bluuebunny/crossref_metadata_2025_split huggingface dataset:
Constant-Moderate and High-Intensity Interval Training Induce Differential Metabolic Benefits on Insulin-Sensitive Tissues in High-Fat Fed Mice
Authors: MARTINEZ-HUENCHULLAN SERGIO F. , BAN LINDA A. , OLAYA LUISA F. , MAHARJAN BABU R. , TAM CHARMAINE , MCLENNAN SUSAN , TWIGG STEPHEN M. 
Published: June 2018

Obesity associates highly with metabolic disorders including insulin resistance. To determine if two exercise prescriptions exert differential metabolic benefits in insulin sensitive tissues, we compared isocaloric programs of constant-moderate endurance (END) and high intensity interval training (HIIT), in a mouse model of diet-induced obesity. Male 10 week old C57BL/6 mice were fed a high fat diet (HFD; 45% kcal fat) ab libitum for 10 weeks, achieving 25% excess weight, and for a further 10 weeks they then underwent isocaloric END or HIIT (3x40min sessions/week). Untrained HFD and chow-fed mice acted as controls. At 30 weeks of age, mice were sacrificed and quadriceps muscle, subcutaneous adipose tissue (SAT) and liver were excised. Neither END or HIIT altered the body weight or the fat/lean mass proportion in HFD mice. An insulin tolerance test (0.65 IU/kg*BW) showed HIIT but not END improved insulin sensitivity in HFD mice (p&lt;0.vs. untrained). In quadricep, HFD induced down-regulation of high-molecular weight adiponectin protein, which was similarly normalized by END and HIIT. In contrast HIIT but not END reversed the HFD-driven downregulation of adiponectin receptor 1 (AdipoR1; p&lt;0.05). In SAT, both programs tended to decrease collagen VI protein (p=0.08), whereas only HIIT induced an upregulation in mRNA (3-fold vs. HFD untrained) and protein (2-fold vs. HFD untrained) of UCP1. In liver, only END was able to reverse the collagen I accumulation (2-fold; p&lt;0.05) and downregulation of CTGF (0.5-fold; protein) seen in HFD untrained mice (p&lt;0.05). Our results suggest that HIIT may promote better systemic metabolic effects, compared to END during high-fat fed conditions, which could be explained by the normalization of muscle AdipoR1 and higher UCP1 induction in SAT. However, END was more effective in normalizing liver changes, suggesting differential metabolic effects of END and HIIT during obesity.

Disclosure
S.F. Martinez-Huenchullan: None. L.A. Ban: None. L.F. Olaya: None. B.R. Maharjan: None. C. Tam: None. S. McLennan: None. S.M. Twigg: Advisory Panel; Self; Abbott. Consultant; Self; Abbott. Advisory Panel; Self; Novo Nordisk Inc., Sanofi-Aventis, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company. Speaker's Bureau; Self; AstraZeneca, Merck Sharp & Dohme Corp.. Other Relationship; Self; Abbott.
Correlations between Serum 25-Hydroxyvitamin D and Pancreatic Islet Function in Type 2 Diabetics
Authors: LI NAN , CHEN MING , DONG JIAQI , YANG SHAOLING , XU LU , WANG YANRU , SUN HANG , LI HONG , QU SHEN 
Published: June 2018

Objective: The relation between type 2 diabetes mellitus (T2DM) and serum-25-hydroxyvitamin D (25[OH]D) is unclear. We aimed to explore the association of 25(OH)D with islet β cell function and insulin resistance in patients with T2DM.
Methods: A total of 466 patients with T2DM and 364 healthy people in our hospital from 2016 to 2017 were enrolled. The difference of 25(OH)D between T2DM group and non-DM group was compared. Patients with T2DM were divided into low 25(OH)D group (LVD group, &lt;47.7nmol/L, n=326) and normal 25(OH)D group(NVD group, &gt;47.7nmol/L, n=140). The correlation between fasting plasma glucose(FPG), fasting insulin(FINS), fasting c-peptid(FCP), glycosylated hemoglobin(HbAlc), HOMA-IR, HOMA-β and 25(OH)D were compared.
Results: Serum level of 25(OH)D in T2DM group was significantly lower than non-DM group (42.33±13.79 vs.69.16±10.78, P&lt;0.001). Levels of FPG, FINS, FCP, HbAlc, HOMA-IR, and HOMA-β in LVD group were higher than NVD group, but there was no significant difference. Correlative analysis showed that there was negative correlation between 25(OH)D and FCP (r=-0.101, P=0.03), but there was no significant correlation with FPG, FINS, HbAlc, HOMA-IR and HOMA-β (r=-0.87, 0.043, -0.290, 0.032, 0.017, all P&gt;0.05). The 25(OH)D of Duration ≥ 5 years was lower than the Duration &lt; 5 years (42.39±13.96 vs. 42.46±13.45, P=0.964). The 25(OH)D of HbAlc ≥ 7% was lower than HbAlc &lt; 7% (42.02±13.85 vs. 44.19±13.50, P=0.192). The 25(OH)D in microvascular group was lower than non-microvascular group (40.86±13.82 vs. 43.35±13.72, P=0.059). The 25(OH)D in macrovascular group was higher than non-macrovascula group (42.49±13.95 vs. 42.09±13.23, P=0.807).
Conclusion: The 25(OH)D in patients with T2DM is lower than healthy people and is downtrend with the increase of diabetic duration and HbAlc. There is no definite correlation between 25(OH)D and the pancreatic islet function. The critical significance should be further studied.

Disclosure
N. Li: None. M. Chen: None. J. Dong: None. S. Yang: None. L. Xu: None. Y. Wang: None. H. Sun: None. H. Li: None. S. Qu: None.
Effects of MEDI0382 on Pancreatic and Incretin Hormones
Authors: PARKER VICTORIA E.R. , TSAI LAN-FENG , ROBERTSON DARREN , PETRONE MARCELLA , RONDINONE CRISTINA , HIRSHBERG BOAZ , JERMUTUS LUTZ , AMBERY PHILIP 
Published: June 2018

MEDI0382, a GLP-1/glucagon dual receptor agonist, is being developed for the treatment of T2DM. GLP-1 receptor agonists promote glucose-dependent insulin release, suppress glucagon, and increase or have minimal effect on glucose-dependent insulinotropic polypeptide (GIP); knowledge of the effect on GLP-1 is limited. We characterized fasting and postprandial hormone profiles associated with MEDI0382 therapy. In a phase 2a study (NCT02548585), 51 subjects with T2DM and BMI 27-40 kg/m2 received MEDI0382 (uptitrated to 200 µg) or placebo (PBO) daily for 41 days. Glucose, insulin, glucagon, GIP, and GLP-1 were measured at baseline (day -1) and day 41 during a liquid mixed-meal tolerance test. MEDI0382 significantly reduced fasting glucose (-49.9 vs. -19.2 mg/dL for PBO; P &lt; 0.0001) and glucose AUC0-4h (-32.8 vs. -10.2% for PBO; P &lt; 0.0001) in association with increased fasting insulin (2.2 mU/L vs. -3.9 mU/L for PBO; P = 0.016), but postprandial insulin AUC was unchanged. In contrast, fasting and postprandial endogenous glucagon, GIP (Figure), and active and inactive GLP-1 were suppressed, and a delay in their kinetics was observed after MEDI0382 therapy. The results suggest that MEDI0382 is insulinotropic and might also cause delayed gastric emptying. The effects of MEDI0382 on GIP have not been observed with GLP-1 receptor mono-agonists and may represent a footprint of dual GLP-1/glucagon receptor agonism in this complex hormone signaling network.

Disclosure
V.E.R. Parker: Employee; Self; MedImmune. Stock/Shareholder; Self; Accenture. Employee; Self; AstraZeneca. 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. B. Hirshberg: Employee; Self; AstraZeneca, MedImmune. L. Jermutus: Employee; Self; AstraZeneca. Stock/Shareholder; Self; AstraZeneca. P. Ambery: Employee; Self; MedImmune. Stock/Shareholder; Self; AstraZeneca.
Effect of a Novel Ficus Carica (Fig) Fruit Extract Standardized in Abscisic Acid on the Glycemic and Insulinemic Responses in Healthy Human Subjects
Authors: ZANGARA ANDREA 
Published: June 2018

Abscisic acid (ABA) is a phyto-hormone present in different fruits and has important implications for human health, such as glucose homeostasis, increase of glucose tolerance, insulinemia attenuation, immune and anti-inflammatory functions. Fig extracts represent an important source of ABA and have therefore the potential to provide a natural balance for sugar and insulin control. The objective of this study was to determine the acute postprandial metabolic response on glycemia and insulinemia of standardized fig extracts (ABAlifeTM). Healthy subjects (n=10) consumed a glucose solution and a fig extract at two different concentrations Reference food: Glucose solution (50 g) in 250 mL of water. Test food 1: Glucose solution + 200 mg ABAlife (80 µg ABA) in 250 mL of water. Test food 2: Glucose solution + 100 mg ABAlife (40 µg ABA) in 250 mL of water. The results showed that the addition of ABAlife extracts to a glucose solution was able to reduce considerably both the glycemic index (GI) and insulinemic index (II) values. Fig Extract (100-200 mg) produced lower peak and overall glycemic and insulinemic responses, between 30-120 minutes, compared with reference food of glucose. The supplementation of Fig Extract (200 mg) to a glucose solution was able to produce considerable reductions of the GI and II values (25%, p&lt;0.001 and 24%, p&lt;0.05, respectively). Moreover, a dose response reduction of II was observed with both ABAlife extracts. Therefore, small amounts of ABA from ABAlife extracts could be proposed as an interesting strategy to reduce postprandial glucose and insulin responses and ABA potential to manage glucose metabolism disorders should be investigated in further chronic clinical trials.

Disclosure
A. Zangara: Employee; Self; Euromed.
Contribution of Eating Behaviours to Glucose Dysmetabolism
Authors: BERTOLI SIMONA , LEONE ALESSANDRO , DE AMICIS RAMONA , BATTEZZATI ALBERTO 
Published: June 2018

The contribution of eating behaviors (EBs) and their psychological constructs to glucose dysmetabolism is still debated. To investigate this issue we conducted a cross-sectional study on 4095 subjects seeking a weight loss program, (71.5% females and 71%% of subjects overweight or obese). Serum glucose and insulin were measured, and HOMA (HI) index was calculated. Impaired fasting glucose (IFG) was defined as a serum glucose ≥100 mg/dL. EBs were investigated using the Binge Eating Scale (BES) and the Eating Disorder Inventory 3 (EDI3). Raw scores for binge eating behavior (BE) bulimia (B), drive for thickness (DT) and body dissatisfaction (BD) were calculated. Multivariable linear and logistic regression models, adjusted for sex, age, BMI, smoking and physical activity were used to assess the association of BES and EDI3 with serum glucose, HI and the risk of IFG, respectively. BES score and EDI3 scales were not associated with serum glucose and HI, whereas DT (-0.1 mg/dL, CI 95%:-0.17,-0.04; for 1-point increment in DT scale) and BD (-0.18 mg/dL, CI95%:-0.24,-0.12; for 1-point increment in BD scale) scales were slightly and inversely associated with serum glucose. BE, B and DT were not associated with IFG. Only subjects experiencing BD had a lower risk of IFG (OR=0.72, CI95%:0.61,0.85).
In conclusion, given the very small effect size, BE, B and DT do not seem to contribute in biologically meaningful manner with glucose profile and IFG risk, whereas BD is associated with a lower risk of IFG. Further study to investigate the effect of BD on food habits and dietary pattern are needed to better understand the contribution of psychological constructs of EBs on glucose dysmetabolism.

Disclosure
S. Bertoli: None. A. Leone: None. R. De Amicis: None. A. Battezzati: None.
T1-REDEEM—An RCT to Reduce Diabetes Distress in Adults with Type 1 Diabetes
Authors: FISHER LAWRENCE , HESSLER DANIELLE M. , POLONSKY WILLIAM , MASHARANI UMESH , GUZMAN SUSAN , BOWYER VICKY , STRYCKER LISA A. 
Published: June 2018

Diabetes distress (DD) refers to the fears, worries and burdens associated with the diabetes experience. DD is common, is distinct from depression, and has been associated with glycemic level and disease management. T1-REDEEM (Type1-Reducing Distress and Enhancing Effective Management) was an RCT that compared two interventions to reduce DD among adults with type 1 diabetes (T1D). After baseline assessment, participants were randomized to either KnowIt, a diabetes education and management program, or OnTrack, which focused on recognizing, normalizing and addressing DD. Both programs involved a 1-day group workshop followed by four 1-hour online group meetings over 3 months. Recruitment occurred at clinic and community sites in three Western U.S. states and Toronto, Canada. Inclusion criteria were T1D ≥ 12 months, elevated DD (≥ 2.0 on the Diabetes Distress Scale), age ≥ 21 years, HbA1C ≥ 7.5% (58 mmol/mol), and English speaking. Regression models analyzed change in DD and HbA1C at 3 and 9 months; missing values were imputed. Nine-month retention was 87% (N = 301 at baseline). DD was significantly reduced in both study arms (p &lt; .001) at 3 months, with modest additional improvements at 9 months (p &lt; .02). Between-group differences were nonsignificant. However, significant group-by-baseline level interactions for key variables revealed for whom the two interventions were most effective: OnTrack led to significantly greater reductions in DD than KnowIt for those with higher DD, poorer emotion regulation, poorer problem-solving skills, and higher knowledge at baseline; KnowIt led to significantly greater DD reductions for those with lower diabetes knowledge at baseline. There was a modest decrease in HbA1C at 3 months (p = .05) that did not differ by group. Findings suggest that effective interventions to address DD must focus on the emotional side of diabetes, especially for participants with high DD, poor emotion regulation skills, poor problem-solving abilities, and different levels of diabetes knowledge.

Disclosure
L. Fisher: Consultant; Self; Eli Lilly and Company, Abbott, Merck & Co., Inc. D.M. Hessler: Consultant; Self; Eli Lilly and Company. W. Polonsky: Consultant; Self; Abbott, AstraZeneca, Dexcom, Inc., Sanofi, Novo Nordisk Inc., Eli Lilly and Company, Intarcia Therapeutics, Inc., Servier, Ascensia Diabetes Care, Merck & Co., Inc., MannKind Corporation, Glooko, Inc., Roche Diabetes Care Health and Digital Solutions. U. Masharani: None. S. Guzman: Consultant; Self; TypeZero Technologies, Inc.. Board Member; Self; Behavioral Diabetes Institute. Consultant; Self; Becton, Dickinson and Company. V. Bowyer: None. L.A. Strycker: None.
Shared Responsibility Moderates Relations between Psychological Distress and Self-Care among Adolescents with T1D
Authors: ABUJARADEH HIBA , HELGESON VICKI , COHEN SUSAN M. , SEREIKA SUSAN M. 
Published: June 2018

Psychological distress and parental involvement in diabetes management are predictors of self-care behaviors among adolescents with T1D. To date, little research has examined parental involvement as a moderator of the association between distress on self-care behaviors. This study examined whether shared responsibility (SR) moderates relations of distress on self-care.
Methods: A secondary analysis was conducted using longitudinal data from 132 adolescents with T1D (53% female; aged 10.7-14.2 years; 1-13 years duration of T1D) and their parents. Adolescents were interviewed and parents completed a questionnaire annually for 5 years. Adolescents and parents reported on the extent to which they shared diabetes care responsibilities. Adolescents reported on distress (depression, anxiety, anger) and self-care. Linear mixed modeling was used to assess whether SR moderated relations of concurrent and lagged psychological distress on self-care.
Results: For concurrent analyses, parent-reported SR moderated relations between both depressive symptoms and anxiety on self-care (p&lt;.001) and anger on self-care (p=.001). For lagged analyses, parent-reported SR moderated relations between depression on self-care (p=.001) and anxiety on self-care (p=.003). Moderation varied over the 5 years. During early to middle adolescence (years 1-4), SR did not moderate relations between distress and self-care; however, during middle to late adolescence (year 5), lower distress was associated with better self-care for higher SR but not associated with self-care for lower levels of SR.
Conclusions: As adolescents get older, lower distress was associated with better self-care for those with higher levels of SR but not for those with low SR. Continuation of SR during adolescence may mitigate the effects of distress on self-care. Healthcare providers should promote parental involvement in diabetes management throughout adolescence for better diabetes outcomes.

Disclosure
H. Abujaradeh: None. V. Helgeson: None. S.M. Cohen: None. S.M. Sereika: None.
Glycemic Variability Associated with Time Spent in Hypoglycemia in Type 1 Diabetes—Explorative Data in Real-World, Real-Time Continuous Glucose Monitoring
Authors: HACHMANN-NIELSEN ELISE , BARTHOLDY TRINE , DJURHUUS CHRISTIAN BORN , KVIST KAJSA 
Published: June 2018

Glycemic variability has previously been associated with risk of hypoglycemia. Cornerstone4Care (C4C), a digital patient management program for diabetes mellitus, supports diabetes self-managing and captures patient data inclusive real-world real-time continuous glucose monitoring (CGM) data. The objective was to explore the association between glucose variability and time spent in hypoglycemia (TIH; percent time with interstitial glucose (IG) &lt;54 mg/dL [3.0mmol/L]) and the association between mean IG and TIH in real-world CGM data. Glucose variability was determined based on CGM data from 112 type 1 diabetes (T1D) patients uploaded via the C4C app and calculated as the coefficient of variation (CV) based on the last 14 days’ available CGM data. For each patient a CV-index, mean IG, and proportion of TIH was determined. The variability CV-index ranged from 11% to 56%. Increase in CV appeared to increase TIH. Mean IG did not seem to influence the time spent in hypoglycemia as much. In addition, when CV exceeded the newly recommended cut-off of 36%, the TIH seemed to increase.
In conclusion, higher glucose variability (CV) based on CGM data from T1D was observed to increase the time spent in hypoglycemia. The increase seemed to occur with a CV around 30-36% and seemed to be more independent of mean IG.
Data source: https://www.cornerstones4care.com/.

Disclosure
E. Hachmann-Nielsen: Employee; Self; Novo Nordisk A/S. T. Bartholdy: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. C. Djurhuus: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. K. Kvist: Employee; Self; Novo Nordisk A/S.
Ketones to Success—Does NICH Involvement Influence DKA Discharge Presentation?
Authors: WAGNER DAVID V. , CHUONG ROSE , KOSKELA NATALIE C. , LUZOD HANNAH , BEESON ERYNN , GUTTMANN-BAUMAN INES , HARRIS MICHAEL A. 
Published: June 2018

Objective: Youth struggling with diabetes management are at increased risk of DKA. Novel Interventions in Children’s Healthcare (NICH) is designed for youth with T1D who are experiencing or are at high risk of experiencing DKA. Previous findings from smaller samples indicate that youth in NICH are less likely to experience a DKA event and typically experience a shorter average hospital stay. However, counter to physician anecdotes, DKA-related lab values at admission for NICH patients do not differ from labs prior to program involvement. This study aims to determine whether patients in NICH are being discharged when less stable.
Methods: Retrospective chart reviews were conducted on 52 youth enrolled and treated with NICH. Data included presence and number of DKA episodes in the year prior to and the year following NICH enrollment, as well as associated lab values at discharge—ketones, blood glucose level, bicarb, and pH. The mean youth age was 14.7 years (SD=3.5); 55.8% were female; and 92.3% were caucasian. Eighteen youth had lab values associated with DKA discharge available both prior to and during NICH.
Results: Youth were less likely (p=.001) to experience DKA during NICH (35.3%) than prior to NICH (69.2%) and experienced fewer DKA events (t(51)=3.53; p=.001) during NICH (M=1.0; SD=1.8) than prior (M=1.8; SD=2.1). Regarding discharge presentation, only the presence of ketones indicated a significant difference (t(17)=2.11; p=0.5), with patients in NICH being discharged with trace to small ketones on average while in the program, as opposed to negative to trace ketones prior to program involvement.
Conclusions: Youth in NICH experience fewer DKA events and are less likely to experience a DKA during program involvement. In addition, youth are discharged, on average, with a stronger presence of ketones during NICH than prior to program involvement. This may reflect increased medical provider confidence that ketones and associated youth health can be managed at home when NICH providers are involved.

Disclosure
D.V. Wagner: None. R. Chuong: None. N.C. Koskela: None. H. Luzod: None. E. Beeson: None. I. Guttmann-Bauman: None. M.A. Harris: Consultant; Self; Eli Lilly and Company.
Accuracy Evaluation of the WaveForm Cascade CGM System vs. Dexcom G5 Sensors
Authors: REBEC MIHAILO , ANDERSON ELLEN M. , DUTT-BALLERSTADT RALPH , HAIDAR AHMAD , JANEZ ANDREJ 
Published: June 2018

Objective: WaveForm is actively pursuing a commercial launch with a new trocar-free CGM system. The Cascade CGM device is based on a variant of an amperometric GOx-based technology. Finishing the algorithm and validating the clinical performance of the device is the final development stage. We are reporting on the outcome of a 10-day clinical study that was used to compare the accuracy of the Dexcom G5 CGM device and our Cascade CGM.
Method: The Clinical study that was used to evaluate the two CGM systems included 15 subjects with type 1 and 2 diabetes. On day 1, 4, 7 and 10, 12-hour in-clinic CGM accuracy studies were performed. Each subject wore two Cascade CGM devices and one Dexcom G5 sensor in the abdominal area. YSI glucose measurements were performed on plasma from venous blood sampled every 15 minutes. The Dexcom device was inserted at the beginning of day 4 in-clinic day and was worn through day 10 of the study (7 days). The overall MARD and MAD calculation for the Cascade CGM was evaluated for the four in-clinic days by prospectively applying an advanced algorithm to data generated during the study. The comparison of accuracy performance between the Cascade and the Dexcom G5 sensors was conducted over 7 days which included 3 in-clinic days for each CGM device.
Result: Head-to-head MARD comparison between the WaveForm and Dexcom sensor over 7 days showed that MARD for the Cascade CGM was better (11.0% vs. 12.2%). Consensus error grid analysis for Cascade device showed that 99% of data points were in zone A and B, with the remaining 1% in zone C.
Conclusions: Overall performance of the Cascade CGM device over 10 days meets the clinical expectations of a commercial device. Direct comparison with the Dexcom G5 sensor - regarded as the current benchmark in the CGM market - shows that the WaveForm device met and even surpassed the performance level of it in this study. The Cascade CGM will be launched as 14-day wear CGM system.

Disclosure
M. Rebec: Employee; Self; Agamatrix LLC. E.M. Anderson: Employee; Self; AgaMatrix LLC. R. Dutt-Ballerstadt: Employee; Self; WaveForm Technology. A. Haidar: Consultant; Self; Eli Lilly and Company. Research Support; Self; AgaMatrix, Medtronic MiniMed, Inc.. A. Janez: None.