups; except for BMI and daily insulin dose, which increased with meal test dose (Table). Change from baseline in HbA1c 16 weeks post randomization was similar for FA vs. IAsp across subgroups. There was a trend in favor of FA vs. IAsp for change from baseline in PPG increments (meal test), but treatment differences did not depend on subgroup. There was a trend towards lower rates of severe or blood glucose-confirmed hypoglycemia with higher insulin doses at meal test, with a benefit for FA vs. IAsp in the >20 U subgroup. Treatment difference (FA vs. IAsp) in change from baseline in PPG increments was unaffected by bolus insulin dose; however hypoglycemia risk may be lower with FA vs. IAsp in adults with long-standing T2D and high bolus insulin requirements.

Disclosure

W. Lane: Research Support; Self; AstraZeneca, Gilead, Mylan, Sanofi, Tolerion, vTv. Other Relationship; Self; Dexcom, Insulet, Novo Nordisk. M. Ekelund: Employee; Self; Novo Nordisk. Stock/Shareholder; Self; Novo Nordisk. Stock/Shareholder; Spouse/Partner; Novo Nordisk. Ó. Thórisdóttir: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. E. Jódar: Other Relationship; Self; Elli Lilly & Co, Novo Nordisk, MSD, Lilly, Janssen, Pfizer, AstraZeneca, Sanofi, UCB, Amgen, FAES, Shire, Mundipharma, Novartis. A. Oviedo: None. N. Rathor: Employee; Self; Novo Nordisk. P. Senior: Research Support; Self; Allergan, Novo Nordisk. G. Sesti: Advisory Panel; Self; Servier, Mylan, Novo Nordisk, Boehringer Ingelheim, Lilly, AstraZeneca, MSD, Sanofi, Amgem, Novartis, GSK. Speaker’s Bureau; Self; Novo Nordisk, Servier, MSD, Boehringer Ingelheim, Lilly, AstraZeneca, L-Nutra, Theras, Sanofi, Mundipharma, Omikron, Novartis. E. Franek: Advisory Panel; Self; Novartis AG. Speaker’s Bureau; Self; AstraZeneca, Bioton, Eli Lilly and Company. Other Relationship; Self; Boehringer Ingelheim, Novo Nordisk.

Funding

Novo Nordisk
1055-P: Glycemic Variability with Dulaglutide vs. Basal Insulin Glargine
Authors: JODAR ESTEBAN , ROMERA IRENE , WANG QIANQIAN , CAVEDA ELENA , GARCIA LUIS EMILIO
Published: June 2020

Reductions in glycemic variability (GV) may be associated with decrease in cardiovascular complications. This analysis assessed GV in people with type 2 diabetes receiving dulaglutide (DU) 1.5 mg once weekly or basal insulin glargine (IGlar) in two clinical trials. AWARD (AW) 2 participants on metformin and glimepiride randomized to DU (N=173) or IGlar (N=161). AW9 participants randomized to DU (N=127) or placebo (N=120), both added to IGlar with/without metformin. GV measured at baseline and study endpoint (AW2: week 26; AW9: week 28). Studies analyzed separately for within-day and between-day GV from self-monitored blood glucose (SMPG), and between-day GV from fasting self-measured plasma glucose (FSMPG), by standard deviation (SD). AW2 DU and IGlar arms were 54% and 51% male at baseline; mean (SD) HbA1c of 8.2 (1.0) and 8.1 (0.9) %; fasting plasma glucose (FPG) 162.0 (46.7) and 161.1 (47.1) mg/dL. DU treatment yielded significantly greater reductions in within-day SMPG GV (Figure) than IGlar. AW9 DU+IGlar and Placebo+IGlar arms included 58% and 58% male participants; mean (SD) HbA1c was 8.4 (0.8) and 8.2 (0.8) %; FPG 154.5 (46.5) and 155.0 (46.7) mg/dL. DU+IGlar showed significantly greater reductions in within-day and between-day GV from SMPG (Figure), and between-day FSMPG GV than placebo+IGlar. DU treatment showed a greater reduction in within-day SMPG GV versus IGlar. DU+IGlar reduces SMPG GV and FSMPG GV more than placebo+IGlar.

Disclosure

E. Jodar: Other Relationship; Self; Elli Lilly & Co, Novo Nordisk, MSD, Lilly, Janssen, Pfizer, AstraZeneca, Sanofi, UCB, Amgen, FAES, Shire, Mundipharma, Novartis. I. Romera: Employee; Self; Eli Lilly and Company. Q. Wang: Employee; Self; Eli Lilly and Company. E. Caveda: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. L. Garcia: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company.

Funding

Eli Lilly and Company
110-LB: The Korean Titration: A Randomized Controlled Trial to Evaluate the Efficacy and Safety of Self-Titration Algorithms of Insulin Glargine 300 Units/ml in Patients with Uncontrolled Type 2 Diabetes
Authors: BAE JAE HYUN , AHN CHANG HO , YANG YE SEUL , MOON SUN JOON , KWAK SOO HEON , JUNG HYE SEUNG , PARK KYONG SOO , CHO YOUNG MIN
Published: June 2020

Background: In the Canadian TITRATION study, the INSIGHT algorithm was as effective as the EDITION algorithm for insulin dose titration in patients with type 2 diabetes. However, these algorithms have not been evaluated in Asian patients.

Objective: To compare the efficacy and safety of two algorithms, the INSIGHT and EDITION, for insulin glargine 300 units/mL (Gla-300) in patients with uncontrolled type 2 diabetes treated with basal insulin

Methods: The Korean TITRATION was a 12-week, single-center, open-label, randomized, treat-to-target, and pragmatic trial. We randomly assigned 130 patients to either the INSIGHT (self-titration by 1 unit/day) or EDITION (self-titration no more than every 3 days) groups to achieve a fasting self-monitored blood glucose (SMBG) in the range of 4.4 to 5.6 mmol/L. The primary endpoint was a proportion of patients reaching fasting SMBG ≤5.6 mmol/L without hypoglycemia.

Results: A total of 129 patients were included in the study. At week 12, patients achieving the primary endpoint were 24.6% (INSIGHT) and 23.4% (EDITION) (P = 0.961). Fasting SMBG were 102.0 mg/dL (INSIGHT) and 111.2 mg/dL (EDITION) (P = 0.110). Proportions of patients with HbA1c ≤7% were 23.1% (INSIGHT) and 20.3% (EDITION) (P = 0.867). There was no difference in changes in fasting plasma glucose, HbA1c, and body weight between the two groups. Mean changes in total daily insulin doses were significantly higher in the INSIGHT group than in the EDITION group (12.83 units/day vs. 6.81 units/day, P = 0.030). However, the incidence of hypoglycemia was comparable between the two groups. In addition, adherence to the algorithm tended to be higher in the INSIGHT group than in the EDITION group (45.7% vs. 35.9%, P = 0.109).

Conclusion: The self-titration of Gla-300 with the INSIGHT algorithm is effective and safe compared to that with the EDITION algorithm in Korean patients with uncontrolled type 2 diabetes.

Disclosure

J. Bae: None. C. Ahn: None. Y. Yang: None. S. Moon: None. S. Kwak: None. H. Jung: None. K. Park: None. Y. Cho: None.
1100-P: Efficacy and Safety of Sotagliflozin by Baseline Renal Function in Adults with Type 1 Diabetes
Authors: HANDELSMAN YEHUDA , GIACCARI ANDREA , SAWHNEY SANGEETA , BANKS PHILLIP L. , DAVIES MICHAEL J. , LAPUERTA PABLO
Published: June 2020

Many adults with T1D are not at glycemic goal and are overweight or obese and this trend appears to be worsening. SGLT inhibitors have been shown to improve metabolic outcomes in T1D. However, the glycemic efficacy of selective SGLT2 inhibitors depends on the amount of glucose filtered in the glomerulus and as such efficacy attenuates as renal function declines. The mechanism of action of sotagliflozin (SOTA) involves inhibition of SGLT2 in the kidney and SGLT1 in the gastrointestinal tract. This post-hoc analysis evaluated the efficacy and safety of SOTA by baseline eGFR (45-<60 [N = 71]; 60-<90 [N = 774]; ≥90 mL/min/1.73 m² [N = 730]) using pooled results in 1575 adults with T1D from the inTandem1 and 2 studies. Baseline A1C and body weight (BW) were not different among groups and baseline systolic blood pressure (SBP) tended to be higher in those with eGFR<60 mL/min/1.73 m². Placebo-adjusted reduction in A1C and BW at Week 24 with SOTA was consistent across eGFR subgroups (Table). The safety profile of SOTA was consistent with results published for entire population, with a higher incidence of DKA and a lower incidence of severe hypoglycemia for sotagliflozin vs. placebo. There was no increase in renal-related adverse events or acute kidney injury with SOTA. The efficacy and safety profile of SOTA was generally similar across adults with T1D and varying degrees of renal function.

Disclosure

Y. Handelsman: Advisory Panel; Self; Amgen, Applied Therapeutics, AstraZeneca. Consultant; Self; Applied Therapeutics, Boehringer Ingelheim Pharmaceuticals, Inc. Research Support; Self; Amgen, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc. Speaker’s Bureau; Self; Amarin Corporation, Amgen, AstraZeneca. A. Giaccari: Speaker’s Bureau; Self; Amgen, AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mundipharma, Novo Nordisk A/S, Sanofi-Aventis. S. Sawhney: None. P.L. Banks: Employee; Self; Lexicon Pharmaceuticals, Inc. M.J. Davies: Employee; Self; Lexicon Pharmaceuticals, Inc. P. Lapuerta: Employee; Self; Lexicon Pharmaceuticals, Inc. Stock/Shareholder; Self; Lexicon Pharmaceuticals, Inc.
1102-P: Impact of Treatment with Sotagliflozin on the Incidence of Severe Hypoglycemia in Patients with T1D
Authors: PETTUS JEREMY , DANNE THOMAS , PETERS ANNE L. , CARROLL AMY K. , SAWHNEY SANGEETA , JIANG WENJUN , BANKS PHILLIP L. , MCGILL JANET B.
Published: June 2020

Objective: Severe hypoglycemia (SH) is an acute and life-threatening complication of T1D. Factors impacting the risk of SH include A1C, eGFR, insulin dose changes, and use of MDI versus CSII. An adjunctive treatment that simultaneously improves glycemic control and reduces SH across broad groups would be beneficial for patients (pts) with T1D.

Methods: Data were pooled from two, 52-week, placebo (PBO)-controlled studies in adults with T1D in the overall population and in prespecified subgroups (Table). SH was defined using Level 3 hypoglycemia criteria and all events were independently adjudicated. Results reflect exposure-adjusted incidence rate per 100 patient-years.

Results: Sotagliflozin (SOTA) 400 mg treatment significantly reduced the overall incidence of SH by 41% vs. placebo (relative risk [95% CI] 0.59 [0.35, 0.98]). A dose-responsive reduction was observed in the overall population, and maintained in subgroup analyses (Table), regardless of baseline A1C, eGFR, or percentage reduction in daily insulin dose. Patients using MDI versus CSII alone are generally at higher risk of SH. SOTA 400mg reduced the risk of SH by 69% (relative risk [95% CI] 0.31 [0.13, 0.68]) in MDI-treated pts but did not affect the relatively low rate in those using CSII.

Conclusion: These data confirm that SOTA reduced the incidence of SH in pts with T1D, and indicates consistent dose-related risk reduction in almost all subgroups.

Disclosure

J. Pettus: Consultant; Self; Diasome Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk Inc., Sanofi. T. Danne: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk A/S, Sanofi. A.L. Peters: Advisory Panel; Self; Abbott, Bigfoot Biomedical, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, MannKind Corporation, Medscape, Novo Nordisk Inc., Sanofi US. Consultant; Self; Livongo Health. Research Support; Self; Dexcom, Inc., vTv Therapeutics. Other Relationship; Self; Livongo Health, Mellitus Health, Omada Health, Stability Healthcare, Whole Biome Inc. A.K. Carroll: Employee; Self; Lexicon Pharmaceuticals, Inc. Stock/Shareholder; Self; Lexicon Pharmaceuticals, Inc. S. Sawhney: None. W. Jiang: Employee; Self; Lexicon Pharmaceuticals, Inc. Stock/Shareholder; Self; Lexicon Pharmaceuticals, Inc. P.L. Banks: Employee; Self; Lexicon Pharmaceuticals, Inc. J.B. McGill: Advisory Panel; Self; Aegerion Pharmaceuticals, Bayer AG, Lilly Diabetes, Novo Nordisk A/S. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc. Research Support; Self; Medtronic, Novo Nordisk Inc., Sanofi. Speaker’s Bureau; Self; Aegerion Pharmaceuticals, Dexcom, Inc., Janssen Pharmaceuticals, Inc.
1110-P: Effect of Raised Alanine Transaminase (ALT) Levels on HbA1c in the Association of British Clinical Diabetologists (ABCD) Nationwide Audits of SGLT2 Inhibitors (SGLT2i)
Authors: DESHMUKH HARSHAL , BICKERTON ALEX , PHILLIPS SUZANNE M. , EVANS ALISON , RAGHAVAN RAJEEV P. , SENNIK DEVESH K. , ROHILLA ANURITA , ADAMSON KAREN , YADAGIRI MAHENDER , GALLEN IAN W. , RYDER ROBERT E. , SATHYAPALAN THOZHUKAT
Published: June 2020

Introduction: Alanine transaminase (ALT) is an important marker for Nonalcoholic Fatty Liver Disease (NAFLD), and its levels are reduced following treatment with SGLT2i. However, how raised ALT levels and hence NAFLD affects HbA1c response to SGLT2i is not known.

Methods: Data for this study was obtained from the ABCD nationwide audits of patients with type 2 diabetes started on SGLT2i. We used a gradient boosting machine learning algorithm (GBM) to identify if ALT is an important predictor of glycaemic response to SGLT2i. The results of the GBM model were confirmed using linear regression analysis where the absolute drop in HbA1c was modelled as a dependent variable with baseline ALT as independent variable adjusted for relevant covariates.

Results: We studied 9,609 patients initiated on Empagliflozin (n=5061), Dapagliflozin (n=3711) or Canagliflozin (n=837). The mean age of the study population was 59(±10.3), 62% male with a mean weight of 96.6(±18.8), baseline eGFR 81(±11) and baseline HbA1c 9.06% (±1.62). At a median 5.8 months follow-up, the mean HbA1c drop was 0.81% and was similar in all three types of SGLT2i. The drop in HbA1c was 0.62%, 0.78% and 1.01% in 1st 2nd and 3rd quartiles of baseline ALT, respectively (P-Anova <0.0001). In the GBM analysis the important predictors of glycaemic response were baseline weight (relative influence (RI)=71%), and baseline HbA1c (RI= 7.2%), baseline ALT (RI= 5.6%) baseline creatinine (RI= 4.9%). The model accuracy was 0.73 (0.71-0.75) and area under the curve was 0.83. In the linear regression model, higher baseline ALT was associated with a larger drop in HbA1c (beta=0.007, P<0.0001) after adjustments for baseline weight, weight loss, baseline HbA1c, and duration of diabetes.

Conclusion: Higher baseline ALT levels are associated with a more significant SGLT2 induced HbA1c drop and SGLT2 inhibitors and are likely to be more effective in those with NAFLD.

Disclosure

H. Deshmukh: None. A. Bickerton: None. S.M. Phillips: None. A. Evans: Other Relationship; Self; AstraZeneca. R.P. Raghavan: Research Support; Self; Allergan plc. Speaker’s Bureau; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Napp Pharmaceuticals, Takeda UK. Other Relationship; Self; Napp Pharmaceuticals. D.K. Sennik: Speaker’s Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. A. Rohilla: None. K. Adamson: None. M. Yadagiri: None. I.W. Gallen: None. R.E. Ryder: Consultant; Self; GI Dynamics Inc. Other Relationship; Self; Novo Nordisk A/S. T. Sathyapalan: Research Support; Self; Amgen, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk A/S. Other Relationship; Self; Ipsen Biopharmaceuticals.
1121-P: Effectiveness of Sodium–Glucose Cotransporter 2 Inhibitors on Coronary Heart Disease Compared with Other Glucose Lowering Drugs
Authors: SHEN YUN , ZHOU JIAN , SHI LIZHENG , NAUMAN ELIZABETH , KATZMARZYK PETER T. , PRICE-HAYWOOD EBONI G. , CHU SAN , YANG SHENGPING , BAZZANO ALESSANDRA N. , NIGAM SOMESH , HU GANG
Published: June 2020

Aims: This study compares the cardiovascular benefits between SGLT2 inhibitors and other glucose-lowering drugs (oGLDs) based on electronic medical record data from a large integrated delivery health system in South Louisiana.

Materials and Methods: Demographic, anthropometric, laboratory and medication prescription information for patients with type 2 diabetes who were new users of SGLT2 inhibitors either as initial treatments or as add-on treatments were obtained from electronic health records. Mediation analysis was performed in demonstrating the association of use of SGLT2 inhibitors and changes of metabolic risk factors with the risk of incident coronary heart disease.

Results: A total of 5,338 new users of SGLT2 inhibitors were matched with 13,821 patients using oGLDs. During a mean follow up of 3.26 years, 2,303 incident cases of coronary heart disease were defined. After adjusting for multiple confounding factors, patients using SGLT2 inhibitors had a lower risk of incident coronary heart disease compared to patients using oGLDs (hazard ratio [HR] 0.63; 95% confidence interval [CI] 0.55-0.72). Patients using SGLT2 inhibitors also had a lower risk of incident coronary heart disease within 6 months (HR 0.32; 95% CI 0.23-0.43), 12 months (HR 0.38; 95% CI0.31-0.48), 24 months (HR 0.49; 95% CI 0.41-0.59) and 36 months (HR 0.59; 95% CI 0.51-0.69), respectively. Reductions in systolic blood pressure attributed the lower risk of coronary heart disease among patients using SGLT2 inhibitors.

Conclusions: Evidence from real world data indicated the contribution of SGLT2 inhibitors to reducing risk of coronary heart disease, as well as the benefits beyond glucose-lowering.

Disclosure

Y. Shen: None. J. Zhou: None. L. Shi: None. E. Nauman: None. P.T. Katzmarzyk: None. E.G. Price-Haywood: None. S. Chu: None. S. Yang: None. A.N. Bazzano: None. S. Nigam: None. G. Hu: None.
1124-P: SGLT2 Inhibitors as Adjuvant Therapy for Type 1 Diabetes: An Italian Center Experience
Authors: PIERALICE SILVIA , TUCCINARDI DARIO , KYANVASH SHADI , MAGGI DARIA , MONTE LAVINIA , BRIGANTI SILVIA IRINA , MANFRINI SILVIA , POZZILLI PAOLO
Published: June 2020

Background and Aim: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are effective in improving glycemic control in both type 2 (T2D) and type 1 diabetes (T1D). Despite dapaglifozin has been recently approved as an adjunctive therapy in T1D, its use is still limited due to the increased risk of diabetic ketoacidosis (DKA). Aim of this study was to assess the effectiveness of SGLT2 inhibitors in combination with insulin in poorly controlled T1D patients.

Methods: In this retrospective observational study, data from 46 adults [M/F 29/17] affected by T1D treated with insulin plus dapaglifozin were collected. Glycated hemoglobin (A1c), anthropometrics, insulin daily requirement and time in range (TIR) were studied at baseline, 3 and 6 months after starting of treatment.

Results: At baseline, mean ± SD age was 32.7 ± 10.2 years, disease duration was 21.4 ± 9.3 years, A1c was 8.3 % ± 1.6. Insulin daily requirement was 0.9 ± 0.38 UI/Kg, whereas BMI was 26.7 ± 1.6 Kg/m2. After 6 months, Dapaglifozin 5 mg/day had significantly decreased A1c levels (change [Δ] -0.86%, p < 0.01), body weight (Δ -2.5 kg, p < 0.001) and insulin daily requirement (Δ -0.17 UI/kg, p < 0.01) from baseline. Moreover, in a subgroup of patients (n=16) using continuous glucose monitoring (CGM) systems, statistically significant improvement of TIR (Δ +9%, p < 0.01) has been observed, while time spent in hypoglycaemia did not change. No significant changes in C-peptide levels was observed (p = 0.09). No serious adverse events occurred during the study period. Discontinuation (10%) was mainly related to genitourinary infections, polyuria or limited effectiveness perceived.

Conclusion: Our real world experience confirms clinical benefits of SGLT2 inhibitors as an adjunctive therapy in poorly controlled T1D patients, ameliorating overall glycometabolic control as well as glycemic variability. Clinical characterization and proper education remain essential in order to identify the right candidate and to minimize DKA risk.

Disclosure

S. Pieralice: None. D. Tuccinardi: None. S. Kyanvash: None. D. Maggi: None. L. Monte: None. S. Briganti: None. S. Manfrini: None. P. Pozzilli: Advisory Panel; Self; Abbott, AstraZeneca, Eli Lilly and Company. Research Support; Self; Medtronic, Sanofi.
1125-P: Association of Plasma Volume with Body Weight and BNP after Long-Term Administration and Subsequent Withdrawal of the SGLT2 Inhibitor Tofogliflozin
Authors: MATSUBAYASHI YASUHIRO , YOSHIDA AKIHIRO , NOJIMA TOSHIAKI , SUGANAMI HIDEKI , FUJIHARA KAZUYA , KAKU KOHEI , SONE HIROHITO
Published: June 2020

SGLT2 inhibitors (SGLT2is) promote diuresis and reduce plasma volume (PV). However, the impact of long-term administration and subsequent withdrawal of SGLT2is on PV is little known. This study investigated the effect of long-term administration and then withdrawal of the SGLT2i, tofogliflozin (TOFO), on PV and explored correlations with variables in type 2 diabetes mellitus (T2DM).

Analyzed were 166 T2DM patients who received TOFO for 52 weeks as initial monotherapy and underwent 2 weeks of withdrawal (week 54) in a phase-3 study. Percent change in estimated PV (%ΔePV) was calculated by the Strauss formula: {100*(pre Hb/post Hb)*[(100 - pre Ht)/(100 - post Ht)] - 100}. Baseline characteristics were: male (66%), age (mean: 58 y), HbA1c (8%), BMI (26kg/m2), BNP (12pg/mL) and eGFR (84mL/min/1.73m2). Paired t-tests analyzed differences from baseline to week 52 and from week 52 to 54. Correlation analysis was performed by Pearson’s product-moment correlation coefficients. Multivariate analysis explored predictors for %ΔePV.

Body weight (BW) [mean, -3kg (-5%)*; * p<0.01 vs. baseline], ePV (-2.7%*) and ln-transformed BNP [ln-BNP: -0.1ln(pg/mL)*] had significantly decreased by week 52. %ΔBW was not significantly correlated with %ΔePV (r=-0.06) and Δln-BNP (r=0.13) while %ΔePV was significantly correlated with Δln-BNP (r=0.35). Higher baseline ln-BNP levels were independently correlated with greater reductions in %ΔePV. After 2 weeks of withdrawal, BW [+0.9kg (+1.3%)†, † p<0.001 vs. week 52], ePV (+6.5%†) and ln-BNP [+0.3ln(pg/mL) †] were significantly increased. %ΔBW was significantly correlated with %ΔePV (r=0.22) and Δln-BNP (r=0.32). Also, %ΔePV was significantly correlated with Δln-BNP (r=0.30).

After long-term TOFO therapy, reduced PV might be correlated not with weight loss but with reduced BNP indicating fluid loss and baseline BNP might predict changed PV. Weight gain after TOFO withdrawal might be caused by fluid gain.

Disclosure

Y. Matsubayashi: None. A. Yoshida: Employee; Self; Kowa Company, Ltd. T. Nojima: Employee; Self; Kowa Company, Ltd. H. Suganami: Employee; Self; Kowa Company, Ltd. K. Fujihara: None. K. Kaku: Advisory Panel; Self; Nippon Boehringer Ingelheim Co. Ltd., Novo Nordisk Inc. Consultant; Self; Sanwa Kagaku Kenkyusho. Research Support; Self; Taisho Pharmaceutical Co., Ltd. Speaker’s Bureau; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo, Eli Lilly Japan K.K., Kowa Company, Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Kyowa Hakko Kirin Co., Ltd., Novartis AG, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co.
1129-P: Effect of Sotagliflozin Added to Insulin Therapy on Beta-Hydroxybutyrate in Patients with Type 1 Diabetes
Authors: PETERS ANNE L. , DANNE THOMAS , SAWHNEY SANGEETA , BANKS PHILLIP L. , DAVIES MICHAEL J. , LAPUERTA PABLO
Published: June 2020

Objective: To evaluate the effect of sotagliflozin (SOTA), a dual SGLT 1 and 2 inhibitor, on beta-hydroxybutyrate (BHB) over 52 weeks in adults with type 1 diabetes (T1D) on insulin therapy.

Methods: Analyses were performed on pooled data from two, 52-week, placebo-controlled studies in 1575 adult patients with T1D on optimized insulin therapy, who were randomly assigned 1:1:1 to placebo (PBO), SOTA 200 mg, and SOTA 400 mg. Descriptive statistics were performed on serum BHB using results from scheduled visits at baseline and Weeks 4, 12, 24, and 52. A 2-sample Wilcoxon rank sum test was performed to test the distribution of change in BHB from baseline between SOTA and placebo. The proportion of patients experiencing ≥1 measurement meeting predefined limits of DKA risk based on BHB levels (≥0.6 mmol/L “ketonemia” and ≥1.5 mmol/L “impending DKA”) was assessed.

Results: Median baseline BHB was 0.13 (IQR 0.10, 0.20), 0.13 (IQR 0.10, 0.22), and 0.14 mmol/L (IQR 0.10, 0.23) in the PBO, SOTA 200-mg, and SOTA 400-mg groups, respectively. While the median change in BHB was 0 mmol/L with PBO, median BHB increased from baseline by 0.03 to 0.05 mmol/L with SOTA, and generally remained stable over 52 weeks (p<0.001 vs. PBO at each time point). Per the predefined limits of DKA risk based on BHB levels, a BHB level ≥0.6 mmol/L was experienced by 19.8, 46.9, and 45.5% and a BHB level ≥1.5 mmol/L in 2.1, 6.3, and 8.2% of patients on PBO, SOTA 200 mg, and SOTA 400 mg, respectively. Approximately 2/3 of the BHB ≥0.6 mmol/L events were observed by Week 16 and ∼2/3 of the BHB ≥1.5 mmol/L events were observed by Week 24.

Conclusion: Treatment with SOTA was associated with small increases in BHB over time, which on average remained well below the clinically important level of 0.6 mmol/L. Although the DKA incidence was <4% overall on SOTA, the proportions of patients with ≥1 BHB measurement ≥0.6 mmol/L (∼45-47%) or ≥1.5 mmol/L (∼6-8%) suggest many BHB elevations were recognized and managed without progression to DKA.

Disclosure

A.L. Peters: Advisory Panel; Self; Abbott, Bigfoot Biomedical, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, MannKind Corporation, Medscape, Novo Nordisk Inc., Sanofi US. Consultant; Self; Livongo Health. Research Support; Self; Dexcom, Inc., vTv Therapeutics. Other Relationship; Self; Livongo Health, Mellitus Health, Omada Health, Stability Healthcare, Whole Biome Inc. T. Danne: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk A/S, Sanofi. S. Sawhney: None. P.L. Banks: Employee; Self; Lexicon Pharmaceuticals, Inc. M.J. Davies: Employee; Self; Lexicon Pharmaceuticals, Inc. P. Lapuerta: Employee; Self; Lexicon Pharmaceuticals, Inc. Stock/Shareholder; Self; Lexicon Pharmaceuticals, Inc.