bluuebunny/crossref_metadata_2025_split huggingface dataset:
1059-P: Unmet Social Needs and Diabetes-Related Emergency Department Visits and Hospitalization: A Nationally Representative Study of U.S. Safety-Net Health Center Patients
Authors: YAN ALICE , SHI ZUMIN , OZIEH MUKOSO N. , WILLIAMS JONI S. 
Published: June 2021

Introduction: Evidence shows that social determinants of health (SDOH) account for more variation in health outcomes than medical care. This study examined the association between unmet social needs and diabetes-related emergency department (ER) visits and hospitalizations.
Methods: Cross-sectional data on adults (aged≥18 years) with self-reported diabetes from the 2014 Health Center Patient Survey (HCPS) was analyzed. Outcome (binary) was diabetes-related ER visits or hospitalizations in prior 12 months. The independent variables were 17 SDOH unmet social factors clustered into three domains: (1) basic needs; (2) health-related social needs; and (3) adverse income or assets factors. Responses were coded as binary (unmet or met). Logistic regression models tested the association between adverse SDOH and outcome, adjusting for sociodemographic covariates.
Results: Among 5592 participants (63.0% female and 22.8% Blacks), 1282 had diabetes (weighted prevalence=22.5%). Of the diabetic participants, 50.9% were unstably housed and 51.3% were food stamp recipients and their top 3 unmet needs were related to service from the health center (home visit, counseling, and health education). In the univariable model, no interpreting service and not receiving help from the health center were statistically inversely associated with, and unstable housing and receiving food stamps were positively associated with the outcome. In the fully adjusted model, those who received food stamps were 3.57 times more likely to have diabetes-related ER visits or hospitalization (95%CI: 1.08 - 11.82). Age was (45-54 vs. 18-44 yrs) (OR= 0.31 95%CI: 0.13-0.78) also significantly associated with ER visits or hospitalizations.
Conclusions: Findings suggest that receiving food stamps was the strongest predictor for diabetes ER visit. Diabetes interventions that target food stamp/SNAP recipients may improve their health outcomes.

Disclosure
A. Yan: None. Z. Shi: None. M. N. Ozieh: None. J. S. Williams: None.
106-OR: A First-in-Human Single Ascending Dose Study of Oxyntomodulin Analog LY3305677 in Healthy Subjects
Authors: THAM LAI-SAN , THOMAS MELISSA K. , BENSON CHARLES , BRAY ROSS , TANG CHENG CAI , LOGHIN CORINA 
Published: June 2021

LY3305677 (LY) is an acylated single chain peptide analog of mammalian oxyntomodulin designed for once weekly dosing. It has dual pharmacology of GLP-1 and glucagon and has therapeutic potential for T2D, obesity and NASH. This randomized, double blind, placebo-controlled phase 1 study assessed safety and tolerability of single ascending doses of LY. Healthy subjects (N=48) were randomized (6:2) and 47 received subcutaneous LY (6 doses: 0.03 mg to 5.0 mg) or placebo. Safety biomarkers, LY pharmacokinetics (PK), and key exploratory pharmacodynamic (PD) biomarkers were assessed including fasting insulin, glucagon, triglyceride levels, and body weight. Most common LY-related AEs were gastrointestinal events. Dose-dependent increase in nausea, decreased appetite, and vomiting were seen. Most of the events were mild and transient. Increase in heart rate was noted, which returned to baseline for most groups at follow-up visit. No injection site reactions were seen. Median time to maximum LY concentration ranged from 18.2 to 72.1 h, and geometric mean half-life ranged from 7.5 to 9.8 days. Generally, mean fasting insulin level increased within 24 h and lasted over 8 days. At Day 8, LY 2.5 mg and 5.0 mg reduced mean fasting glucagon levels by 2.33 pmol/L and 2.67 pmol/L, respectively as compared with placebo. At Day 5, mean fasting triglyceride levels reduced from baseline by 0.5 mmol/L with LY 5.0 mg as compared to 0.1 mmol/L with placebo. Change from baseline in body weight reached a maximum -2.4 kg with the 5 mg dose, versus -0.5 kg for placebo at Day 8 and this effect was sustained through Day 29 at 5 mg.
LY3305677 PK properties are suitable for once-weekly dosing with a safety and tolerability profile similar to other incretins in Phase 1 trials, supporting future clinical evaluation.

Disclosure
L. Tham: Employee; Self; Eli Lilly and Company. M. K. Thomas: Employee; Self; Eli Lilly and Company, Stock/Shareholder; Self; Eli Lilly and Company. C. Benson: Employee; Self; Eli Lilly and Company. R. Bray: None. C. Tang: Employee; Self; Eli Lilly and Company, Employee; Spouse/Partner; Novartis AG. C. Loghin: Employee; Self; Eli Lilly and Company.

Funding
Eli Lilly and Company
1062-P: Attainment of Glycemic Targets among Adults with Diabetes in Canada: A Cross-Sectional National Diabetes Repository Study
Authors: WEISMAN ALANNA , PERKINS BRUCE A. 
Published: June 2021

Objective: International societies and clinical practice guidelines recommend a Hemoglobin A1c target of ≤7.0% for the majority of adults with type 1 (T1D) and type 2 diabetes (T2D). However, the proportion meeting this target and its predictors have not been comprehensively described outside of the USA or in population-based data sources.
Methods: Adults with diabetes were identified in the National Diabetes Repository, a primary care electronic medical record (EMR) database from 5 Canadian provinces, from January 2015 to June 2019. Individuals were categorized as T1D (using a previously validated algorithm), T2D not prescribed insulin, or T2D prescribed insulin. Using the most recent HbA1c, proportions of individuals with HbA1c ≤7.0% were determined and compared using Chi-square tests. Multivariable logistic regression models were used to assess the association between predictors and meeting the HbA1c target.
Results: Of 83,273 eligible adults in the National Diabetes Repository, 1484 had T1D, 10,473 had T2D prescribed insulin and 71,316 had T2D not prescribed insulin. Proportions meeting the HbA1c target of ≤7.0% were 23.9%, 24.9%, and 62.4%, respectively (p=0.4 for T1D vs. T2D prescribed insulin, p&lt;0.0001 for other comparisons). In multivariable logistic regression models, depression was associated with reduced likelihood of meeting the HbA1c target for T1D (OR 0.74, 95% CI 0.55-0.98). Male sex, lower income quintile, and insulin use were associated with reduced likelihood of meeting the HbA1c target for T2D (0.85(0.83-0.88); 0.83(0.79-0.88); 0.23(0.22-0.24)).
Conclusions: In a Canadian population-based primary-care EMR database, less than one-fourth of adults with T1D and T2D prescribed insulin, whereas two-thirds of adults with T2D not prescribed insulin, attain the recommended HbA1c target of ≤7.0%. Further research and implementation approaches are required to optimize outcomes in diabetes, particularly for those requiring insulin.

Disclosure
A. Weisman: None. B. A. Perkins: Advisory Panel; Self; Abbott Diabetes, Boehringer Ingelheim International GmbH, Insulet Corporation, Novo Nordisk Canada Inc., Other Relationship; Self; Abbott Diabetes, Medtronic, Novo Nordisk Canada Inc.

Funding
Diabetes Action Canada
1068-P: Diabetes and Comorbidities Risk Assessment in Hospitalization and Fatalities from the Mexican COVID-19 Surveillance System
Authors: GALLARDO-RINCÓN HECTOR , MONTOYA ALEJANDRA , MARTINEZ-JUAREZ LUIS ALBERTO , LOMELIN-GASCON JULIETA , SAUCEDO-MARTINEZ EDUARDO R. , MUJICA-ROSALES RICARDO , TAPIA-CONYER ROBERTO 
Published: June 2021

The SARS-CoV-2 outbreak poses a challenge to the Mexican health care system due to its high complication and lethality rates in patients with diabetes and comorbidities. Here, we evaluate the association among diabetes and main comorbidities [obesity, hypertension and chronic kidney disease (CKD)] on COVID-19 outcomes (prevalence, hospitalization, lethality and hospital fatality) in Mexican population. We used available public data released by the Mexican COVID-19 surveillance system (MC-19SS) from January 1st to December 31st of 2020. All 3,401,172 records of SARS-CoV-2 suspected population over or equal to 20 years old were included, out of whom 1,384,470 tested positive. Multiple logistic regression models were fitted to assess the risk over several outcomes (hospitalization and fatality), with self-reported diabetes and comorbidities in confirmed cases, adjusting for age, sex, smoking status and marginalization of the place of residence. Overall population tested, 399,953 (11.8%) subjects had diabetes. Of them, 47.8% also had hypertension, 9.0% obesity and 7.0% CKD. Patients who tested positive to COVID-19 had a higher proportion of diabetes (14.7%). From the 203,310 COVID-19 positive patients with diabetes, 95,225(46.8%) were hospitalized and of those 45,128(47.4%) died; also 4,701 died without had been hospitalized. People with diabetes had significant (p&lt;.005) higher odds of hospitalization OR:2.2, hospital 1.27 and non-hospital 1.98 fatality. Nevertheless, subjects with diabetes and other chronic disease experience higher rates of several outcomes. Diabetes and CKD had the highest odds of hospitalization 7.3 died in hospital (2.14) or out of hospital (6.5) compared with cases without diabetes. This analysis points out that diabetes contributes to the risk of infection and worse outcomes for those infected by SARS-CoV-2. More must be done to combat and prevent diabetes and comorbidities to reduce the burden of COVID-19.

Disclosure
H. Gallardo-rincón: None. A. Montoya: None. L. Martinez-juarez: Research Support; Self; Lilly Global Health Partnership. J. Lomelin-gascon: None. E. R. Saucedo-martinez: None. R. Mujica-rosales: None. R. Tapia-conyer: None.
1069-P: How Does Exposure to Overnutrition In Utero Lead to Childhood Adiposity? A Longitudinal Study in the Exploring Perinatal Outcomes among Children (EPOCH) Cohort
Authors: PERNG WEI , KELSEY MEGAN M. , SAUDER KATHERINE A. , DABELEA DANA 
Published: June 2021

We explored the longitudinal sequence of metabolic changes linking overnutrition in utero to development of adiposity among initially normal weight children in the EPOCH cohort. This study includes 312 normal weight youth (body mass index [BMI] z &lt;1 SD per the World Health Organization growth reference) that were exposed (n=144) or unexposed (n=168) to overnutrition in utero (maternal BMI ≥25 kg/m2 or gestational diabetes). Fasting insulin, glucose and adiposity were obtained at research visits during childhood (age 10 y) and adolescence (age 16 y). We examined associations of overnutrition in utero with natural log transformed fasting insulin at baseline, followed by associations of baseline fasting insulin with adiposity (BMI z, subcutaneous [SAT] and visceral fat depots [VAT]), insulin resistance (HOMA-IR), and fasting glucose during follow-up using linear mixed models that accounted for child age, sex, and race/ethnicity; maternal education and prenatal smoking. Baseline BMI z, fasting glucose, HOMA-IR, and adiposity markers (except for slightly higher SAT in exposed youth [+10 mm2]) were not different by exposure status. Overnutrition in utero corresponded with 14% (1%, 29%) higher baseline fasting insulin, even after controlling for child VAT, SAT, or VAT:SAT. Higher baseline fasting insulin was, in turn, associated with greater adiposity (0.41 [0.26, 0.55] SD BMI z; 13.9 [2.4, 25.4] mm2 SAT; 2.0 [0.1, 3.8] mm2 VAT) and HOMA-IR (0.88 [0.69, 1.07]) across follow-up, but not with fasting glucose. These results suggest that overnutrition in utero may result in hyperinsulinemia during childhood and precede accrual of adiposity. However, since our study started at age 10 y, studies in normal weight youth starting earlier, and with repeated assessments of insulin sensitivity, β cell function and glycemia, are needed to clarify the sequence of metabolic changes resulting from early exposures.

Disclosure
W. Perng: None. M. M. Kelsey: Other Relationship; Self; Boehringer Ingelheim (Canada) Ltd., Daiichi Sankyo, Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp. K. A. Sauder: None. D. Dabelea: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK068001); Colorado Clinical and Translational Sciences Institute (KL2-TR002534 to W.P.)
1078-P: Disparities in HbA1c Testing and Diabetes Outcomes: SEARCH for Diabetes in Youth
Authors: SAUDER KATHERINE A. , STAFFORD JEANETTE M. , EHRLICH SHELLEY R. , LIESE ANGELA D. , MARCOVINA SANTICA M. , MOTTL AMY K. , PIHOKER CATHERINE , SAYDAH SHARON , SHAH AMY S. , DAGOSTINO RALPH , DABELEA DANA 
Published: June 2021

Hemoglobin A1c (HbA1c) monitoring over time is thought to facilitate care and support diabetes management goals, but only half of youth and young adults with diabetes report ≥3 HbA1c tests/year despite poor glycemic control. We explored disparities in HbA1c testing over time and association with HbA1c levels and microvascular complications (retinopathy, neuropathy, or nephropathy) in the SEARCH for Diabetes in Youth study. Individuals diagnosed with diabetes at &lt;20 years (n=707 type 1, n=112 type 2) did research visits at 8 and 13 years diabetes duration (mean ages 18 and 23 years, respectively). We used one logistic regression model per diabetes type to identify correlates of reporting ≥3 HbA1c tests/year at both visits, and used one multiple linear and one logistic regression model per type to examine associations of reporting ≥3 HbA1c tests/year at both visits with HbA1c levels or microvascular complications, adjusting for HbA1c testing correlates. In type 1 diabetes, odds of reporting ≥3 HbA1c tests/year at both visits decreased with older age at diagnosis (OR 0.91 [95%CI 0.88-0.95]), longer duration of diabetes (OR 0.91 [0.84-0.999]), not having a personal doctor (0.43 [0.30-0.62]), and lapses in health insurance (OR 0.51 [0.28-0.93]). In turn, HbA1c testing ≥3 times/year at both visits was associated with lower HbA1c levels (-0.32% [-0.61 to -0.03]) but not microvascular complications (OR 0.74 [0.49-1.10]) at 13 years duration. In type 2 diabetes, odds of reporting ≥3 HbA1c tests/year at both visits was lower when not receiving care from endocrinologists (OR 0.15 [0.04-0.48]), but not associated with other sociodemographic or clinical factors, and not observed to be associated with HbA1c levels or microvascular complications at 13 years duration.
In conclusion, we report that mainly healthcare-related factors are associated with disparities in HbA1c testing frequency over time in youth-onset type 1 and type 2 diabetes, and these disparities are associated with HbA1c levels in type 1 diabetes.

Disclosure
K. A. Sauder: None. R. Dagostino: Consultant; Self; AstraZeneca, Biogen, Daiichi Sankyo. D. Dabelea: None. J. M. Stafford: None. S. R. Ehrlich: None. A. D. Liese: None. S. M. Marcovina: None. A. K. Mottl: Advisory Panel; Self; Bayer U. S. C. Pihoker: None. S. Saydah: None. A. S. Shah: None.

Funding
National Institutes of Health; Centers for Disease Control and Prevention
109-LB: Comparative Effectiveness of Insulin Glargine 300 U/mL (Gla-300) and Insulin Degludec 100 U/mL (iDeg-100) in Insulin-Naïve Type 2 Diabetes Adults: RESTORE-2 Real-World Study
Authors: FADINI GIAN PAOLO , BUZZETTI RAFFAELLA , NICOLUCCI ANTONIO , ROSSI MARIA CHIARA , LAROSA MONICA , CUCINOTTA DOMENICO ,   ON BEHALF OF RESTORE-2 STUDY GROUP
Published: June 2021

Second generation basal insulin (2BI) provide similar/improved efficacy with better safety compared to first generation BI. Real-world data on 2BI in patients with type 2 diabetes (T2D) are still limited.
The study aimed at comparing effectiveness of 2BI (Gla-300 vs. iDeg-100) in insulin-naïve T2D.
This was a retrospective, non-inferiority, multicenter study, from electronic medical records. All patients initiating Gla-300 or iDeg-100 in January 2017-2020 were 1:1 propensity score matched. Linear mixed models for repeated measures were applied to assess changes during 6 months in HbA1c, fasting blood glucose (FBG), body weight, and insulin doses. Incidence rates (IR) of hypoglycemic events were compared using Poisson regression models.
Overall, 19 centers provided data on 357 patients in each PSM cohort. Estimated mean baseline levels of HbA1c were 9.2%. Marked reductions in HbA1c after 6 months were documented: -1.70%; (95%CI -1.90; -1.50) in Gla-300 group and -1.69%; (95%CI -1.89; -1.49) in IDeg-100 group (between group mean difference: 0.01; 95%CI -0.29; 0.27), confirming non-inferiority of Gla-300 vs. IDeg-100. FBG was reduced by about 60 mg/dl in both groups; minor changes in body weight were documented. In both groups, the mean prescribed dose was about 12 U (0.15 U/Kg) and was slightly titrated during 6 months up to +4U (0.20 U/Kg).
IR (episodes per patient-months) of BG≤70 mg/dl was 0.13 (95%CI 0.07;0.26) in Gla-300 group and 0.14 (95%CI 0.07;0.27) in IDeg-100 group (p=0.87). IR of BG&lt;54 mg/dL was 0.02 (95%CI 0.01;0.05) in Gla-300 group and 0.02 (95%CI 0.01;0.04) in IDeg-100 group (p=0.49). No severe hypoglycemic episodes were reported. In T2DM adults, initiation of Gla-300 or IDeg-100 was associated with similar improvements in glycemic control, no weight gain, low hypoglycemia rates, with no severe episodes. These data can contribute in overcoming clinical inertia in BI initiation and dose titration.

Disclosure
G. Fadini: Board Member; Self; Novo Nordisk, Sanofi, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk, Sanofi. R. Buzzetti: None. A. Nicolucci: Advisory Panel; Self; AstraZeneca, Research Support; Self; Novo Nordisk, Pikdare, Sanofi, Shionogi & Co., Ltd., SOBI. M. Rossi: Research Support; Self; Novo Nordisk, Sanofi, Shionogi & Co., Ltd., Swedish Orphan Biovitrum AB. M. Larosa: Employee; Self; Sanofi. D. Cucinotta: None. On behalf of restore-2 study group: n/a.

Funding
Sanofi
1090-P: Diabetes in Japanese COVID-19 Patients as the Primary Factor of Accelerated Progression to Severe State
Authors: KANEKO SHIZUKA , KITA HIDEO , MOTOHASHI KAZUYA , TOKUMOTO SHINSUKE , YOKO UEBA , EGUCHI HIDEKI , TSUNEMATSU ICHIRO 
Published: June 2021

During the COVID-19 pandemic, Japanese victims number less than in other countries, perhaps due to gene specifics, aspects of Japanese lifestyle and coagulation system characteristics typically less potent in Japanese than in Caucasians. The Osaka prefectural government stratified patients into mild, moderate and severe, distributing them amongst various alternative accommodation to relieve overburdened hospitals. Hospitalized patients were managed based on national government guidelines. Focusing on moderate patients, i.e., whose oxygen saturation levels were favorable even if presenting characteristics in computed tomography, we conducted a retrospective analysis in type 2 diabetes (T2D) patients compared with a control. Of a study total of 102 patients (male 51%, aged 62.2±16.0, BMI 27.6±5.2), 49% were T2D patients (aged 71.2±13.8, A1c 6.8±1.3%, BMI 24.5±5.2). Twenty-five patients (24.5%) moved to the severe classification. Eighteen patients (17.6%) (aged 74.8±8.6, A1c 6.9±1.0%, BMI 24.3±2.5), of whom 88.9% had T2D (aged 76.1±10.2, A1c 6.7±1.1%, BMI 23.8±10.2), were ventilated and transferred to another hospital for advanced treatment. Seven patients (6.9%), of whom 71.4% had T2D, died (aged 85±3.4) after ventilation was declined by the families due to advanced age and dementia. One scleroderma patient on home oxygen therapy for intestinal pneumonia died of sudden respiratory failure. Twenty-five diabetes patients (24.5%) improved. No significant correlation exists between hypertension, body mass index, lung disease, renal failure and receiving insulin therapy. In our study, 88% of moderate patients moving to the severe classification had T2D. In Japanese, diabetes may constitute a much larger risk factor than those factors identified in other countries in the evolution of COVID-19 patients from the moderate to severe classifications. A more comprehensive study is needed. BMI: body mass index, A1c: hemoglobin A1c.

Disclosure
S. Kaneko: Advisory Panel; Self; Novo Nordisk Pharma Ltd., Consultant; Self; Novo Nordisk Pharma Ltd., Research Support; Self; Eli Lilly Japan K. K., Novo Nordisk Pharma Ltd., Speaker’s Bureau; Self; AstraZeneca, Eli Lilly Japan K. K., Mitsubishi Tanabe Pharma Corporation, Nippon Boehringer Ingelheim Co. Ltd., Novo Nordisk Pharma Ltd., Sumitomo Dainippon Pharma Co., Ltd. H. Kita: None. K. Motohashi: None. S. Tokumoto: None. U. Yoko: None. H. Eguchi: None. I. Tsunematsu: None.
1096-P: Analysis of Medication Use in Type 2 Diabetes Mellitus in Korea Using a Common Data Model Based on the Claim Data of the Health Insurance Review and Assessment Service
Authors: LEE KYUNG AE , JIN HEUNG YONG , KIM YU JI , PARK TAE SUN 
Published: June 2021

Observational Health Data Sciences and Informatics is an international collaboration created an international data network of researchers (Observational Medical Outcomes Partnership Common Data Model, OMOP-CDM). This retrospective, observational study was aim to analyze treatment patterns of type 2 diabetes mellitus (T2DM) using HIRA national patient sample (NPS) from 2012 to 2017 transformed into OMOP-CDM. ATLAS ver. 2.7.6, an OHDSI’s open-source software is publicly available, was used for analysis. HIRA-NPS contain about 1.4 million patients. The proportion of adult patients treated for T2DM increased from 78,581 (5.5%) in 2012 to 101,710 (7.0%) in 2017. Ages 50-69 were the most common (47.7% in 2017), and T2DM was most noticeably increased from 28.7% to 44.9% among those aged 70 and over for 5 years. Metformin was the most prescribed drug (82.8%) followed by sulfornylurea (SU) (62.4%), DPP-4 inhibitor (29.5%) in 2012. In 2017, metformin was still the most prescribed (87.0%), and DPP-4 inhibitor prescription increased rapidly up to 62.7%, while the SU prescription rate decreased to 46.5%. Prescription of the most recently approved SGLT2 inhibitors also continued to increase, reaching 7.2% in 2017. The rate of insulin prescription decreased from 20.2% to 17.5%. Over time, mono and dual therapy decreased while triple and quadruple combinations steadily increased. Dual combination was the most common with metformin and DPP-4 inhibitor, triple combination was the most with metformin, SU, and DPP-4 inhibitor in 2017. Drug prescriptions for hypertension remained unchanged from 71.2% in 2012 to 70.0% in 2017, while prescriptions for dyslipidemia increased from 50.7% in 2012 to 68.4% in 2017. Antiplatelet drugs prescriptions decreased slightly from 47.3% to 42.6%. T2DM is constantly increasing, and medication utilization patterns have changed significantly over the past 5 years with a shift towards newer drugs.

Disclosure
K. Lee: None. H. Jin: None. Y. Kim: None. T. Park: None.