bluuebunny/crossref_metadata_2025_split huggingface dataset:
147-LB: The Effects of Berberine, Cinnamon, or Fenugreek Seeds on Glucose and Lipid Metabolism in Prediabetes and Diabetes: An Assessment of the Quality of the Clinical Trials
Authors: ABDI IBSA 
Published: June 2020

The prevalence of diabetes is increasing. Several antidiabetic drugs are available to treat the disease, however, none has been effective in halting the progression decline in β-cell function and insulin sensitivity. Plant-derived nutraceuticals provide therapeutic potential and are widely used in integrative medicine. However, clinical trials that evaluated the efficacy of antidiabetic nutraceuticals have been inconsistent in their findings. This study assessed the quality of the clinical trials that investigated the effects of berberine, cinnamon, or fenugreek seeds on glucose and lipid metabolism. Five databases (UB Wahlstrom, PubMed, Cochrane Library, CINAHL, and Science Direct) were systematically searched for randomized controlled studies that investigated the effects of berberine, cinnamon, or fenugreek seeds on glucose and lipid metabolism in prediabetes and diabetes. Forty-three studies (11, 20, 12 on berberine, cinnamon, and fenugreek, respectively), involving 3, 459 study participants were retrieved. The studies were appraised for trial quality using the Jadad scale and the CONSORT checklist. The included berberine, cinnamon, and fenugreek studies had a Jadad score of 3.2, 3.4, and 2.4, respectively. The studies, combined, had a Jadad score of 2.98 and only 62.7% had a score ≥3. Appraisal for reporting quality showed that 33% of the trials were identified in the title or abstract as randomized. Allocation concealment, random sequence generation, and baseline demographics and clinical characteristics were reported in 35, 44 and 74% of the trials, respectively. The included studies had suboptimal methodological and reporting qualities. The studies were not efficacious enough to support their use in clinical decision making. Further RTCs with emphasis on methodological and reporting quality and comparative effectiveness need to be conducted to determine efficacious conclusions.

Disclosure
I. Abdi: None.
1470-P: Among Black New Yorkers with Type 2 Diabetes Afro-Caribbeans Are Younger and Have Lower BMI than African Americans: NYC HANES 2013/14
Authors: HORLYCK-ROMANOVSKY MARGRETHE F. 
Published: June 2020

Despite type 2 diabetes (T2DM) risk differences by BMI and age among populations of African descent, current T2DM screening criteria regard all black populations as one. Few studies have had opportunity to compare T2DM point prevalence among African Americans and Afro-Caribbeans living in the United States.
Objectives: This study evaluated among African American and Afro-Caribbean New Yorkers: a) point prevalence of T2DM, b) odds of T2DM, and c) contributors to T2DM odds in either group. We used 2013/14 New York City Health and Nutrition Examination Survey (NYC HANES) data for African Americans (n=208, age 42.7±15.3y (mean±SD), BMI 29.9±7.8 kg/m2) and Afro-Caribbeans (n=111, age 48.3±14.8 years, BMI 28.6±5.7 kg/m2). T2DM was defined as self-reported diagnosis by a physician, or measured HbA1c≥6.5%, or fasting plasma glucose ≥126mg/dL. BMI was based on measured height and weight. Age, socioeconomic variables and health behaviors were self-reported. Weighted logistic regression estimated T2DM odds (aOR), adjusting for age, BMI, income, marital status, smoking, fruit and vegetable intake and physical activity.
Results: Compared to African Americans, Afro-Caribbeans had higher T2DM prevalence (20.2% vs. 15.5%). Afro-Caribbeans with T2DM were younger (age 58.8±11.2y) than African Americans with T2DM (age 61.3±15.8y), and had lower BMI of 30.1±4.4 vs. 32.8±7.6kg/m2 respectively. Odds of T2DM were not different among Afro-Caribbeans and African Americans (aOR=1.85 (95%CI 0.71, 2.40, P=0.415). In separate analyses among African Americans, BMI was associated with higher T2DM odds [aOR=1.07 (95%CI 1.01, 1.14), P=0.047]. Among Afro-Caribbeans BMI was not associated with T2DM odds [aOR=1.04 (95%CI 0.96, 1.130), P=0.37].
Conclusion: To enhance detection of T2DM among African Americans and Afro-Caribbeans future screening criteria should reflect differences in T2DM risk by BMI and age by ethnic group.

Disclosure
M.F. Horlyck-Romanovsky: None.
1481-P: Patients with Cystic Fibrosis–Related Diabetes Present with Specific Pancreatic Anomalies
Authors: ALEXANDRE-HEYMANN LAURE , PUERTO MARIE , BURGEL PIERRE-RÉGIS , LARGER ETIENNE 
Published: June 2020

Cystic fibrosis related diabetes (CFRD) is found in 20 to 50% of adults with cystic fibrosis (CF). Repeated oral glucose tolerance tests are used to screen for CFRD, but are not perfect indicators and can be tiresome for patients who already undergo many medical tests. We hypothesized that pancreatic imaging may differ between patients with and without CFRD and that the patients with the more “at-risk” pancreatic morphology could be followed more closely with the aim to detect diabetes early. We performed a non-matched case-control retrospective study comparing the abdominal ultrasounds (U.S.) and computed tomography (CT) (including abdominal slices of thoracic CT) of patients with CF with or without CFRD (“CFRD patients” and “CF patients”, respectively). Forty-four CFRD patients and 58 CF patients were included. Thirty-seven percent of the U.S. results were either uninterpretable or discordant with the CT results. Therefore, only the results of the CT were eventually analyzed. Seventy-one percent of CFRD patients presented with complete pancreatic involution (CPI), versus 57% of CF patients (p = 0.0016), and 98% of CFRD patients presented with at least partial pancreatic involution. Patients with CPI presented more frequently with exocrine pancreatic insufficiency than patients with a normal CT scan (95% versus 29%, p&lt; 0.0001). Unexpectedly, 22% of CFRD patients presented with pancreatic calcifications, versus none of the CF patients (p = 0.0003). Patients with pancreatic calcifications did not differ from patients without, except that they were less likely to be homozygous for DeltaF508 mutation (22 versus 53%, p = 0.04). CPI is more often seen in CFRD patients than in CF patients, but is still a very frequent occurrence. A more distinctive feature is the presence of pancreatic calcifications. These might be used as a warning signal to look more closely for diabetes in patients with CF, and can be searched for on abdominal slices of routinely performed thoracic CT.

Disclosure
L. Alexandre-Heymann: None. M. Puerto: Other Relationship; Self; Ipsen Biopharmaceuticals. P. Burgel: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Chiesi USA, Inc., Vertex Pharmaceuticals. Consultant; Self; GlaxoSmithKline plc., Pfizer Inc., Teva Pharmaceutical Industries Ltd., Zambon. Speaker’s Bureau; Self; Novartis AG. E. Larger: None.
1482-P: Effect of Age on Diabetes-Specific Autoantibodies in a Large Laboratory-Based Cohort
Authors: DAHL AMANDA R. , PITTOCK SIOBHAN , MCKEON ANDREW , FOSTER JESICA , MILLS JOHN 
Published: June 2020

Type 1 diabetes mellitus (T1DM) can occur at any age, the presence of diabetes related autoantibodies predicts increased risk of disease and supports an autoimmune etiology for T1DM. Since 2017, Mayo Clinic Laboratories has been offering a comprehensive type 1 diabetes autoantibody evaluation (DM1Eval) which includes testing for 4 autoantibodies targeting glutamic acid decarboxylase autoantibodies (GAD), protein tyrosine phosphatase-like islet antigen 2 (IA-2), insulin (IAA), and zinc transporter 8 protein (ZnT8).
The aim of this study was to determine the frequency of individual antibodies and antibody clusters (2, 3 or 4) stratified into 4 ages groups (children 0-17, young adult 18-35, middle aged 36-55 and older &gt;55 years).
Over a 30 month period (June 2017-Nov 2019) the DM1Eval was performed on 6,446 samples. At least 1 autoantibody was found in 3596 (56%) of all samples: 68% of children, 49% of young adults, 40% of middle aged and 41% of older adults.
In patients with at least 1 antibody positive, GAD 65 antibodies were the most common in all age groups followed by ZnT8 in those &lt;36 years or IAA antibody in those 36 and older older (Figure). The frequencies of IA2 and ZnT8 antibodies dropped significantly with increasing age strata.
Autoantibody clusters of 3 or 4 antibodies were more frequently encountered in younger patients (41% of pediatric and 27% of young adult patients in contrast to just 12% in middle and older age groups).

Disclosure
A.R. Dahl: None. S. Pittock: None. A. McKeon: None. J. Foster: None. J. Mills: None.
1486-P: Identification of Undiagnosed Diabetes Mellitus and Associated Alternation of Predicted ASCVD Risk Using Chinese and U.S. Risk Calculators
Authors: YANG JING , ZHAO YANGLU , REN YI , LAN LIZHEN , XU LINXIN , YIN JIANHONG , XU QISHAN , LI YONGZE 
Published: June 2020

Background: It is unknown how the identification of undiagnosed DM (UDM) among Chinese changes the estimation of atherosclerotic cardiovascular disease (ASCVD) risk using the Chinese and the U.S. risk calculators.
Methods: We included 1884 adults aged 30-75 free of ASCVD from 4 urban and rural communities in Shanxi Province, China. UDM was defined as newly found DM by glucose or HbA1c with no DM history or DM medication. 10-year ASCVD risk was estimated using the Prediction for ASCVD Risk in China (China-PAR) score and 2013 AHA/ACC Pooled Cohort Equation (PCE) and classified into risk categories. For those with UDM, the risk scores were calculated before and after DM diagnosis.
Results: Among 266 (14.1%) DM patients, 161 (8.5%) were UDM. Compared to those with diagnosed DM, those with UDM had milder DM and better CVD risk profiles. The mean China-PAR among non-DM, UDM (before diagnosis) and diagnosed DM were 6.0% 14.3% and 18.8% and mean PCE were 2.5%, 5.3% and 13.0%, respectively. Among those with UDM, the mean China-PAR and PCE increased to 16.7% and 9.2% after DM diagnosis (both p &lt;0.0001); 6.2% and 34.8% were reclassified into higher risk groups according to the Chinese and U.S. guidelines (Figure).
Conclusion: Identification of UDM had greater impact on estimated ASCVD risk using PCE than China-PAR among Chinese and may change the preventive treatment by risk reclassification.

Disclosure
J. Yang: None. Y. Zhao: None. Y. Ren: None. L. Lan: None. L. Xu: None. J. Yin: None. Q. Xu: None. Y. Li: None.

Funding
Research Fund for Public Welfare, National Health, and Family Planning Commission of China (201402005)
149-OR: In Utero Exposure to Gestational Diabetes Mellitus Is Associated with Increased Food Intake and Orbital Frontal Cortex Responses to Food Cues
Authors: LUO SHAN H. , ANGELO BRENDAN C. , CHOW TING , ALVES JASMIN , BUCHANAN THOMAS A. , XIANG ANNY , PAGE KATHLEEN A. 
Published: June 2020

Children exposed to gestational diabetes mellitus (GDM) in utero have an increased propensity of developing obesity. Little is known about the mechanisms underlying this propensity. Here we examine the relationship between GDM exposure and its timing on energy intake (EI) and brain reward responses to food cues in children. Participants were 142 children (39% boys; 56% GDM-exposed) aged from 7 to 11 years old. GDM status was extracted from EMR. Adiposity measurements were collected. Repeated 24-hour recalls were conducted to assess mean daily EI (kcal/day). A subset (n=89) of children completed an MRI session where they viewed food and non-food cues. %signal change in the orbital frontal cortex (OFC), insula and amygdala for food vs. non-food contrast was measure of interest. GDM exposure was modeled by: 1) yes vs. no at any time in pregnancy and 2) GDM diagnosed at &lt;= 26 weeks (early exposed), &gt; 26 weeks (late exposed) and unexposed. GDM exposure (vs. unexposed) was associated with greater EI (mean difference ±SE: 169 ±65, P=0.01) and OFC food cue reactivity (0.19±0.09, P=0.04). Results were strengthened after adjusting for age, sex, physical activity, SES and pre-pregnancy BMI (EI: P=0.008; OFC: P=0.024). In the adjusted models, both subgroups (early exposed(N=27): 178 ± 92, P=0.055; late exposed (N=53): 173±72, P=0.018) had greater EI than controls. Early exposed group had greater OFC food cue reactivity than controls (0.30±0.15, P=0.048) and the difference between late exposed and controls was marginally significant (0.20±0.11, P=0.07). Children exposed to GDM (vs. unexposed) had larger WHR (0.02±0.01, P=0.03), and this was driven by the difference between early exposed vs. controls (0.04±0.01, P=0.006). Exposure to GDM in utero, in particular before 26 weeks gestation, is associated with increased energy intake, enhanced OFC food cue reactivity and increased WHR. Whether these changes predict development of obesity remains to be determined.

Disclosure
S.H. Luo: None. B.C. Angelo: None. T. Chow: None. J. Alves: None. T.A. Buchanan: None. A. Xiang: None. K.A. Page: None.

Funding
National Institutes of Health (K01DK11563)
1490-P: Disparities in Deaths Due to Diabetes, Diabetes Ketoacidosis, and Diabetic Coma by Urbanization among Children, Adolescents, and Young Adults: 1999-2017, United States
Authors: SHAYDAH SHARON , IMPERATORE GIUSEPPINA , MERCADO CARLA , BULLARD KAI M. , BENOIT STEPHEN R. 
Published: June 2020

Although previous studies have reported higher diabetes (DM) mortality among individuals who live in rural areas, little is known about deaths due to DM, diabetic ketoacidosis (DKA) or diabetic coma by urbanization among U.S. population under age 45 years. We used National Vital Statistics System data from 1999 to 2017 filed in all 50 states and the District of Columbia obtained from CDC Wonder (wonder.cdc.gov). DM-related deaths were based on any listed ICD-10 codes E10-E14. DKA or diabetic coma deaths were based on any listed ICD-10 codes E10-E14 with X.1 or X.0. Urbanization was classified into 5 categories based on the 2013 National Center for Health Statistics definition. Results were reported for 1999- 2007, 2008-2017 and age standardized to the 2000 U.S. population by 10-year age groups for age 5 to 44 years. For both DM-related and DKA and diabetic coma deaths, rates for large fringe metro were lower than other areas (p &lt; 0.001). (Table) The absolute difference in DM-related deaths increased over time in all urbanization categories (p &lt; 0.05) except in large central metro. Rates of DKA or diabetic coma death increased significantly in medium/small and non-core areas (p &lt; 0.05), but remained stable in large central metro. (Table) Exploring underlying causes for the disparities in deaths by urbanization may lead to improved care and fewer deaths.

Disclosure
S. Shaydah: None. G. Imperatore: None. C. Mercado: None. K.M. Bullard: None. S.R. Benoit: None.
1497-P: Secular Trends in Incidence and One-Year Mortality Rates of Lower Extremity Amputation in People with Diabetes in Hong Kong between 2001 and 2016
Authors: WU HONGJIANG , YANG AIMIN , LAU ERIC S. , MA RONALD C. , KONG ALICE P. , CHOW ELAINE , SO WING YEE , CHAN JULIANA C. , LUK ANDREA 
Published: June 2020

Objective: Diabetes is a leading cause of nontraumatic lower extremity amputation (LEA). We describe the secular trends in incidence rates of LEA and one-year mortality rates after LEA in people with diabetes in Hong Kong between 2001 and 2016.
Methods: The Hong Kong Diabetes Surveillance Database (HKDSD) is a territory-wide population-based diabetes cohort identified from the Hong Kong Hospital Authority electronic medical system. We identified LEA events using ICD-9 procedure codes and that of one-year mortality after LEAs from the linkage to the Hong Kong Death Registry. We used Joinpoint regression models to describe the trends in incidence of LEAs from 2001 to 2016 and one-year mortality rates after LEAs from 2001 to 2015.
Results: Between 2001 and 2016, a total of 390,071 men and 380,007 women with diabetes aged 20 years or older were included in the HKDSD, among whom 6,113 LEAs in men and 4,149 LEAs in women were recorded. The event rates of minor LEAs declined by 48.6% (average annual percent change [AAPC]: -3.8, 95% CI -5.7, -1.9) from 14.0 to 7.2 per 10,000 in men and by 59.5% (AAPC: -6.3, 95% CI -10.6, -1.8) from 7.9 to 3.2 per 10,000 in women. The rates of major LEAs declined by 77.9% (AAPC: -8.0, 95% CI -9.6, -6.5) from 19.5 to 4.3 per 10,000 in men and by 79.3% (AAPC: -10.4, 95% CI -13.1, -7.6) from 11.6 to 2.4 per 10,000 in women. The one-year mortality rates after both minor and major LEAs remained constant during the surveillance period in both sexes. The AAPC for one-year mortality rates was 1.5 (95% CI -3.0, 6.1) in men and 0.6 (95% CI -4.7, 6.1) in women after minor LEAs, and was -2.1 (95% CI -4.8, 0.6) in men and 2.6 (-1.4, 6.7) in women after major LEAs.
Conclusions: Although the event rates of LEAs have declined overall in people with diabetes in Hong Kong, there was no improvement in one-year mortality rates after LEAs. Urgent action to improve the quality of care and ongoing surveillance after LEAs in people with diabetes is needed.

Disclosure
H. Wu: None. A. Yang: None. E.S. Lau: None. R.C. Ma: Advisory Panel; Self; AstraZeneca. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., Merck & Co., Inc., Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Tricida Inc. A.P. Kong: Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; AstraZeneca. Speaker’s Bureau; Self; Abbott, AstraZeneca, Sanofi. Other Relationship; Self; AstraZeneca, Novartis Pharmaceuticals Corporation, Sanofi. E. Chow: None. W. So: None. J.C. Chan: None. A. Luk: Research Support; Self; Bayer Healthcare Pharmaceuticals Inc., Roche Pharma. Other Relationship; Self; Merck Sharp & Dohme Corp.
1498-P: A Feedback Loop between miRNA Processing Complex and miR-3975 in Western Diet–Induced Brown Adipose Tissue Dysfunction
Authors: PARK MIN HI , MERUVU SUNITHA , ZHANG JIAN , CHOUDHURY MAHUA 
Published: June 2020

Brown adipose tissue (BAT) is considered as promising therapeutic targets for obesity and metabolic disorder through modulation of energy homeostasis. microRNAs (miRNAs) are established as essential modulators of biological processes in many tissues, including the differentiation and function of BAT. Here we demonstrated that high-fat/high fructose associated dysfunction of BAT coincides with impaired miRNA-processing pathway in a feedback loop with miR-3975 activation. Eight-week-old male C57BL/6 mice were fed a low-fat diet (10% fat and 17% sucrose; LFD) and high fat-high fructose (45% fat, 17% sucrose, and 17% fructose; HFHFD) for 4, 12, and 20 weeks (n=6-9 per group). We evaluated expression levels of apoptosis markers, thermogenesis markers, miRNA biogenesis regulators, and miRNAs in BAT. Mice fed an HFHFD showed a gradually significance increased body weight and brown adipose tissue weight when compared to the mice fed with LFD. BAT of HFHFD fed mice has a pale appearance versus feeding period matched LFD fed mice. The protein expression of thermogenesis markers, UCP1 (P &lt;0.05), and PGC1α (P &lt;0.05) were shown to decrease after 12 weeks of HFHFD diet feeding. The apoptosis marker, the Bax/Bcl-2 ratio, was upregulated at 12 weeks (P &lt; 0.01). Mice fed HFHFD for 12 and 20 weeks showed a significant decrease in Dicer (P &lt; 0.01 for 12 and 20 weeks) and TRBP2 (P &lt; 0.01 for 12 weeks and P &lt; 0.0001 for 20 weeks). miR-3975, which is predicted miRNA to regulate both Dicer and TRBP2 by IPA was activated at 12 weeks (P &lt; 0.01), while inactivated at 20 weeks (P &lt; 0.001). Our results suggest that miR-3975 acts as a component of a negative feedback loop that blocks miRNA biogenesis machinery through the inhibition of Dicer and TRBP2 expression. Therefore, long-term HFHFD may disturb miRNA processing and contribute to brown adipose tissue dysfunction and apoptosis by modulation of miRNA expression. We are currently investigating the novel feedback loop in brown adipocyte primary cells.

Disclosure
M. Park: None. S. Meruvu: None. J. Zhang: None. M. Choudhury: None.
1499-P: Hepatobiliary Disease in Type 2 Diabetes: Is It Increasing and Is Fatty Liver Important?
Authors: DAVIS TIMOTHY , DAVIS WENDY A. 
Published: June 2020

Objective: To determine whether the incidence/adverse outcomes of hepatobiliary disease (HPD) has increased over recent decades in community-based Australians.
Methods: Longitudinal data from the Fremantle Diabetes Study Phase I (FDS1; recruitment 1993-1996) and Phase II (FDS2; 2008-2011) were analyzed. Participants with type 2 diabetes from both Phases were age-, sex- and zip code-matched 1:4 to people without diabetes. Incident HPD and associated mortality were ascertained from hospitalization, cancer registration and/or death certification for an ICD-coded diagnosis (principal/secondary) of liver disease, viral hepatitis, primary malignancy, and gallbladder/biliary tract disease. Incidence rates (IRs) and IR ratios (IRRs) for those with versus without diabetes in FDS1 and FDS2 were calculated.
Results: Data relating to IRs for HPD and associated mortality are shown in the Table. HPD IRs for people without diabetes did not change between Phases but the IRR increased, reflecting an IRR (95% CI) for people with diabetes in FDS2 versus FDS1 of 1.30 (1.01-1.68). Nonalcoholic fatty liver disease/steatohepatitis (NAFLD/NASH) accounted for &lt;20% of HPD and &lt;10% of liver-related deaths in both Phases.
Conclusions: HPD is more frequent in people with versus without type 2 diabetes. This discrepancy has increased in the 15 years between FDS Phases. Hospitalizations/deaths due to NAFLD/NASH remain uncommon.

Disclosure
T. Davis: Advisory Panel; Self; Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S. Speaker’s Bureau; Spouse/Partner; Boehringer Ingelheim International GmbH. Speaker’s Bureau; Self; Lilly Diabetes, Merck Sharp & Dohme Corp., Mylan, Novo Nordisk A/S, Sanofi-Aventis. Other Relationship; Self; Protemics International. Other Relationship; Spouse/Partner; Protemics International. W.A. Davis: Advisory Panel; Spouse/Partner; Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S. Speaker’s Bureau; Self; Boehringer Ingelheim International GmbH. Speaker’s Bureau; Spouse/Partner; Lilly Diabetes, Merck Sharp & Dohme Corp., Mylan, Novo Nordisk A/S, Sanofi-Aventis. Other Relationship; Self; Proteomics International. Other Relationship; Spouse/Partner; Proteomics International.

Funding
Raine Foundation; University of Washington; National Health and Medical Research Council (513781, 1042231); Medical Research Future Fund Practitioner Fellowship