bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robust Glucose Control and Weight Loss after Six Weeks of Treatment with MEDI0382, a Balanced GLP-1/Glucagon Receptor Dual Agonist, in Patients with Type 2 Diabetes
Authors: AMBERY PHILIP , STUMVOLL MICHAEL W. , POSCH MAXIMILIAN G. , HEISE TIM , PLUM-MOERSCHEL LEONA , TSAI LAN-FENG , ROBERTSON DARREN , PETRONE MARCELLA , RONDINONE CRISTINA , PARKER VICTORIA E. , HIRSHBERG BOAZ , JERMUTUS LUTZ 
Published: June 2018

MEDI0382 is under development for the treatment of type 2 diabetes mellitus (T2DM). In a double-blind study (NCT02548585), 51 T2DM patients with BMI 27-40 kg/m2 were randomized (1:1) to daily SC MEDI0382 200 μg or placebo (PBO). Based on ANCOVA with treatment and baseline (BL) values as covariates, MEDI0382 markedly reduced fasting glucose (change from BL at day 41, -49.9 vs. -19.2 mg/dL; P &lt; 0.0001) and postprandial glucose in a mixed-meal tolerance test (percent change from BL in glucose AUC0-4h, -32.8 vs. -10.2; P &lt; 0.0001) (Figure 1) with no increase in hypoglycemia. HbA1c levels decreased -0.9% with MEDI0382 and -0.6% with PBO (P = 0.0004). Weight loss was 3.8 kg vs. BL (1.7 kg vs. PBO; P = 0.0008); 92% of MEDI0382 patients lost &gt;2 kg. Mean reduction in ambulatory systolic BP was -4.2 for MEDI0382 vs. -1.5 mmHg for PBO (P = ns). As with marketed GLP-1 analogs, a mean pulse increase of 6.8 BPM for MEDI0382 vs. a fall of 2.0 BPM for PBO was seen (P &lt; 0.0001). Treatment-related AEs such as decreased appetite, vomiting, and headache were seen in more patients on MEDI0382 (20 vs. 15); 0 were grade &gt;3 severity, 3 led to study discontinuation for MEDI0382 vs. 1 for PBO, and 1 SAE in the PBO arm. Overall, MEDI0382 normalized fasting and postprandial blood glucose, significantly reduced body weight, and had an acceptable safety profile over 41 days of dosing in obese/overweight T2DM patients.

Disclosure
P. Ambery: Employee; Self; MedImmune. Stock/Shareholder; Self; AstraZeneca. M.W. Stumvoll: Speaker's Bureau; Self; Novartis Pharmaceuticals Corporation. Advisory Panel; Self; AstraZeneca, Novo Nordisk A/S. Speaker's Bureau; Self; Merck Foundation. M.G. Posch: None. T. Heise: Research Support; Self; ADOCIA, Boehringer Ingelheim GmbH, Dance Biopharm, Eli Lilly and Company, Janssen Research & Development, MedImmune, Merck Sharp & Dohme Corp., Mylan, Nordic Bioscience, Novo Nordisk A/S, Poxel SA, Roche Diagnostics Corporation, Saniona, Sanofi, Senseonics, Zealand Pharma A/S. Advisory Panel; Self; Novo Nordisk A/S, Mylan. Speaker's Bureau; Self; Dexcom, Inc., Eli Lilly and Company, Novo Nordisk A/S, Sanofi. L. Plum-Moerschel: None. L. Tsai: Employee; Self; MedImmune. D. Robertson: Employee; Self; MedImmune. Employee; Spouse/Partner; GlaxoSmithKline plc. M. Petrone: Employee; Self; MedImmune. Stock/Shareholder; Self; MedImmune. C. Rondinone: Employee; Self; MedImmune. Stock/Shareholder; Self; AstraZeneca, F. Hoffmann-La Roche Ltd., Abbott, AbbVie Inc. V.E. Parker: Employee; Self; MedImmune. Stock/Shareholder; Self; Accenture. Employee; Self; AstraZeneca. B. Hirshberg: Employee; Self; AstraZeneca, MedImmune. L. Jermutus: Employee; Self; AstraZeneca. Stock/Shareholder; Self; AstraZeneca.
Semaglutide Treatment and Renal Function in the SUSTAIN 6 Trial
Authors: VILSBØLL TINA , GUMPRECHT JANUSZ , SILVER ROBERT J. , HANSEN THOMAS , PETTERSSON JONAS , WILDING JOHN P. 
Published: June 2018

Semaglutide is a new GLP-1 analog for the once-weekly treatment of T2D. This post-hoc analysis assessed the effect of semaglutide on renal function by baseline eGFR in the SUSTAIN 6 trial.
Overall, mean eGFR decreased from baseline to week 104 across all treatment groups and subgroups, with the largest decreases in subjects with normal renal function or mild renal impairment (Figure). Urine albumin-to-creatinine ratio decreased with increasing renal impairment for semaglutide 1.0 mg, but not other treatment groups (Table). AEs related to acute renal failure were generally higher with increasing baseline renal impairment, except with semaglutide 1.0 mg vs. placebo. New or worsening nephropathy was lower with both doses of semaglutide vs. placebo (Table).

No renal-related safety issues were observed with semaglutide regardless of baseline renal function in SUSTAIN 6.

Disclosure
T. Vilsbøll: Advisory Panel; Self; Amgen Inc., Boehringer Ingelheim GmbH, Eli Lilly and Company, AstraZeneca, MSD K.K., Sanofi, Novo Nordisk A/S. Consultant; Self; Amgen Inc., Boehringer Ingelheim GmbH, Eli Lilly and Company, AstraZeneca, MSD K.K., Sanofi, Novo Nordisk A/S. Speaker's Bureau; Self; Amgen Inc., Boehringer Ingelheim GmbH, Eli Lilly and Company, AstraZeneca, MSD K.K., Sanofi, Novo Nordisk A/S. Research Support; Self; Eli Lilly and Company, Novo Nordisk A/S. J. Gumprecht: Speaker's Bureau; Self; AstraZeneca. Consultant; Self; Bayer AG. Speaker's Bureau; Self; Bioton, Berlin-Chemie AG, Eli Lilly and Company, Merck Sharp & Dohme Corp., Boehringer Ingelheim GmbH, Novo Nordisk A/S, Polfa Tarchomin S.A., Polpharma. R.J. Silver: Consultant; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc., Eli Lilly and Company, AstraZeneca. T. Hansen: None. J. Pettersson: Employee; Self; Novo Nordisk A/S. J.P. Wilding: Other Relationship; Self; Astellas, AstraZeneca, Boehringer Ingelheim GmbH, Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi, Eli Lilly and Company, Orexigen Therapeutics, Inc., Merck & Co., Inc..
Glucagon-Like Peptide-1 Receptor Agonists and Pancreatic Cancer—A Meta-analysis with Trial Sequential Analysis
Authors: PINTO LANA C. , RADOS DIMITRIS V. , FALCETTA MARIANA R. , LEITAO CRISTIANE B. 
Published: June 2018

Background: Glucagon-like peptide-1 (GLP-1) receptors were identified in both acinar and ductal cells of pancreas. Animal studies suggested an association of GLP-1 agonists use and pancreatic premalignant changes. Randomized controlled trials (RCT) in humans did not report this association, but it may be due to lack of sample power of individual studies.
Aim: To access if GLP-1 agonists are associated with pancreatic cancer.
Methods: Systematic review and meta-analysis of randomized trials with GLP-1 agonists as intervention. Trials that lasted more than 48 weeks were included. Trial sequential analysis (TSA) was performed to access if available information is enough to discard this association.
Results: Twelve trials met study criteria, including 36, 397 patients. GLP-1 analogs did not increase the risk for pancreatic cancer when compared to other treatments (OR 1.14; 95% CI 0.68 to 1.92; I2 0%)(Figure 1). TSA confirmed that enough patients were randomized to exclude this association, and a number needed to harm (NNH) higher than 1000 was reached (Figure 2).

Conclusion: There is enough information to discard the concern regarding GLP-1 agonists and pancreatic cancer.

Disclosure
L.C. Pinto: None. D.V. Rados: None. M.R. Falcetta: None. C.B. Leitao: None.
Investigations into Tissue Distribution and Inhibition of Food Consumption with Efpeglenatide
Authors: PARK YOUNG JIN , CHOI IN YOUNG , TRAUTMANN MICHAEL E. , HOMPESCH MARCUS , SORLI CHRISTOPHER H. 
Published: June 2018

Efpeglenatide (efpeg), a long-acting glucagon-like peptide-1 receptor agonist in development for type 2 diabetes, induces weight loss through satiety and reduced food intake. Studies in Sprague Dawley rats investigated how peripheral and central mechanisms contribute to the anorectic effects of efpeg. Tissue distribution of efpeg was assessed by whole-body autoradioluminography with 14C-efpeg. The contribution of vagal nerve signaling to food intake control was assessed in vagotomized rats treated with exenatide (0.15 or 0.45 nmol/kg twice daily) or efpeg (0.71 or 2.1 nmol/kg every 2 days). Pharmacokinetic parameters and mean radioactivity of 14C-efpeg in selected organs/tissues are shown in Figure. Peak concentration (Cmax) of 14C-efpeg was highest in the kidney cortex; Cmax at all other sites was similar to/lower than in blood, relatively high in the intestine and pituitary, with below-quantifiable levels in the cerebellum/cerebrum. Inhibition of food intake was not attenuated in vagotomized vs. sham-operated rats at higher doses of efpeg (3-day cumulative intake: 47.4 vs. 49.4 g) or exenatide (54.9 vs. 60.7 g), suggesting a non-vagal mechanism for these anorectic effects. These findings suggest that central mechanisms are involved in the anorectic effects of efpeg in this animal model; potential cell-signaling effects of efpeg in the intestine and pituitary need to be investigated further.

Disclosure
Y. Park: Employee; Self; Hanmi Pharmaceutical. Stock/Shareholder; Self; Hanmi Pharmaceutical. I. Choi: Employee; Self; Hanmi Pharmaceutical. Stock/Shareholder; Self; Hanmi Pharmaceutical. M.E. Trautmann: Consultant; Self; ProSciento. Stock/Shareholder; Self; Eli Lilly and Company. Consultant; Self; Hanmi Pharmaceutical, CeQur Corporation, Intarcia Therapeutics, Inc., Servier. M. Hompesch: Other Relationship; Self; Hanmi Pharmaceutical. C.H. Sorli: Employee; Self; Sanofi.
iGlarLixi Effectively Reduces Residual Hyperglycemia in Patients with Type 2 Diabetes on Basal Insulin—A Post-Hoc Analysis from the LixiLan-L Study
Authors: GIORGINO FRANCESCO , RETNAKARAN RAVI , VIDAL JOSEP , ARODA VANITA , SAREMI ARAMESH , LIU MINZHI 
Published: June 2018

Residual hyperglycemia (glycated hemoglobin [HbA1c] over target despite fasting plasma glucose [FPG] at target) presents an obstacle in achieving glycemic control in T2D. GLP-1 receptor agonist (RA) therapy can target excessive postprandial glycemia (PPG) and thereby address residual hyperglycemia. This analysis investigated the effect of iGlarLixi, a fixed-ratio combination of insulin glargine (iGlar) U100 and the GLP-1 RA lixisenatide (Lixi), on the proportion of patients with T2D with discordant HbA1c/FPG (HbA1c ≥7% and FPG &lt;140 mg/dL) in the LixiLan-L trial. Patients who had suboptimal glycemic control despite basal insulin ± oral antidiabetes drugs (OADs) stopped all OADs but metformin and, after 6 weeks of iGlar run-in, were randomized to iGlarLixi or iGlar for 30 weeks (N=736). At baseline (post-run-in), proportions with discordant HbA1c/FPG were similar in the two arms. After 12-week randomized treatment, proportions with discordant HbA1c/FPG were 32.1% (iGlarLixi) and 49.9% (iGlar; p&lt;0.0001; Figure). After 30 weeks, the prevalence of discordant HbA1c/FPG was further reduced with iGlarLixi vs. iGlar (22.7% vs. 45.9%; p&lt;0.0001).
In conclusion, iGlarLixi reduces the proportion of T2D patients with discordant HbA1c/FPG levels more than iGlar does, reflecting its capacity to address residual hyperglycemia by targeting both FPG and PPG.

Disclosure
F. Giorgino: Consultant; Self; Abbott, AstraZeneca, Boehringer Ingelheim GmbH. Research Support; Self; Eli Lilly and Company, Johnson & Johnson Services, Inc.. Consultant; Self; MedImmune, Merck Sharp & Dohme Corp., Roche Diabetes Care Health and Digital Solutions, Sanofi. Research Support; Self; Takeda Development Centre Europe Ltd. R. Retnakaran: Research Support; Self; Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Sanofi, Eli Lilly and Company. J. Vidal: None. V. Aroda: Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc., AstraZeneca, Calibra Medical, Eisai Inc., Sanofi. Consultant; Self; Sanofi. Research Support; Self; Theracos, Inc.. Employee; Spouse/Partner; Merck & Co., Inc.. Other Relationship; Self; American Diabetes Association. Consultant; Self; ADOCIA. A. Saremi: Employee; Self; Sanofi US. M. Liu: Employee; Self; Sanofi.
Preclinical Effects of Efpeglenatide, a Long-Acting Glucagon-Like Peptide-1 Receptor Agonist, Compared with Liraglutide and Dulaglutide
Authors: TRAUTMANN MICHAEL E. , CHOI IN YOUNG , KIM JUNG KUK , SORLI CHRISTOPHER H. 
Published: June 2018

Efpeglenatide (efpeg) is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA) in development for type 2 diabetes. The effects of efpeg vs. those of liraglutide (lira) and dulaglutide (dula) on glucodynamics and weight/lipid profiles were studied over 4 weeks in mouse models of diabetes (db/db) and obesity (diet-induced obesity [DIO]), respectively; doses tested wereefpeg 1.45, 2.89, or 4.35 nmol/kg once every 2 days (Q2D); twice-daily lira 30 nmol/kg (db/db study) or 50 nmol/kg (DIO study); dula 0.98 or 1.96 nmol/kg Q2D (equivalent human doses/key results in Table). At the highest doses tested, efpeg was significantly more effective at lowering blood glucose (vs. lira and dula) and reducing the increase in glycated hemoglobin (HbA1c) from Day 0 (vs. lira) in db/db mice. Efpeg also improved insulin sensitivity (vs. lira and dula) and postprandial glucose control (vs. dula). In DIO mice, efpeg significantly reduced body weight and mesenteric fat mass (vs. dula), and cholesterol (vs. lira and dula; at highest doses). Overall, efpeg showed greater reductions in blood glucose, HbA1c increase, weight, and cholesterol vs. other GLP-1 RAs in mice. These effects may be due to the distinct receptor binding properties of efpeg, which enhance intracellular signaling and insulin release in β-cells. Further studies are needed to assess the clinical relevance of these findings.

Disclosure
M.E. Trautmann: Consultant; Self; ProSciento. Stock/Shareholder; Self; Eli Lilly and Company. Consultant; Self; Hanmi Pharmaceutical, CeQur Corporation, Intarcia Therapeutics, Inc., Servier. I. Choi: Employee; Self; Hanmi Pharmaceutical. Stock/Shareholder; Self; Hanmi Pharmaceutical. J. Kim: Employee; Self; Hanmi Pharmaceutical. Stock/Shareholder; Self; Hanmi Pharmaceutical. C.H. Sorli: Employee; Self; Sanofi.
Efficacy and Safety of ITCA 650, an Injection-Free GLP-1RA, in T2D Patients—A Pooled Analysis of Phase 3 Studies
Authors: KJEMS LISE L. , PRABHAKAR PRAKASH , SCHWARTZ BRIAN , HUANG HOLLY , BARON MICHELLE A. 
Published: June 2018

ITCA 650 consists of a small titanium osmotic mini-pump that is subdermally placed in the abdominal wall during a brief office procedure. As an investigational product for the treatment of type 2 diabetes (T2D), ITCA 650 provides a continuous subcutaneous infusion of exenatide over 3 or 6 months. An integrated analysis of efficacy and safety was conducted from 2 double-blind, randomized, Phase 3 studies, which evaluated pooled data with ITCA 650 20/60 mcg/d vs. placebo or sitagliptin for the treatment of patients with T2D, inadequately controlled on antidiabetic drugs. The efficacy endpoints were mean change from baseline at Week 39 for HbA1c, body weight, composite endpoints of HbA1c and weight loss, and proportion achieving HbA1c &lt;7%. The incidence of treatment-emergent adverse events (TEAEs) was also reported. Significant and clinically meaningful improvements at 39 weeks were observed with ITCA 650 20/60 mcg/d for all these endpoints. The higher incidence of TEAEs with ITCA 650 vs. comparators was explained by the higher incidence of GI TEAEs. Similar proportions of patients in each group discontinued for TEAEs. The results are consistent with results observed from individual Phase 3 studies, which demonstrated that ITCA 650 is effective for lowering HbA1c and weight, for achieving a composite of HbA1c/weight reduction and target HbA1c &lt;7%, and is well tolerated.

Disclosure
L.L. Kjems: Employee; Self; Intarcia Therapeutics, Inc.. Stock/Shareholder; Self; Intarcia Therapeutics, Inc.. P. Prabhakar: None. B. Schwartz: Employee; Self; Intarcia Therapeutics, Inc.. H. Huang: None. M.A. Baron: Employee; Self; Intarcia Therapeutics, Inc..
Effect of a Novel Long-Acting GLP-1/GIP/Glucagon Triple Agonist (HM15211) in a NASH and Fibrosis Animal Model
Authors: CHOI IN YOUNG , KIM JUNG KUK , LEE JONG SUK , PARK EUNJIN , KIM YOUNG HOON , JUNG SUNG YOUB , KIM SUN JIN 
Published: June 2018

Nonalcoholic steatohepatitis (NASH), a potential consequence of NAFLD, may lead to end stage liver disease including cirrhosis and hepatocellular carcinoma. Despite its severity and prevalence, NASH currently lacks effective treatment. In this respect, we developed a novel long-acting, GLP-1/GIP/Glucagon triple agonist, HM15211. With a unique activity profile, HM15211 could provide synergistic benefits on body weight loss and lipid profile improvement while avoiding hyperglycemic risk. Previously, we showed that HM15211 exerts potent reductions in body weight and hepatic TG (triglycerides) in DIO mice, and showed a liver preferential distribution, suggesting HM15211 as a potential treatment for NASH. Here, we evaluated the effect of HM15211 in NASH and fibrosis using MCD-diet mice with various disease induction periods. In MCD-diet mice (6 weeks induction), HM15211 treatment led to significant decrease in hepatic TG (-82.6% vs. vehicle) and TBARS (oxidative stress marker, -60.7% vs. vehicle), which coincided with significant reduction in ALT and bilirubin. Time course MRI/MRS imaging further confirmed the progressive steatosis resolution by HM15211. Furthermore, histopathological analysis indicated that HM15211 significantly reduced hepatic inflammatory gene expression and NAFLD activity score (1.3 for HM15211, 3.4 for liraglutide, and 2.7 for vehicle). To further evaluate the therapeutic potential in fibrosis, MCD-diet mice was used for an extended period (10 weeks induction) to achieve overt liver fibrosis. In line with NASH improvement, HM15211 successfully resolved liver fibrosis as demonstrated in histological evaluation. Histological improvements were accompanied by a remarkable decrease in disease biomarkers including hepatic hydroxyproline. Based on these observations, HM15211 may offer a therapeutic potential for NASH and fibrosis as well as obesity.

Disclosure
I. Choi: Employee; Self; Hanmi Pharmaceutical. Stock/Shareholder; Self; Hanmi Pharmaceutical. J. Kim: Employee; Self; Hanmi Pharmaceutical. Stock/Shareholder; Self; Hanmi Pharmaceutical. J. Lee: Employee; Self; Hanmi Pharmaceutical. Stock/Shareholder; Self; Hanmi Pharmaceutical. E. Park: Employee; Self; Hanmi Pharmaceutical. Y. Kim: Employee; Self; Hanmi Pharmaceutical. S. Jung: None. S. Kim: Employee; Self; Hanmi Pharmaceutical. Stock/Shareholder; Self; Hanmi Pharmaceutical.
Improvement of Type 2 Diabetes (T2DM) and Reduction of Major Adverse Cardiovascular Events and Mortality in Hypogonadal Men Receiving Long-Term Treatment with Injectable Testosterone Undecanoate (TU)—Real-Life Evidence from a Urological Registry Study
Authors: SAAD FARID , HAIDER KARIM S. , HAIDER AHMAD 
Published: June 2018

Background: Hypogonadism is highly prevalent in men with T2DM.
Methods: Of 805 hypogonadal men in a urological registry, 311 men (39%) had T2DM diagnosed and treated elsewhere. 141 received TU 1000 mg/12 weeks (T-group), 170 opted against treatment (CTRL). Mean changes over time between groups were compared by mixed effects model. Changes were adjusted for age, weight, waist circumference, HbA1c, blood pressure (BP), lipids to account for baseline differences between the two groups.
Results: Mean follow-up 7.5 years for 2.319 patient-years. Age: 62.8±5.1 years. T-group: HbA1c progressively decreased from 9.0±1.2 to 5.9±0.3% at 10 years (p&lt;0.0001) with statistical significance vs. previous year for the first 7 years. CTRL: HbA1c increased from 7.8±0.7 to 10.6±1.7% (p&lt;0.0001). Estimated adjusted difference between groups; -6.2% (p&lt;0.0001). T-group: fasting insulin decreased from 29.6±4.1 to 13.5±5 µU/mL (p&lt;0.0001) with statistical significance vs. previous year for the first 6 years. CTRL: fasting insulin increased from 26.1±2.7 to 36.7±2 µU/mL (p&lt;0.0001). Estimated adjusted difference between groups: -28 µU/mL (p&lt;0.0001). T-group: HOMA-IR decreased from 10.2±2.1 to 3.3±1.2 after 10 years (p&lt;0.0001). The decrease was statistically significant vs. previous year for the first 6 years. CTRL: HOMA-IR increased from 7.5±1.3 to 17.1±6.3 (p&lt;0.0001). Estimated adjusted difference between groups: -14.8 (p&lt;0.0001). Since injections were administered in the doctor’s office and no patient dropped out, there was a 100% adherence to TTh. 8 patients (5.7%) in T-group died. In CTRL, 47 myocardial infarctions (27.6%), 37 strokes (21.8%), and 41 deaths (24.1%) occurred.
Conclusions: Long-term TTh with TU in hypogonadal men with T2DM improved diabetic measures and reduced MACE compared to untreated controls.

Disclosure
F. Saad: Employee; Self; Bayer AG. Stock/Shareholder; Self; Bayer AG, Novo Nordisk A/S. K.S. Haider: Other Relationship; Self; Bayer AG. A. Haider: Research Support; Self; Bayer AG.
Outcomes of Split Thickness Skin Grafting on Lower Extremity Wounds in Diabetics
Authors: WALTERS ELLIOT , STIMAC GREG , RAJPAL NEHA , NAZ IRAM , ELMARSAFI TAMMER , STEINBERG JOHN , EVANS KAREN , ATTINGER CHRISTOPHER , KIM PAUL 
Published: June 2018

Background: Split thickness skin grafting is a widely used surgical technique for wound coverage. Despite the popularity of this procedure, outcomes data has been poorly reported.
Methods: Under IRB approval we reviewed the records of all patients receiving split thickness skin grafting for lower extremity wounds from 2014 to 2016. We have defined success as wound healing of ≥99.5%.
Results: 180 diabetic patients were included in this study. 103 (95%) had hypertension, 75 (69%) had hyperlipidemia, 29 (27%) had congestive heart failure, and 22 (20%) had venous stasis. Complete epithelialization was obtained for 29 (22%) patients at 30d, 48 (36%) patients at 60d, 63 (48%) patients at 90d, and 77 (58%) patients at 365d of follow-up. At last available follow-up 79 (60%) wounds obtained complete healing (≥99.5% coverage). Venous stasis led to inadequate healing at 30d (p&lt;0.0371), 90d (p&lt;0.0006), and 365d (p&lt;0.0005) and trended toward significance at 60d (p&lt;0.0809). Congestive heart failure led to inadequate healing at 60d (p&lt;0.0334), and 90d (p&lt;0.0015). The presence of bacteria on wound bed cultures did not show a significant effect on wound healing. The most common bacteria were coagulase negative Staphylococcus, MRSA, and Enterococcus faecalis. Only enterococcus faecalis showed significance at 30d if present following the initial debridement.
Conclusion: The data suggests that split thickness skin grafting can be a successful coverage technique for diabetic patients with chronic lower extremity wounds. The bacterial milieu of chronic wounds in diabetics is diverse but with excisional debridement these bacteria have little impact on wound healing after split-thickness skin grafting. However, comorbidities (i.e., congestive heart failure and venous stasis) can significantly impact the healing of skin grafts and should be taken into consideration when contemplating split thickness skin grafting in a diabetic patient.

Disclosure
E. Walters: None. G. Stimac: None. N. Rajpal: None. I. Naz: None. T. Elmarsafi: None. J. Steinberg: Consultant; Self; Acelity, Integra LifeSciences. K. Evans: None. C. Attinger: Consultant; Self; Acelity, Integra LifeSciences. P. Kim: Consultant; Self; Acelity, Integra LifeSciences.