bluuebunny/crossref_metadata_2025_split huggingface dataset:
914-P: Predictors of ED and Inpatient Admissions after Hypo- and Hyperglycemic Events: Leveraging Remote Monitoring Data of People with Diabetes
Authors: LU WEI , JAMES ROBERTA , PAINTER STEFANIE L. , SHAH BIMAL 
Published: June 2020

Background: Predictive models to identify people with diabetes mellitus (DM) at high-risk for future ED visits and inpatient admissions (IA) are an area of clinical interest. The models do not include self-monitoring blood glucose (SMBG) levels. Livongo, the leader in Applied Health Signals, includes cellular-enabled BG meter that allows instantaneous uploading of SMBG values into the cloud with millions of values in people with DM.
Methods: Leveraging data collected via the Livongo program with medical and pharmacy claims, machine learning techniques were used to identify the 25 most predictive variables of severe hypo- and hyperglycemia (BG ≤54 mg/dL and ≥400 mg/dL, respectively) resulting in an ED or IA encounter within three days. Four models were constructed for DM (type 1 and type 2) and encounter (ED and IA). Participants had to be enrolled for at least 12 months with continuous medical benefits eligibility for 24 months. Variable categories included in modeling were demographics, comorbidities based on ICD-10 codes, prior HCU, new and current medications, 30-days SMBG patterns with mean BG levels, and months on program. Area under the curve (AUC) was used to assess model performance.
Results: There were 7,633 people selected. They had a mean age of 54 years, 48% were female, and 11% had type 1 DM. In this group, 924 and 1,518 severe hypo- and hyperglycemic with ED or IA encounters occurred. Random forest models had the highest AUC with values greater than 98% and sensitivity and specificity above 93% and 99%, respectively. HCU variables were the most predictive variables in all 4 models. Mean 7-day BG level, 30-day count of BG checks, and before-breakfast checking were also highly predictive.
Conclusions: SMBG variables are independent predictors of hypo- and hyperglycemia with ED and IA encounters. Real-time BG remote monitoring programs have the capability to identify people at high-risk of costly HCU and develop interventions to improve care.

Disclosure
W. Lu: Employee; Self; Livongo Health. R. James: Advisory Panel; Self; AstraZeneca. Employee; Self; Livongo Health. S.L. Painter: Employee; Self; Livongo Health. B. Shah: Employee; Self; Livongo Health.
917-P: Features of Glucose Profiles in Newly Diagnosed Fulminant Type 1 Diabetes Mellitus
Authors: GAN LU , LIN BEISI , ZHOU YONGWEN , YAN JINHUA , XU WEN , YANG DAIZHI , LUO SIHUI , ZHENG XUEYING , LIANG HUA , YAO BIN , WENG JIANPING 
Published: June 2020

Fulminant type l diabetes mellitus (FT1DM) is a subtype of T1DM with acute onset, but data on its feature of glucose profiles is limited. This study aimed to compare the glucose profiles between newly diagnosed patients with FT1DM and typical type 1 diabetes mellitus (TT1DM). From Sep. 2013 to Oct. 2019, newly diagnosed patients who fulfilled respective criteria of FT1DM and TT1DM in our department were included in the analysis. After diabetic ketoacidosis correction, the MiniMed Paradigm 722 insulin pump was used to monitor the real-time glucose levels for 3 consecutive days. Demographic and clinical data at the onset were collected. CGM metrics were compared between the two groups. A total of 8 patients (female, 50%) were diagnosed as FT1DM with 2 of them developed diabetes during pregnancy, and 20 patients (female, 60%) were diagnosed as TT1DM. At the onset, patients in FT1DM group had higher age (30.5 [24.0, 38.0] vs. 21.0 [9.5, 32.3] yrs, P&lt;0.01), lower level of HbA1c (6.31 ± 0.58 vs. 11.73 ± 3.47%, P&lt;0.001) and C-peptide (0h, 0.04 [0.04, 0.04] vs. 0.06 [0.04, 0.11] nmol/L; 2h, 0.04 [0.04, 0.04] vs. 0.19 [0.14, 0.27] nmol/L, all P&lt;0.05) than those with TT1DM. Larger glycemic fluctuation was observed in FT1DM group with significantly higher level of SD (3.2 ± 0.8 vs. 2.5 ± 0.8 mmol/L, P&lt;0.05), CV (36.14 ± 7.40 vs. 29.55 ± 5.69%, P=0.02) and MAGE(8.10 ± 1.46 vs. 6.25 ± 1.92 mmol/L, P=0.02). The five key metrics were similar between the two groups: mean glucose (8.5 [7.7, 9.1] vs. 7.8 [7.1, 9.0]mmol/L), glucose management indicator (6.9 [6.5, 7.4] vs. 6.5 [6.1, 7.3]%), time spent in range 3.9-10.0mmol/L (72.6 [60.8, 79.5] vs. 78.6 [69.1,89.8]%), time spent &lt;3.9 mmol/L (1.2 [0.1, 4.1] vs. 0.1 [0.0, 2.5]%) and time spent &gt;10.0mmol/L (27.2 [16.4, 35.1] vs. 18.7 [8.7, 28.9]%) (all P&gt;0.05).Newly diagnosed patients with FT1DM had significantly larger glycemic fluctuation than those with TT1DM even with a well-controlled inpatient management.

Disclosure
L. Gan: None. B. Lin: None. Y. Zhou: None. J. Yan: None. W. Xu: None. D. Yang: None. S. Luo: None. X. Zheng: None. H. Liang: None. B. Yao: None. J. Weng: None.

Funding
National Key Research and Development Program of China (2017YFC1309600); Natural Science Foundation of Guangdong Province (2018A030313251)
923-P: Improved Glycemic Variability and Control without Increased Risk of Hypoglycemia when Linagliptin Is Added to Glimepiride Therapy in Patients with HNF1A-Diabetes
Authors: CHRISTENSEN ALEXANDER S. , HAEDERSDAL SOFIE , STØY JULIE , STORGAARD HEIDI , KAMPMANN ULLA , SEGHIERI MARTA , HOLST JENS J. , HANSEN TORBEN , KNOP FILIP K. , VILSBØLL TINA 
Published: June 2020

Sulfonylurea (SU) is first-line treatment of hepatocyte nuclear factor 1-alpha (HNF1A)-diabetes but has limitations due to the risk of hypoglycemia. We hypothesized that SU in combination with the dipeptidyl peptidase-4 inhibitor linagliptin would provide an efficacious treatment with less glycemic variability and hypoglycemia in patients with HNF1A-diabetes compared with SU monotherapy. In a randomized, double-blinded, crossover trial, patients with HNF1A-diabetes (n = 19, [mean ± SD]; age: 43 ± 14 years; BMI 24 ± 3 kg/m2; HbA1c 7.4 ± 0.2% [57 ± 7 mmol/mol]) were randomly assigned to treatment with glimepiride + linagliptin (16 weeks), wash-out (4 weeks) and treatment with glimepiride + placebo (16 weeks) (or vice versa). Treatments were evaluated by continuous glucose monitoring (CGM), HbA1c and a meal test. Compared with glimepiride + placebo, glimepiride + linagliptin showed significant improvements in glycemic variability (assessed as coefficient of variation (CV) and SD on CGM), HbA1c and body weight (Figure 1). Incidence of hypoglycemia (assessed by patient-reported episodes and CGM) was similar between treatments.
In conclusion, linagliptin as add-on treatment to SU in patients with HNF1A-diabetes improved glycemic variability, glycemic control and body weight without increasing the risk of hypoglycemia.

Disclosure
A.S. Christensen: None. S. Haedersdal: None. J. Støy: None. H. Storgaard: None. U. Kampmann: Stock/Shareholder; Spouse/Partner; Novo Nordisk A/S. M. Seghieri: None. J.J. Holst: Advisory Panel; Self; AstraZeneca, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Zealand Pharma A/S. Other Relationship; Spouse/Partner; Antag Therapeutics. T. Hansen: None. F.K. Knop: Advisory Panel; Self; AstraZeneca, Merck Sharp & Dohme Corp., Mundipharma International, Novo Nordisk A/S, Sanofi. Consultant; Self; Carmot Therapeutics, Inc., Eli Lilly and Company, Novo Nordisk A/S. Research Support; Self; AstraZeneca, Gubra, Novo Nordisk A/S, Sanofi, Zealand Pharma A/S. Speaker’s Bureau; Self; AstraZeneca, Lupin Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Norgine B.V., Novo Nordisk A/S. T. Vilsbøll: Advisory Panel; Self; AstraZeneca, Mundipharma International, Novo Nordisk A/S, Sun Pharmaceutical Industries Ltd. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Medscape, Merck Sharp & Dohme Corp., Sanofi.
929-P: Dulaglutide Shows Sustained A1C Reduction: Two-Year U.S. Real-World Study
Authors: MODY REEMA , YU MARIA , GRABNER MICHAEL , BOYE KRISTINA , TENG CHIA-CHEN , KWAN ANITA 
Published: June 2020

The primary objective of this retrospective, observational study was to evaluate glycemic control over a 2 yr follow-up period among dulaglutide (DU) initiators with continuous treatment using U.S. claims data from the HealthCore Integrated Research Database (HIRD®) between May 2014 and May 2019 (index date=earliest DU fill during index period between November 2014 and May 2017). Patients (pts) ≥18 yrs old with T2D, ≥1 pharmacy claim for DU during the index period, continuous enrollment in the 6 months pre index (=baseline [BL]) and 2 yrs post index, ≥1 claim for DU or ≥60 days supply in every quarter during the 2-yr follow-up period, and ≥1 A1C result at both BL and 2 yrs were included. At BL, pts (N=872; 47.5% female) were (mean ± SD) 54.5 ± 8.2 yrs old with an A1C of 8.7 ± 1.8%. Antihyperglycemic medication use pre/post index included: insulin, 28%/35%; DPP-4 inhibitors, 37%/20%; SGLT2 inhibitors, 29%/44%. More than two-thirds were being treated for dyslipidemia, hypertension, or CVD. Key results are included in the Figure. Significant A1C reduction was observed from BL to 2 yrs (-1.3%, p&lt;0.0001). Forty-three percent of pts achieved an A1C &lt;7% and 74% achieved an A1C &lt;8% at 2 yrs. In this real-world study among DU initiators with continuous treatment, a clinically significant reduction in A1C was seen at the 3-month assessment and persisted for up to 2 yrs. These data support the use of DU as an effective long-term treatment for T2D in clinical practice.

Disclosure
R. Mody: Employee; Self; Eli Lilly and Company. M. Yu: Employee; Self; Eli Lilly and Company. Employee; Spouse/Partner; LifeLabs. Stock/Shareholder; Self; Eli Lilly and Company. M. Grabner: Research Support; Self; Eli Lilly and Company. K. Boye: Employee; Self; Lilly Diabetes. Stock/Shareholder; Self; Eli Lilly and Company. C. Teng: Research Support; Self; Eli Lilly and Company. A. Kwan: Employee; Self; Eli Lilly and Company. Employee; Spouse/Partner; Eli Lilly and Company. Stock/Shareholder; Spouse/Partner; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company.
931-P: Optimal Treatment Intensification for Glycemic Control in Patients with T2D on Two Oral Agents: Real-World Comparison of GLP-1, OADs, and Insulin
Authors: DESOUZA CYRUS , KIRK ANDREAS ROSS , MANGLA KAMAL K. , WOLDEN MICHAEL L. , LINGVAY ILDIKO 
Published: June 2020

Introduction: Health care providers have many options for achieving glycemic control in individuals with T2D requiring treatment intensification. In this analysis from the PATHWAY study we address the question of optimal treatment choice, comparing intensification with additional oral antidiabetic drug (OAD), glucagon-like peptide-1 (GLP-1) analogs or insulin in individuals on 2 OADs.
Methods: Electronic medical records and claims data were from IBM MarketScan Explorys Claims-EMR (index period: 3/1/13-10/31/18). Inclusion required ≥1 claim for 2 different OADs in the 180 days pre-index, ≥1 claim for another OAD/GLP-1/insulin (day 0; index date), ≥1 HbA1c and weight measurement 180 days post-index (+/− 90 days), and ≥1 HbA1c and weight measurement close to index date (baseline). Cohorts for GLP-1s vs. OADs and vs. insulin were propensity score matched pairwise by baseline variables and exact matched by HbA1c category (Figure).
Results: Cohorts were well balanced across all baseline characteristics after matching. GLP-1 cohorts were significantly more likely to reach target HbA1c &lt;7% and HbA1c &lt;7% with no weight gain than either OADs or insulin (Figure).
Conclusions: Our results support clinical decision-making at treatment intensification, indicating that individuals on 2 OADs are more likely to achieve targets with GLP-1s than with further OAD or insulin.

Disclosure
C. Desouza: Consultant; Self; AstraZeneca, Bayer AG, Novo Nordisk A/S. A. Kirk: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. K.K. Mangla: Employee; Self; Novo Nordisk A/S. M.L. Wolden: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. I. Lingvay: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk A/S, Sanofi, TARGET PharmaSolutions, Valeritas, Inc. Other Relationship; Self; Novo Nordisk A/S.

Funding
Novo Nordisk A/S
941-P: A Trial to Assess the Pharmacokinetics, Safety, and Tolerability of Semaglutide in Healthy Chinese Subjects
Authors: SHI AIXIN , XIE PANPAN , NIELSEN LASSE L. , SKJOETH TRINE V. , HE XUEMEI , HAUGAARD SINE P. 
Published: June 2020

Semaglutide is a glucagon-like peptide-1 analogue (GLP-1) approved for once-weekly (OW) subcutaneous treatment of type 2 diabetes (Ozempic®). This randomised, double-blind, placebo-controlled, 13-week trial assessed the pharmacokinetics, safety and tolerability of OW semaglutide in healthy male and female Chinese subjects. A total of 36 subjects were randomised to 0.5 mg (n=12) or 1.0 mg (n=12) OW semaglutide, or corresponding volumes of placebo (n=12). The primary endpoint was steady-state semaglutide exposure (AUC0 168h [area under the curve over a dosing interval]). Semaglutide exposure at steady state (see Figure) was consistent with dose-proportionality. Treatment ratios (1.0 mg/0.5 mg) were: AUC0-168h: 1.99, and Cmax: 1.94. Accumulation was consistent with the half-life (∼1 week). In this trial, treatment with OW semaglutide was well tolerated, consistent with the GLP-1 class. The PK profile in Chinese subjects was consistent with previous trials. The most common adverse events were gastrointestinal events. NCT03288740.

Disclosure
A. Shi: None. P. Xie: None. L.L. Nielsen: None. T.V. Skjoeth: Employee; Self; Novo Nordisk A/S. X. He: None. S.P. Haugaard: Employee; Self; Novo Nordisk A/S.

Funding
Novo Nordisk A/S
947-P: Semaglutide Added to Treatment or Changed from Other GLP-1 Receptor Agonist in Type 2 Diabetes: A Study to Evaluate Real-World Effectiveness
Authors: FERRER-GARCÍA JUAN CARLOS , GALERA RAQUEL ALBALAT , ARRIBAS LUIS , TORRENS MERCEDES TOLOSA , LORENTE ANDREA SÁNCHEZ , PORTILLA ANA J. , ARTERO ANA , SÁNCHEZ-JUAN CARLOS 
Published: June 2020

Objective: To evaluate real-world clinical outcomes of semaglutide on glycemic control and weight as an add-on to treatment or changed-on from other GLP-1 in patients with T2D who initiate treatment.
Patients and Methods: To better understand the effectiveness of semaglutide on clinical outcomes in a real-world setting, this retrospective cohort study included eligible patients were at least 18 years old with uncontrolled T2D (HbA1c 6.5-11%) receiving stable therapy that initiated subcutaneous semaglutide 0.5 or 1.0 mg once weekly added to their therapy or after a change from other GLP-1. Primary endpoint was change from baseline in glycated Hb (HbA1c) and confirmatory secondary endpoint was change from baseline in body weight, both at week 24. Semaglutide was initiated as part of their diabetes therapy based in clinical practice.
Results: in this study, were included 147 patients had a mean age of 60.3 ± 10.1 years, T2D duration of 14.0 ± 7.4 years, and baseline A1C of 8.3 ± 1.34%. Seventy-five were naïve in treatment with GLP-1 and seventy-four received previously another GLP-1 (liraglutide 1.8 mg daily or dulaglutide 1.5 mg once weekly). At 6 months follow-up, 145 patients who remained on-treatment showed an A1C reduction of 1.2 ± 1.15% (p&lt;0.05), A1C lowering was seen in both groups: a reduction de 1.8±1.8% (p &lt; 0.05) in patients that received GLP for first time and 0.6± 1.0%(p&lt; 0.05) in group prior use of GLP-1. Mean weight reduction was 5.1 ± 4.6 kg (p &lt; 0.001) in the group initiated GLP-1 for first time and 2.1±4.0 kg (p&lt;0.01) in group that changed from another GLP-1. Four patients presented gastrointestinal adverse events to retire the treatment, all of them in the group that never had been treated with GLP-1.
Conclusion: In this real-world study, patients initiating semaglutide had significant reductions in HbA1c and weight. The effect was reached whether patients received GLP-1 for the first time or if a change had been made from another GLP-1.

Disclosure
J. Ferrer-García: None. R. Albalat Galera: None. L. Arribas: None. M. Tolosa Torrens: None. A. Sánchez Lorente: None. A.J. Portilla: None. A. Artero: None. C. Sánchez-Juan: None.
95-OR: Plasma miRNAs Levels at First Trimester of Pregnancy Predict Insulin Sensitivity Estimated at the Second Trimester of Pregnancy
Authors: LÉGARÉ CÉCILIA , DESGAGNÉ VÉRONIQUE , WHITE FRÉDÉRIQUE , SCOTT MICHELLE S. , PERRON PATRICE , HIVERT MARIE-FRANCE , GUÉRIN RENÉE , BOUCHARD LUIGI 
Published: June 2020

Background: Gestational diabetes mellitus (GDM) is the most common pregnancy complication with a prevalence of 14% worldwide and has important consequences on both the mother and her child. GDM results from imbalance between insulin secretion capacity response and decreasing insulin sensitivity in pregnancy. MicroRNAs (miRNAs) are small (19-24nt) single-stranded RNA molecules involved in post-transcriptional regulation through binding to targeted mRNAs. MiRNAs are thought to regulate many physiological processes including glucose homeostasis.
Objective: Identify plasmatic miRNAs at the first trimester of pregnancy that predict insulin sensitivity (IS; as estimated with the Matsuda index) assessed between the 24th and the 28thweek of pregnancy. Methods: miRNAs were quantified by next generation sequencing in 443 plasma samples from the Gen3G birth-cohort. DESeq2 package was applied to identify miRNAs associated with IS. Glmnet package was used to compute lasso regression and find the minimum number of miRNAs predicting IS.
Results: On average, participants were 28.43 ± 4.3 (18-47) years old and had a BMI of 26.1 ± 6.1 (16.6-54.1) kg/m2 at first trimester and had a Matsuda index of 8.41 ± 4.9 (0.77-37.53) at second trimester. A total of 106 miRNAs were associated with IS (p-adjusted for false discovery rate &lt;0.1) when analyses were corrected for gestational age at blood collection, with 37 of them remaining significant after further correction for maternal age and BMI measured at first trimester. A lasso regression selected 27 of these miRNAs along with maternal age and BMI and overall explained 32% of the variability of IS at second trimester.
Conclusion: miRNAs quantified at first trimester of pregnancy are associated with and predictive of maternal IS estimated at second trimester. These miRNAs are likely involved in the pathophysiology of GDM and provide novel promising biomarkers for predicting glucose metabolism dysregulation in pregnancy.

Disclosure
C. Légaré: None. V. Desgagné: None. F. White: None. M.S. Scott: None. P. Perron: None. M. Hivert: None. R. Guérin: None. L. Bouchard: None.

Funding
IRSC (IGH-155183)
958-P: Once-Weekly Exenatide Effects on EGFR Slope and UACR as a Function of Baseline UACR: An EXSCEL Trial Post Hoc Analysis
Authors: CLEGG LINDSAY E. , DER AART ANNEMARIE VAN , PENLAND ROBERT C. , BOULTON DAVID W. , SJÖSTRÖM C. DAVID , MENTZ ROBERT J. , HOLMAN RURY R. , HEERSPINK HIDDO L. 
Published: June 2020

GLP-1 RA effects on major kidney outcome in unselected T2D patients at high cardiovascular (CV) risk are modest or neutral. However, GLP-1 RA may provide renal benefit in those at high risk of worsening kidney disease. We examined once-weekly exenatide (EQW) effects on eGFR slope and UACR change, as a function of baseline UACR, in a subset of EXSCEL participants. Of 14752 EXSCEL participants, eGFR slope was assessed in those with baseline UACR and ≥1 post-baseline eGFR (n=3503 [23.7%]) via mixed model repeated measures (MMRM) analysis (median follow-up 3.3 years). UACR percent change from baseline to first post-baseline measurement (median time 8.9 months) was assessed in those with baseline and ≥1 follow-up UACR (n=2828 [19.2%]) via ANCOVA of log-transformed UACR, with baseline UACR as a covariate. Participants with baseline UACR measurements were generally similar to the overall EXSCEL population, and balanced across treatment arms. EQW improved eGFR slope in those with baseline UACR&gt;100mg/g and UACR&gt;200mg/g, but not at lower UACR thresholds. No difference in EQW effect on eGFR was observed as a function of baseline eGFR, CV disease history, RAAS inhibitor use, or SBP. UACR improvement was similar across UACR categories. This EXSCEL post-hoc analysis suggests that EQW reduces UACR, with improvement in eGFR slope specifically in participants with elevated baseline UACR.

Disclosure
L.E. Clegg: Employee; Self; AstraZeneca. A. van der Aart: None. R.C. Penland: Employee; Self; AstraZeneca. Stock/Shareholder; Self; AstraZeneca. D.W. Boulton: Employee; Self; AstraZeneca. Stock/Shareholder; Self; AstraZeneca, Bristol-Myers Squibb. C. Sjöström: Employee; Self; AstraZeneca. Stock/Shareholder; Self; AstraZeneca. R.J. Mentz: Consultant; Self; Amgen, AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Sanofi. Research Support; Self; GlaxoSmithKline plc. R.R. Holman: Advisory Panel; Self; Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S. Research Support; Self; AstraZeneca, Bayer AG, Merck Sharp & Dohme Corp. H.L. Heerspink: Consultant; Self; AbbVie Inc., AstraZeneca, Boehringer Ingelheim International GmbH, CSL Behring, Gilead Sciences, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Mitsubishi Tanabe Pharma Corporation, Mundipharma International, Retrophin, Inc.

Funding
AstraZeneca
96-OR: Integrative Omics Analysis Revealed That the Metabolic Changes in Placental Cells from Gestational Diabetes Mellitus Are Reflected in Their Secreted Exosomes
Authors: NAIR SOUMYALEKSHMI , JAYABALAN NANTHINI , SCHOLZ-ROMERO KATHERIN , GUANZON DOMINIC , LAI ANDREW , MCINTYRE DAVID , LAPPAS MARTHA , SALOMON CARLOS 
Published: June 2020

Exosomes are membrane-bound extracellular vesicles secreted from a range of cells including human placental cells and contain specific cargo such as proteins, and miRNAs. The aim of this study was to determine the miRNA and protein profile in primary human trophoblast (PTH) and their secreted exosomes obtained from placentae from women with normal glucose tolerant (NGT) and gestational diabetes mellitus (GDM). Using quantitative proteomic analysis, 34 proteins were significantly different in PTH from GDM compared with NGT. Similarly, a specific set of proteins were significantly different in PTH exosomes from GDM compared with NGT. An Illumina TrueSeq Small RNA kit was used to construct a small RNA library from PTH and exosomes. We identified a set of miRNAs (miR-181, miR-151, miR-10a, miR-744, miR-1468 and miR-4507) which their expression varied in a consistent pattern in PTH and their secreted exosomes in GDM compared with NGT. Interestingly, a specific set of proteins and miRNAs were selectively enriched with exosomes and compared with their PTH of origin in NGT and GDM indicating a specific packaging of proteins and miRNAs into exosomes. We used Ingenuity Pathway Analysis (IPA) analysis to identify miRNA-gene interactions using the miRNA and proteomic data and created a network link with the down- and up-regulated pairs of miRNA-proteins. IPA core analysis showed that the top canonical pathway associated with these miRNAs were PI3/AKT signalling and glucose metabolism/insulin resistance, respectively. We proposed that exosomes are “fingerprints” of the releasing cells and their metabolic status. Exosomes released from placenta can modify the phenotype of target cells, inducing metabolic changes in GDM to contribute to changes in insulin sensitivity during pregnancy.

Disclosure
S. Nair: None. N. Jayabalan: None. D. Guanzon: None. A. Lai: None. D. McIntyre: Other Relationship; Self; Novo Nordisk A/S. M. Lappas: None. C. Salomon: None.

Funding
Diabetes Australia; Fondo Nacional de Desarrollo Científico y Tecnológico (1170809)