bluuebunny/crossref_metadata_2025_split huggingface dataset:
704-P: Influence of Acute Stress on Heart Rate and Glycemia during Exercise
Authors: HOBBS NICOLE , PARK MINSUN , CHU MINSEUNG , SONG YOUNGKWAN , QUINN LAURIE T. , SEVIL MERT , CINAR ALI 
Published: June 2020

People with type 1 diabetes (T1D) have personal strategies for maintaining euglycemia while exercising which generally serves them well during training. Their strategy often yields wildly differing results during a competition. The influence of competition stress (notably, epinephrine causing prompt elevations in glucose) and high-intensity and/or long-duration efforts can yield dysglycemia. Two different studies were conducted to observe this phenomenon. In a small study of subjects with T1D completing athletic competitions, perceived stress level as reported by the individual is insufficient for determination impact upon glycemia. An elevated heart rate during the competition over what was observed at the same running pace in training was a better indicator of an increase in glycemia. To recreate an athletic stress scenario in a clinical setting, 13 subjects with T1D completed a low intensity treadmill protocol for 3 sessions: non-stress, verbally reported mental math with an audience, and stressful video games to observe the influence on glycemia and heart rate. The treadmill protocol, prior meal, and insulin doses were matched for each individual for the 3 sessions. When compared to the non-stress treadmill session, an elevated average heart rate was observed in 10 of the 13 video game sessions and an elevated average glucose was observed in 9 of the 13 video game sessions. In the mental math sessions, an average heart rate elevated heart rate was observed in 6 of the 13 sessions with 7 of 13 having a higher average glucose compared to the non-stress session. While individual response to acute stress yields a high degree of intersubject variability, the video game sessions may more closely match the competition stress experienced and physiological response to stress observed during an athletic competition. The cause of the stressor may be critical in detection of stress and predicting glycemic response for the management of T1D.

Disclosure
N. Hobbs: None. M. Park: None. M. Chu: None. Y. Song: None. L.T. Quinn: None. M. Sevil: None. A. Cinar: Research Support; Self; Dexcom, Inc., JDRF. Stock/Shareholder; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk A/S, Tandem Diabetes Care.

Funding
JDRF (A18-0036-001); National Institutes of Health (DP3DK101075, F31DK116524)
705-P: "Going for a Walk as the Only Option": Are Medical Diabetes Guidelines Relevant to People with Diabetes in Pakistan When It Comes to Physical Activity?
Authors: TARIQ OMAMA , ROSTEN CLAIRE , HUBER JORG W. 
Published: June 2020

Background: It is recommended that people living with type 2 diabetes (PLwD) increase their levels of physical activity to help manage their condition. Previous studies have reported on strong family ties in South Asian culture. However, understanding of family involvement in relation to diabetes is South Asian culture is limited.
Objective: To explore the influence of family roles within South Asian culture on physical activity by PLwD.
Methods: 30 PLwD (13 men; aged 30-70 years), 17 family members of PLwD (4 men; 22-61 years) and nine doctors were recruited in metropolitan Lahore, Pakistan who mostly used state health services for relatively disadvantaged populations. Interviews were analyzed using thematic analysis.
Results: Three themes were identified: (1) Going for a walk as (the only) convenient physical activity; (2) The role of family members in influencing physical activity; (3) Cultural acceptance of walking as physical activity. Across all themes gender and age create flexibilities or constraints for the choices of physical activity, available to PLwD. Intersections of gender, age and in addition family roles appear to create most flexibility for younger men, e.g., going for a run instead of just walking, and the constraints for a younger woman who may need to find another woman so as to not walk on her own. For an older woman these constraints are less severe, as it is acceptable to her, her family and the wider culture to be seen walking on her own.
Conclusion: These complex pattern of flexibilities and constraints for urban dwellers who would not be able to afford or be permitted to use a fee charging sports facilities are not recognised by PROMPT, a recently published diabetes guideline for Pakistan. The findings suggest an urgent need to develop guidance which recognise familial expectations and propose lifestyle adjustments, acceptable to urban dwellers in a country like Pakistan.

Disclosure
O. Tariq: None. C. Rosten: None. J.W. Huber: None.
706-P: Recreational Soccer Training as a Tool Activity to Prevent Bone Issues in Type 2 Diabetes Patients
Authors: DE SOUSA MAYSA VIEIRA , DA SILVA MARIA R. 
Published: June 2020

Bone formation is suppressed in the diabetic state, being the osteoporotic fractures a serious co-morbidity and complication of diabetes. A better lifestyle with proper diet and exercise have been linked to delay the progression of diabetes and may improve bone metabolism. With diabetes negatively affecting bone health we evaluated the impact of diet and exercise on serum bone markers, hormones and densitometry. This study assessed effects of twelve weeks of recreational soccer training combined with a caloric restricted diet (SO+D) vs. diet alone (D) in markers of bone health of type 2 diabetes (T2D) patients. Training sessions were performed for 40 min, 3 times per week for 12 weeks. We examined the following baseline and postprandial serum bone markers of formation: procollagen type 1 N-terminal propeptide (P1NP), and osteocalcin (OC); and C-terminal telopeptides of type I collagen (CTX) as bone resorption marker. Bone metabolic hormones such as parathyroid hormone (PTH) and 25-hydroxyvitamin D (25[OH]D) were also measured.
Results: Compared to baseline levels, the first soccer session for SO+D induced acute increases of osteocalcin (35.0 ± 14.3 to 48.0 ± 26.3 ng/mL, P&lt;0.05) and CTX remained unchanged. Osteocalcin, P1NP and CTX were lower in the D group (P&lt;0.05). Compared to the D group, SO+D group resulted in increased osteocalcin (P&lt;0.05), while P1NP and CTX levels did not alter. After 12 weeks, bone mineral density increased in both SO+D and D groups (P&lt;0.05) and baseline levels of PTH remained unchanged, whereas 25[OH]D increased only in SO+D group (19.1±1.2 to 22.1 ± 1.4 ng/mL, P&lt;0.05). Diet alone or combined with soccer training improved bone health status among T2D patients elicited by suppression on bone resorption marker and increased bone mineral density. However, recreational soccer training enhanced bone formation marker and vitamin D levels decreasing risk factors associated with osteoporosis and osteoporotic fractures in T2D patients better than diet alone.

Disclosure
M. Vieira de Sousa: None. M.R. da Silva: None.

Funding
Fundação de Amparo a Pesquisa do Estado de São Paulo (2012/01400-0)
711-P: Associations of Early-Year Exposure to Famine with Abdominal Fat Accumulation Are Independent of Family History of Diabetes and Physical Activity
Authors: HU XIANG , GU XUEJIANG 
Published: June 2020

Background/Aims: Famines provide researchers with a quasi-experimental setting to investigate the long-term impact of nutritional deprivation during gestation and childhood on the adult health outcome. The present study was to investigate the association of early-year exposure to famine with abdominal fat accumulation and function, and further evaluate the influence of family history of diabetes and physical activity on this association.
Methods: The present work analyzed a part of the baseline data of REACTION study. A total of 3033 women were enrolled. Central obesity was defined as waist circumferences (W) ≥ 85 cm. Chinese visceral adiposity index (CVAI) was used to evaluate visceral adipose distribution and function in Chinese population.
Results: After adjusted for age and menopause status, partial correlation analysis showed body mass index (BMI), W, glycated hemoglobin A1c, and CVAI were associated with early-year exposure of famine (both P &lt; 0.05). Logistic regression showed that the risks of overall overweight/obesity and central obesity in fetal, early-childhood, mid-childhood, and late-childhood exposed subgroups were increased significantly (all P &lt; 0.05). Compared with non-exposed group, the BMI, W, and CVAI of fetal, early- to late-childhood exposed subgroups were significantly increased with the interference of family history of diabetes and physical activity degree, respectively (all P &lt; 0.05). The associations of BMI, W, and CVAI with early-year exposure to famine were independent of their associations with family history of diabetes (P = 0.001 for BMI and &lt; 0.001 for W and CVAI) or physical activity degree (all P &lt; 0.001).
Conclusions: Early-year exposure to famine is associated with an increased risk of central obesity. Early-year exposure to famine contributed to abdominal fat accumulation and dysfunction, which was independent of the influence of genetic background and lifestyle intervention.

Disclosure
X. Hu: None. X. Gu: None.

Funding
Wenzhou Science and Technology Bureau (Y20190126, Y20170047); Zhejiang Provincial Natural Science Foundation of China (LY20H070003); National Key Research and Development Program of China (2016YFC1305202); National Natural Science Foundation of China (81900737)
719-P: A Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Glucose-Lowering Effect of Green Jackfruit Flour in Type 2 Diabetes Mellitus Patients
Authors: JOSEPH JAMES , RAO A. GOPAL , NAYAK SUNIL 
Published: June 2020

Objective: We tested the effects of 30g Jackfruit365™ Green Jackfruit flour in participants with type 2 diabetes (T2DM) as an integral part of daily meal by observing change of glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and postprandial glucose (PPG) in blood from baseline.
Research Design and Methods: A randomized double blind design was used in 40 participants with T2DM. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), postprandial glucose (PPG) were determined at day 0 (pre-dose) and 84 day (12 weeks). Paired t test was used for statistical analysis of changes within the group and independent t test was used for statistical analysis of changes between the groups.
Results: There were 40 participants with type 2 diabetes mellitus having mean age of 46.20±9.12 years (24 males and 16 females). One participant was lost to follow up in placebo group and total 39 participants with type 2 diabetes mellitus completed the study. In participants taking Green Jackfruit Flour meal, mean HbA1c at baseline was 7.23 ± 0.47 % and at end of study (12 weeks) mean HbA1c was 6.98 ± 0.48%. In participants taking placebo meal, mean HbA1c at baseline was 7.26 ± 0.45 % and at end of study (12 weeks) mean HbA1c was 7.28 ± 0.49%. A significant decrease in HbA1c was observed in participants taking Green Jackfruit flour meal (HbA1c mean difference of 0.25 in Green Jackfruit flour meal vs. -0.02 placebo meal; p =0.006) from baseline to end of the study. Fasting and Postprandial plasma glucose levels also showed similar improvements in participants taking Green Jackfruit flour meal.
Conclusions: Our results indicate decrease in Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), postprandial glucose (PPG) following consumption of Jackfruit365™ Green Jackfruit flour meal, suggesting a therapeutic potential of Green Jackfruit flour meal in improving glycemic control in T2DM.

Disclosure
J. Joseph: Board Member; Self; Diet Fibre 365 Food Products Pvt Ltd. Stock/Shareholder; Self; God’s Own Food Solutions Pvt Ltd. Other Relationship; Self; God’s Own Food Solutions Pvt Ltd. A. Rao: None. S. Nayak: None.

Funding
Diet Fibre 365 Food Products Private Limited
72-LB: Novel Epidermal Adhesive Sensors to Enhance Continuous Glucose Measurement in Patients with Diabetes: The EASE Study
Authors: CHAO EDWARD , PAZ ANDRES ERNESTO DE LA , BARFIDOKHT ABBAS , WANG JOSEPH 
Published: June 2020

By providing a more comfortable and convenient glucose testing experience, non-invasive, wearable biosensors could bolster patients’ engagement with their diabetes mellitus (DM). We investigated the accuracy and acceptability of a novel, needle-free continuous glucose sensor.
At 2 g and 5 x 4 mm, this sensor is ultra-light, thin, flexible, and self-adherent to the skin. A mild electrical current applied to the epidermis causes sodium ions, then interstitial fluid (ISF) glucose molecules, to migrate toward an electrode. The sensor gauges glucose by detecting its electrical charge strength. Four individuals with DM participated (age 42-61 years, mean 51.5 years; 1 patient with type 1 DM). Over 4 hours, we obtained 3 sensor and 3 glucometer readings concurrently at each of the following time points: following an 8-hour fast, and every 60 minutes after a standard 500-kcal, 75-g high-carbohydrate meal.
The correlation coefficient of sensor and glucometer readings was 0.80 (p = 0.00023). Participants rated on a 1-5 scale, with 5 being the highest: 4.25 for comfort, and 4.0 for being receptive to long-term use of such a sensor. Two individuals denied discomfort; 1 felt tingling; and 1 noted a needle-like sensation.
The function and patient-friendly design of a wearable glucose sensor may help substantially advance glucose testing, and in turn, improve clinical outcomes and quality of life.

Disclosure
E. Chao: None. E. De La Paz Andres: None. A. Barfidokht: None. J. Wang: None.

Funding
University of California, San Diego; National Institutes of Health (UL1TR001442)
721-P: Fat Added to High-Glycemic–Index Foods Reduces Both Glycemic and Insulinemic Response to Moderate-Size Meals
Authors: JASS DANIEL K. 
Published: June 2020

Fat has been shown to be a powerful modifier of dietary glycemic response (Flint et al 2004). But other research shows addition of fat to high GI meals worsens insulinemic response (Gannon et al 1993). The author hypothesized that researched insulin response was more related to excessive meal size (50+ gms of both carbohydrate and fat) than to fat content per se.
The current study compared starch or sugar based nonfat 50 gm carb meals (∼250 kcal) with meals containing 30 gm amounts of both fat and carb (∼450 kcal) in 12 healthy 21-75 year old volunteers (6-8 per subgroup) without glucose intolerance. Size of subgroups was similar to that used in establishing the glycemic index (Jenkins et al 1981). Each subject served as their own control. Despite the larger meal size, the balanced carb/fat meals had lower glycemic and insulin responses, with p values of 0.009 and 0.016 for glycemic response, and 0.014 and 0.0275 for insulin response to starch and sugar-based meals, respectively (Wilcoxson, one tailed). Post-study interviews also demonstrated that subjects preferred the balanced meals.
This pilot study has demonstrated that adding fat to moderate sized meals lowered, not raised, insulin levels, even when compared to much smaller nonfat meals. It also confirms previous research that fat lowers glycemic response and improves palatability.
Taken together, these findings support further research into the potential benefit of balanced carb/fat meal combinations. Such meals might improve diet sustainability as well as efficacy. Future research can explore other fat types/amounts, and evaluate the utility of this concept in real world dietary management.

Disclosure
D.K. Jass: None.
729-P: Decreased Serum Vitamin D Level Implies Increased Cardiovascular Risk in Diabetes
Authors: LJUBIC SPOMENKA , JAZBEC ANAMARIJA , CUDINA IVONA , TOMIC MARTINA , RAHELIC DARIO 
Published: June 2020

Increase in homocysteine (HCY) level may increase cardiovascular risk (CVR), partly because of an impact on apolipoproteins and inflammation. Absorption of vitamin B12, involved in the regulation of HCY level, decreases with vitamin D deficiency. A possible association of vitamin D with visceral obesity and HCY was studied. HCY, 25-hydroxyvitamin D, vitamin B12, lipids, and other diabetes-related markers, including lipid accumulation product (LAP), were tested in 612 type 2 diabetic patients divided into four groups (1st group: LAP ≤ Q1; 2nd group: Q1 &lt; LAP ≤ Med; 3rd group: Med &lt; LAP ≤ Q3, 4th group: LAP ≥ Q3) according to LAP quartiles (Q1 = 28.5; Med = 50.59; Q3 = 80.64). LAP as an index, combining waist circumference and triglycerides, is related to risk of metabolic syndrome, diabetes and CVR. In all statistical tests: ANOVA, Tukey post-hoc test, and stepwise multivariate linear regression, α=0.05 was considered as statistically significant. Significant difference in vitamin D and B12, and high-density lipoprotein (HDL) according to LAP groups was determined. HDL differed significantly between the 1st (1.56±0.27) and the 3rd (1.24±0.17), and between the 1st and the 4th (1.19±0.25) group, vitamin D between the 1st (67.21±11.87) and the 3rd (60.34±10.78), and between the 1st and the 4th (51.29±13.41) group, and vitamin B12 differed significantly between the 1st (319.33±158.71) and the 3rd (212.14±71.92) group. After stepwise regression two best predictive variables for vitamin D were glomerular filtration rate (GFR) (parR2=0.12) and LAP (parR2=0.07), for vitamin B12 HCY (parR2=0.07) and age (parR2=0.07), and for HCY GFR (parR2=0.23) and vitamin B12 (parR2=0.09). Vitamins D and B12 differed according to quartiles of LAP, implying an influence of central obesity on their levels. LAP was one of the main predictors of vitamin D, and vitamin B12 was among the best predictive variables for HCY. The relationship between vitamin D, vitamin B12 and HCY implies involvement of decreased vitamin D in increased CVR.

Disclosure
S. Ljubic: None. A. Jazbec: None. I. Cudina: None. M. Tomic: None. D. Rahelic: None.
737-P: Positive Impact of Social Support and Diabetes Community Participation on Patient-Reported Outcomes
Authors: SUHL SARA , ROST JONATHAN B. , STONER KEATON C. , GOWEN REBECCA , FLORISSI CATERINA , WOOD RICHARD 
Published: June 2020

Social support plays an important role in both mental and physical well-being. This study used patient-reported outcomes to better understand the effect of social support and diabetes communities on the behaviors and health outcomes of those living with diabetes. People with diabetes (n=4,717) from an opted-in U.S. research panel were surveyed about their level of social support using the Interpersonal Support Evaluation List-12 (ISEL-12). Physical activity level was determined using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and health and demographic information were collected. Findings show that higher levels of support are associated with better glycemic control, healthier lifestyle choices, and lower rates of diabetes complications and comorbidities.
Notably, when controlling for overall level of social support and evaluating participants within one SD of the ISEL-12 mean, diabetes community members are more likely than those not in a community to have high diet adherence (≥80%) and high levels of physical activity. These diabetes community members are also less likely to have A1c &gt;7, heart/circulation problems, high blood pressure, and cholesterol/triglyceride problems. These findings emphasize the importance of social support on the overall health of those with diabetes and suggest that diabetes communities are an important tool for managing diabetes.

Disclosure
S. Suhl: Employee; Self; This work was funded by dQ&A Diabetes Research, a provider of research services to multiple companies and patient organizations in the diabetes field. J.B. Rost: Employee; Self; This work was funded by dQ&A Diabetes Research, a provider of research services to multiple companies and patient organizations in the diabetes field. K.C. Stoner: Other Relationship; Self; Various companies and organizations. R. Gowen: Employee; Self; This work was funded by dQ&A Diabetes Research, a provider of research services to multiple companies and patient organizations in the diabetes field. C. Florissi: Employee; Self; This work was funded by dQ&A Diabetes Research, a provider of research services to multiple companies and patient organizations in the diabetes field. R. Wood: Consultant; Self; Abbott, ADOCIA, American Diabetes Association, Ascensia Diabetes Care, Boehringer Ingelheim Pharmaceuticals, Inc., CeQur Corporation, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation. Employee; Self; dQ&A Market Research Inc.
75-OR: Dietary Nitrate and Fecal Transplantation Prevent Cardiac Dysfunction and Attenuate Left Ventricular Mitochondrial Reactive Oxygen Species Emission in High-Fat Diet-Fed Mice
Authors: PETRICK HEATHER L. , BRUNETTA HENVER , KIRSH ALEAH , BARBEAU PIERRE-ANDRE , OGILVIE LESLIE M. , SIMPSON JEREMY , SCHERTZER JONATHAN D. , HOLLOWAY GRAHAM 
Published: June 2020

Cardiometabolic diseases are multifactorial conditions involving dysfunction within the left ventricle (LV), adipose tissue (AT), and gut microbiome. Nitrate supplementation has been shown to influence cardiac contractility, mitochondrial function, and microbial populations, effects which require commensal gut bacteria to metabolize nitrate. Therefore, we examined if dietary nitrate and fecal microbial transplant (FMT) from nitrate-fed mice were capable of preventing high fat diet (HFD) induced cardiac abnormalities.
Male C57Bl/6N mice were fed a control diet, or HFD (60% fat) in the absence or presence of 4mM sodium nitrate in drinking water for 8 weeks. A further subset of HFD-fed mice were gavaged with feces from HFD+nitrate donors or HFD donors for 3 days at the beginning of week 7, and followed until week 8.
Compared to controls, HFD mice presented with ∼25% reduction in end diastolic volume, stroke volume, and cardiac output, in association with an increase in cardiac fibrosis, AT inflammation, and serum lipids. In contrast, dietary nitrate prevented these detrimental effects. The improvement in cardiac function following dietary nitrate was not attributed to changes in LV mitochondrial respiration, however, nitrate prevented the increase in LV mitochondrial reactive oxygen species (ROS) emission associated with HFD. While FMT from HFD+nitrate donors did not influence AT inflammation or cardiac fibrosis, HFD+nitrate FMT decreased serum lipids, LV ROS, and improved cardiac function compared to FMT from HFD-fed donors, without increasing serum nitrate concentrations.
Altogether, dietary nitrate prevents the detriments of HFD on cardiac function and LV mitochondrial ROS emission, effects which may not be directly dependent on increasing serum nitrate. Rather, the beneficial effects of nitrate may be linked to changes in the gut microbiome, as FMT from nitrate-fed donors improved LV function.

Disclosure
H.L. Petrick: None. H. Brunetta: None. A. Kirsh: None. P. Barbeau: None. L.M. Ogilvie: None. J. Simpson: None. J.D. Schertzer: None. G. Holloway: None.

Funding
Natural Sciences and Engineering Research Council of Canada (400362)