bluuebunny/crossref_metadata_2025_split huggingface dataset:
227-OR: The Effect of Dietary Fiber in Combination with Metformin Therapy in Type 2 Diabetes
Authors: TRAMONTANA FLAVIA , MADDALONI ERNESTO , GRECI SARA , DEFEUDIS GIUSEPPE , STROLLO ROCKY , POZZILLI PAOLO , NAPOLI NICOLA 
Published: June 2020

Background: The efficacy of increasing dietary fiber intake (DFI) to ameliorate glycemic control in patients with type 2 diabetes (T2D) is still controversial. In this randomized open-label comparator-controlled study we tested the effect of high-fiber diet and fiber supplement on glycemic control in patients with T2D on metformin monotherapy.
Methods: Seventy-eight T2D overweight patients on metformin monotherapy were randomized 1:2:1 to 12 weeks intensive nutrition program to follow high-fiber diet (HFD), dietary fiber supplementation (FS) or standard diet recommendations (SDR). Dietary recommendations were reinforced in all groups every 4 weeks by study dieticians. Biochemistry, anthropometric measures, food frequency questionnaires to asses DFI were collected at baseline and after 12 weeks.
Results: At baseline groups did not differ in terms of mean age, BMI, metformin intake, HbA1c, fiber and calorie intake (p&gt;0.05 for all). After three months, DFI significantly increase in both HDF and FS group but not in SDR group (HFD: 19.8 ± 6.1 g vs. 24.3 ± 6.8 g, p= 0.0001; FS: 17.5 ± 5.9 g vs. 27.0 ± 6.2 g p&lt; 0.0001; SDR: 22.8 ± 9.1 g vs. 21.2 ± 6.4 g, p= 0.32). HbA1c significantly improved in all groups (HFD: 7.1 ± 0.5 % vs. 6.6 ± 0.6 %, p&lt; 0.0001; FS: 7.1 ± 0.5 % vs. 6.8 ± 0.5 % p&lt; 0.001; SDR: 7.2 ± 0.4 % vs. 6.7 ± 0.5 g, p&lt; 0.001). All HFD, FS and SDR intervention reduced mean body weight by 2.1 ± 2.6 Kg (p&lt; 0.0001), 1.0 ± 1.8 Kg (p&lt; 0.05) and 1.1 ± 2.1 Kg (p&lt; 0.05), respectively. Changes in HbA1c and body weight did not differ among groups. A significant correlation between calorie intake and the reduction of HbA1c levels was seen across groups (r= 0.307 p&lt;0.01). No significant correlation between DFI and HbA1c levels was observed.
Conclusions: Intensive nutrition education programs with monthly meetings similarly reduced HbA1c in all groups. Furthermore, our study suggested that rather than fiber intake, caloric restriction followed by moderate weight loss is the main driver for glycemic improvement in overweight patients with T2D.

Disclosure
F. Tramontana: None. E. Maddaloni: Consultant; Self; Merck KGaA. Speaker’s Bureau; Self; Abbott, AstraZeneca, Pikdare. S. Greci: None. G. Defeudis: None. R. Strollo: None. P. Pozzilli: Advisory Panel; Self; Abbott, AstraZeneca, Eli Lilly and Company. Research Support; Self; Medtronic, Sanofi. N. Napoli: None.
2271-PUB: Rate of Diabetes Complications during the Initial 6 Months of the First Large-Scale Longitudinal Nationwide Study on Management and Real-World Outcomes of Diabetes in India (LANDMARC)
Authors: GHOSH ROMIK , DAS ASHOK K. , JOSHI SHASHANK , MITHAL AMBRISH , KUMAR PRASANNA , KALRA SANJAY , UNNIKRISHNAN AMBIKA GOPALAKRISHNAN , THACKER HEMANT , SETHI BIPIN , MOHANASUNDARAM SENTHILNATHAN , MENON SHALINI K. , NAIR ARJUN , RAIS NADEEM , WANGNOO SUBHASH KUMAR , CHOWDHURY SUBHANKAR , ZARGAR ABDUL H. 
Published: June 2020

LANDMARC (CTRI/2017/05/008452) aims to evaluate the development and progression of diabetes complications over 3 years in Indian participants with T2D. Rate of diabetes complications was compared from baseline to 6 months (visit 2 [V2]) using McNemar’s test and Chi square test (when complications were stratified in subgroups). There was an increase in the rate of microvascular complications by V2 (Table). Microvascular complications were reported more commonly in participants with A1C≥7% than A1C&lt;7%, with BMI≥23 kg/m2 than BMI&lt;23 kg/m2, and in those with than without cardiovascular (CV) risk factors (Table). In case of macrovascular complications, 7 new cases of peripheral vascular disease, 2 new cases each of MI, stroke and ACS, but no new case of heart failure or unstable angina were reported at V2. Notably, neuropathy was the most common complication at 6 months. The real-world data on complications in LANDMARC may help in understanding disease progression and offer insights on treatment adjustments.

Disclosure
R. Ghosh: Employee; Self; Sanofi. A.K. Das: Advisory Panel; Self; Novo Nordisk A/S, Sanofi. S. Joshi: Advisory Panel; Self; Novo Nordisk A/S, Roche Pharma, Sanofi. A. Mithal: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Johnson & Johnson, Lilly Diabetes, Novo Nordisk A/S. K. Kumar: None. S. Kalra: Advisory Panel; Self; Eli Lilly and Company. Speaker’s Bureau; Self; Novo Nordisk A/S, Sanofi-Aventis. A. Unnikrishnan: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. Speaker’s Bureau; Self; Eli Lilly and Company, Ipca Laboratories, Merck Sharp & Dohme Corp., Novartis AG. H. Thacker: None. B. Sethi: None. S. Mohanasundaram: Employee; Self; Sanofi. S.K. Menon: None. A. Nair: Employee; Self; Sanofi. N. Rais: None. S. Wangnoo: None. S. Chowdhury: Advisory Panel; Self; Novo Nordisk A/S. A.H. Zargar: None.

Funding
Sanofi India Limited
2295-PUB: Impaired First-Phase Insulin Secretion Predicts the Development of Hyperglycemia in a Human Model of Acute Beta-Cell Mass Reduction
Authors: MEZZA TERESA , FERRARO PIETRO MANUEL , GIUSEPPE GIANFRANCO DI , ASSUNTA CEFALO CHIARA MARIA , MOFFA SIMONA , QUERO GIUSEPPE , CINTI FRANCESCA , IMPRONTA FLAVIA , CAPECE UMBERTO , ALFIERI SERGIO , MARI ANDREA , GIACCARI ANDREA 
Published: June 2020

β-cell functional defects temporally anticipate (and eventually cause) the subsequent development of hyperglycemia, whereas a significant reduction (∼50%) of beta-cell mass is observed at diagnosis of T2D. To further investigate the relative role of beta-cell mass reduction/dysfunction in the development of T2D, we performed, pre- and post-surgery, oral glucose tolerance tests (OGTT) and hyperglycemic clamps (HC), followed by arginine stimulation and mixed meal test (MMT), in 39 patients undergoing pancreatoduodenectomy (PD), as model of acute mass reduction. Based on post-surgery OGTT, subjects were divided into 3 groups depending on glucose tolerance: normal (NGT, n=11), impaired (IGT, n=10) or diabetic (DM, n=18) (23 F/16 M, 63±13.7 yrs, BMI 23.9±4.5 kg/m2). To evaluate β-cell function, β-cell glucose sensitivity (GS) was calculated during HC, MMT e OGTT as the ratio of insulin secretion (IS) and glucose increments. Comparison among the 3 groups revealed that PD had a significantly different effect on time-dependent change of glucose and insulin levels during all tests (P&lt;0.01 for the interaction between PD, time and glucose tolerance). Before surgery, Arginine-stimulated Insulin Secretion rates (AIS) and GS were similar across groups, whereas incremental 1st phase IS were significantly lower in IGT and DM as compared with NGT subjects (p=0.01). Following PD, the reduction of GS during HC e OGTT was greater in IGT and DM compared to NGT (p=0.01 per HC and OGTT). A similarly reduction was observed in ΔAIS and 2nd phase of IS (p&lt;0.01), but not in ΔIS1 (p=0.33). In this study the acute beta-cell mass reduction had a different impact on insulin secretory capacity, despite comparable functional mass at baseline, according to pre-surgery IS characteristics. This suggests that underlying impairment in β-cell dysfunction anticipates the decline of beta-cell responses, being the pivotal mechanism for the development of hyperglycemia.

Disclosure
T. Mezza: None. P. Ferraro: None. G. Di Giuseppe: None. C. Cefalo: None. S. Moffa: None. G. Quero: None. F. Cinti: None. F. Impronta: None. U. Capece: None. S. Alfieri: None. A. Mari: Consultant; Self; Lilly Diabetes. Research Support; Self; Boehringer Ingelheim International GmbH. A. Giaccari: Speaker’s Bureau; Self; Amgen, AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mundipharma, Novo Nordisk A/S, Sanofi-Aventis.
2318-PUB: Indices Using Basal Glucose and Insulin Values Are Comparable to Dynamic Values in Assessing Changes in Glucose Metabolism following Bariatric Surgery (BS)
Authors: BRIX JOHANNA , TURA ANDREA , LUDVIK BERNHARD 
Published: June 2020

Introduction: Improvement of insulin resistance (IR) as contributor of diabetes remission and prevention is a beneficial effect of BS. We investigated the ability of indices using either basal or stimulated glucose/insulin values to assess changes in IR and insulin sensitivity (IS) in morbid obese (MO) patients.
Methods: We included 339 patients: 27 with diabetes mellitus (DM, age 44±12 yrs, BMI 49±10kg/m²), 91 with impaired fasting glucose or impaired glucose tolerance (IFG/IGT), (age 41±11 yrs, BMI 47± 7kg/m²) and 221 with normal glucose tolerance (NGT, age 38±10 yrs, BMI 46± 7kg/m²). All patients underwent a 75g OGTT, glucose and insulin levels were repeatedly measured. IR and IS indices were calculated.
Results: Remission to NGT occurred in 70.4% of DM and in 97.8% of IFG/IGT. Basal and stimulated indices were equally able to demonstrate changes of glucose metabolism (table1). Before BS, IR was higher in DM for all indices (p&lt;0.001). After BS, there were no differences in AUC glucose (p=0.454), HOMA (p=0.905) and Matsuda (p=0.469) but IFG/IGT patients had a higher AUC insulin (p=0.024) and a lower IGI (p=0.024) compared to DM.
Conclusion: Indices using basal values are equally able to assess changes in glucose metabolism compared to stimulated indices. They represent a tool for simple and valid determination of glucose metabolism in this cohort.

Disclosure
J. Brix: None. A. Tura: None. B. Ludvik: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk A/S, Sanofi. Research Support; Self; Bayer Healthcare Pharmaceuticals Inc., Eli Lilly and Company, Merck & Co., Inc., Novartis Pharmaceuticals Corporation. Speaker’s Bureau; Self; Amgen.
2319-PUB: Adipose Tissue Distribution Is Associated with the Risk of Stones in Patients with Type 2 Diabetes: A Cross-Sectional Study in China
Authors: NIE YUANPENG , TANG XIXIANG , LI HAICHENG , LI TING , LI MEI , PENG RONGDONG , MU PAN-WEI , CHEN YANMING 
Published: June 2020

Purpose: This study aims to investigate the correlation between adipose tissue distribution and the prevalence of gallstones and urinary stones in patients with type 2 diabetes.
Methods: A total of 2477 patients with type 2 diabetes (T2DM) admitted to the Third Affiliated Hospital from January 2016 to December 2018 were enrolled in the study. Each patient was subjected to physical examinations including measurements of height, body weight, waist circumference (WC), hip circumference (HC), standard biochemical tests and abdominal ultrasound measurement. Body mass index (BMI) and waist to hip ratio (WHR) were calculated. Patients were stratified into 4 quartiles based on WHR: ˂0.8817, 0.8817-0.9240, 0.9240-0.9574 and ˃0.9574.
Results: There is a significant association between abdominal obesity and increased risk of stones in T2DM patients. After adjusting with regular confounding factors, multivariate logistic regression analysis showed that T2DM patients at the 4th quartile of WHR had a higher risk of gallbladder stones compared with patients in the 1st quartile (OR = 3.78, 95%CI:1.16-12.30, P = 0.027). Moreover, after adjusting for some confounding factors other than BMI, T2DM patients at 4th quartile of waist-to-hip ratio also had a significantly higher risk of kidney stones than those in the 1st quartile (OR=5.34, 95% CI: 1.14-25.01, P=0.033). However, after further adjusted for BMI, it was not significant.
Conclusion: T2DM patients with more severe abdominal obesity, i.e., the 4th quartile of WHR, show a significantly increased risk of gallstones. We conclude that WHR is an independent risk factor for gallstone in T2DM patients.

Disclosure
Y. Nie: None. X. Tang: None. H. Li: None. T. Li: None. M. Li: None. R. Peng: None. P. Mu: None. Y. Chen: None.

Funding
Research and Development Plans in Key Areas of Guangdong Province (2019B020227003); National Natural Science Foundation of China (81770826); National Key Research and Development Program of China (2017YFA0105803)
2322-PUB: PM2.5 Accelerated Impaired Pancreatic a-Cells by Increasing Expression of Inflammatory Factors in Mice with Streptozotocin
Authors: YIN RUILI , YANG LONGYAN , LANG JIANAN , ZHAO DONG 
Published: June 2020

We investigated how PM2.5 exposure could affect glucose homeostasis in mice with streptozotocin (STZ). Male C57BL/6 mice were housed under filtered air (FA) or PM2.5 for 12 weeks and then received intraperitoneal injection of STZ (40 mg/kg of bodyweight) or acetic buffer daily for consecutive five days. Four weeks after the last injection, fasting glucose test was performed. Cholesterol and triglyceride levels were determined in the plasma and liver. Homeostasis Model Assessment of β cell function (Homa-β) were computed using fasting insulin and glucose. Interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) levels in plasma, visceral adipose tissues, macrophage RAW264.7 and pancreatic β-cells MIN6 treated with PM2.5 (0-50 μg/ml) were quantified by ELISA. Before STZ injection, fasting blood glucose (FBG) levels were similar between FA and PM2.5 groups (p=0.92). After STZ injection, FBG levels were 1.2- fold higher in mice pre-exposed to PM2.5 than those pre-exposed to FA (p=0.17). When taking FBG levels ≥7 mmol/L as the criteria for impaired glucose tolerance, its incidence was 53.3% and 77.8% in FA and PM2.5 groups, respectively (p=0.08). IL-1β and TNF-α levels in the adipose tissues were greater in diabetic mice pre-exposed to PM2.5 than diabetic mice pre-exposed to FA (p&lt;0.05 for all). The addition of PM2.5 stimulated IL-1β and TNF-α production in macrophages and pancreatic β-cells, and impaired the incretion of insulin in MIN6 cells in a dose-dependent manner.
In conclusion, pre-exposure of PM2.5 impaired pancreatic β-cells in mice upon STZ injection, partially via enhanced inflammation and suppressed the incretion of insulin.

Disclosure
R. Yin: None. L. Yang: None. J. Lang: None. D. Zhao: None.

Funding
National Natural Science Foundation of China (81800768)
267-OR: Reduction in Self-Reported Adverse Events Related to Severe Hypoglycemia in Individuals Using a Predictive Low Glucose System: Results from a Real-World Setting
Authors: SINGH HARSIMRAN , MANNING MICHELLE L. , MCELWEE-MALLOY MOLLY , HABIF STEPHANIE 
Published: June 2020

Severe hypoglycemia (SH) is an acute complication of diabetes with potentially adverse clinical and psychosocial consequences. There is little published literature in terms of SH-related adverse events (AEs) in patients with type 1 diabetes (PwT1D) in a real-world setting. We recruited PwT1D who had recently started using the Tandem t:slim X2 insulin pump with Basal-IQ Predictive Low Glucose Suspend (PLGS). Amongst other measures, PwT1D reported SH-related AEs at baseline and then again at 6 months post-assessment (PA). Pre-Post differences were analyzed using Fisher’s exact test. In all, 665 PwT1D were included in the analysis (19% of these were &lt;18 years old, mean age=37.11 years, female=55.5%, mean HbA1c=7.2%). Overall, 14.9% used multiple daily injections (MDIs) while 85.2% used insulin pumps as baseline therapy method. Nearly 91% of the sample reported using CGM at baseline. At PA, number of participants who reported to have 1 or more paramedic visits due to SH had significantly decreased from 35 to 19 (p&lt;0.001), emergency room (ER) visits dropped to 9 (vs. 39 at baseline, p&lt;0.001), and hospital admissions were reduced to 6 (vs. 24 at baseline, p&lt;0.05) for the entire sample. These differences were observed irrespective of the baseline therapy method (MDIs vs. pump users) although the largest differences were noticed for MDIs (reduction of -9.47% (paramedic visits), -10.53% (ER visits), and -8.42% (hospital admissions). Risk-ratio assessment for AEs overall, per 100 person years showed a drop at PA for all 3 AE categories (paramedic visits, 21.98 vs. 7.33; ER visits, 19.24 vs. 4.27; hospital admissions, 11.30 vs. 2.75). The Basal-IQ PLGS technology demonstrated remarkable reductions in self-reported SH-related AEs for both pediatric and adult PwT1D.

Disclosure
H. Singh: Employee; Self; Tandem Diabetes Care. M.L. Manning: Employee; Self; Tandem Diabetes Care. M. McElwee-Malloy: Employee; Self; Tandem Diabetes Care. S. Habif: Employee; Self; Tandem Diabetes Care.
268-OR: Conversations and Reactions around Severe Hypoglycemia (CRASH): Survey Responses of People Aged 65+ with T1DM or Insulin-Treated T2DM and Caregivers
Authors: SNOEK FRANK J. , SPAEPEN ERIK , BUSHNELL DONALD M. , CHILD CHRISTOPHER J. , BALANTAC ZANETA , MITCHELL BETH , PEYROT MARK 
Published: June 2020

The CRASH online survey examined the experience and treatment of a severe hypoglycemic event (SHE) in people with T1DM or insulin-treated T2DM (PWD) or caregivers (CG). Eligible participants experienced ≥1 SHE in the last 3 years with insulin treatment at the time of event. Reported here are results from PWD aged ≥65 (T1DM 74, T2DM 104) and CG (T1DM 95, T2DM 231) from Canada, Germany, Spain, UK, and USA. During the last SHE, reported glucagon use was low for T1DM (9.5%) and T2DM (7.5%); primary reason reported was no prescription available or filled (T1DM 24.3%, T2DM 29.3%). Of those who ever discussed SHE at their healthcare provider (HCP) visit (T1DM 138, T2DM 243), less than half (T1DM 41.3%, T2DM 34.2%) reported discussion of SHE at every HCP visit. No discussion of the most recent SHE occurred for 34.3% (T1DM) and 31.0% (T2DM). During the most recent SHE many felt unprepared (T1DM 35.5%, T2DM 47.2%), scared (T1DM 60.9%, T2DM 64.2%), and helpless (T1DM 39.1%, T2DM 51.3%). After the last SHE, changes were reported to insulin regimens, meal plans, carrying sugar/sweets, checking blood glucose more often or using continuous glucose monitors, and increasing access to glucagon. Clinical guidelines recommending discussion of hypoglycemia at each HCP visit for PWD at risk for SHE are not being met and should occur, and CGs should be included in preparedness strategies.

Disclosure
F.J. Snoek: Advisory Panel; Self; Abbott, Lilly Diabetes, Novo Nordisk A/S, Roche Diabetes Care. Research Support; Self; Sanofi. E. Spaepen: None. D.M. Bushnell: None. C.J. Child: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. Z. Balantac: Other Relationship; Self; Eli Lilly and Company. B. Mitchell: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. M. Peyrot: Advisory Panel; Self; Eli Lilly and Company. Consultant; Self; CeQur Corporation, Eli Lilly and Company. Research Support; Spouse/Partner; Eli Lilly and Company.

Funding
Eli Lilly and Company
272-OR: Do Diabetes Prevention Treatments Promote Regression to Normal Glucose Regulation? A Network Meta-analysis
Authors: GALAVIZ KARLA I. , WEBER MARY BETH , GUJRAL UNJALI , WEI JINGKAI , SUVADA KARA , HAW JEEHEA SONYA , NARAYAN K.M. VENKAT , ALI MOHAMMED K. 
Published: June 2020

Objective: In this meta-analysis, we compared the effect of different non-surgical diabetes prevention strategies on regression to normoglycemia among people with prediabetes.
Methods: We systematically searched MEDLINE, EMBASE and Cochrane Library for articles published between 01-01-2000 to 05-30-2017. We included randomized controlled trials testing non-surgical interventions to prevent diabetes or improve glucose tolerance in adults with prediabetes, lasting at least three months, and reporting regression to normoglycemia rates. Using the number of participants that regressed to normoglycemia (fasting blood glucose &lt;100 mg/dL, or two-hour post load glucose &lt;140 mg/dL, or Hemoglobin A1c &lt;5.7%) at the end of the intervention, we estimated the pooled risk difference (RD), number needed to treat (NNT) and relative risk using a Bayesian arm-based network meta-analysis.
Results: Fifty-one studies were included (25,440 participants, mean age 54 years, 46% male). Of these, 30 study arms tested lifestyle modification (LSM), 15 tested medications (60% glucose sensitizers), 8 tested medications+LSM, 8 tested dietary supplements (vitamins, minerals and herbs), and 7 tested supplements+LSM. Compared to control arms (n=29) at a mean 1.6 years of follow up [range 0.2-5.0], medications achieved the largest regression rates (RD=12%, NNT=8), followed by LSM (RD=6%, NNT=17), medications+LSM (RD=5%, NNT=20), and supplements (RD=2%, NNT=50 with or without LSM). The corresponding relative risks were 2.06 (1.39, 2.95) for medications, 1.76 (1.34, 2.36) for LSM, 2.36 (1.55, 3.52) for medications+LSM, 2.60 (1.74, 3.66) for supplements+LSM, and 1.67 (1.07, 2.55) for supplements.
Conclusion: Medications, glucose sensitizers in particular, are the most effective treatments for restoring normal glucose regulation in adults with prediabetes. LSM is also effective either alone or in combination with medications.

Disclosure
K.I. Galaviz: None. M. Weber: None. U. Gujral: None. J. Wei: None. K. Suvada: None. J. Haw: None. K. Narayan: None. M.K. Ali: Research Support; Self; Merck & Co., Inc.

Funding
National Heart, Lung, and Blood Institute (1K01HL149479-01); National Institute of Diabetes and Digestive and Kidney Diseases (P30DK111024)
304-OR: 5-Hydroxymethylcytosines in Circulating Cell-Free DNA Reveal Diabetic Nephropathy
Authors: ZENG CHANG , YANG YING , ZHANG ZHOU , HE CHUAN , ZHANG WEI , LIU SONG-MEI 
Published: June 2020

Background: Long-term complications of type 2 diabetes (T2D) are the major causes for T2D-related disability and mortality. Notably, diabetic nephropathy (DN) has become the most frequent cause of end-stage renal disease in most countries. A clinically convenient, noninvasive approach for monitoring the development of DN would improve the overall life quality of patients with T2D and help reduce healthcare burden through preventive interventions.
Methods: A selective chemical labeling strategy, the 5hmC-Seal, was used to profile genome-wide 5-hydroxymethylcytosines (5hmC), an emerging class of epigenetic markers implicated in complex diseases including diabetes, in patient-derived circulating cell-free DNA (cfDNA) in plasma. Differentially modified 5hmC marker genes were identified through the pair-wise comparisons among T2D patients with DN (DN) (n=12), T2D patients with non-DN complications(non-DN) (n=29), and T2D controls with no complications (T2D) (n=14),respectively.
Results: A panel of 271 differentially modified genes (fold-change &gt; 10% and nominal p-value &lt; 0.05) were detected between T2D and DN, involving genes and pathways relevant to synthesis of bile acids and bile salts, fatty acid metabolism(ACAA2), mitochondrial gene expression (POLRMT), and ion transport (OTX1, SRI). In addition, a 4-gene 5hmC marker panel (DNAH1, RAB11FIP4, POLRMT, RAB36) was found to be differentially modified among T2D, DN and non-DN patients. Further analysis indicated that this 4-gene signature showed capacity for differentiating DN from T2D (AUC= 83%; 95% confidence interval [66-100%]), healthy individuals (AUC= 83% [64-100%]), and non-DN (AUC = 88% [76-100%]).
Conclusion: The 5hmC profiles in cfDNA reflect epigenetic changes in T2D and DN that have the potential to be a clinically convenient, noninvasive approach for monitoring the presence and severity of diabetic retinopathy in high risk T2D patients.

Disclosure
C. Zeng: None. Y. Yang: None. Z. Zhang: None. C. He: Advisory Panel; Self; Shanghai Epican Genetech Co., Ltd. W. Zhang: Advisory Panel; Self; Shanghai Epican Genetech Co., Ltd. S. Liu: None.