bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Preexisting Dysglycaemia among Inpatients with Acute Coronary Syndrome and Associations with Outcomes
Authors: MAHENDRAN DINESH , HAMILTON GARRY , WEISS JEREMY , LEW JEREMY , KHOO KAYLYN , EKINCI ELIF I. 
Published: June 2018

Objective: We aimed to determine the prevalence of preexisting dysglycaemia in inpatients admitted with acute coronary syndrome (ACS), their characteristics and, association with acute and 12-month clinical outcomes.
Research Design and Methods: In this prospective observational cohort study, admission HbA1c testing was undertaken on consecutive inpatients aged ≥54 years admitted with ACS. Patients were categorised into those with diabetes (prior diagnosis or HbA1c ≥ 6.5%, ≥48mmol/mol), prediabetes (HbA1c 5.7-6.4%, 39-46mmol/mol) and no diabetes (HbA1c &lt;5.6%, &lt;38mmol/mol).
Results: Between July 2013 and July 2015, 847 consecutive inpatients aged ≥54 years were admitted with ACS. 313 (37%) inpatients had diabetes, 312(37%) had prediabetes and 222(25%) had no diabetes. After adjusting for age, sex, smoking status and previous myocardial infarction, diabetes, as opposed to no diabetes, was associated with higher odds of Acute Pulmonary Oedema (APO) (OR 2.60, P&lt;0.01), longer length of stay (LOS) (IRR 1.18, P=0.02) and, higher odds of 12-month ACS recurrence (OR 1.86, P&lt;0.05). Prediabetes was not a statistically significant marker of adverse clinical outcomes. However, analysed as a continuous variable, every 1% (11 mmol/mol) increase in HbA1c was associated with increased odds of APO (OR 1.28, P=0.002) and, longer LOS (IRR 1.05, P=0.03).
Conclusions: In our study, three-quarters of all inpatients aged ≥54 years admitted with ACS had preexisting dysglycaemia. Inpatients with diabetes had increased odds of APO, longer LOS and higher 12-month ACS recurrence. Higher HbA1c, was associated with increased odds of APO and longer LOS. Randomised studies with cardioprotective anti-hyperglycaemic agents are necessary in determining if improving dysglycaemia in ACS patients improves clinical outcomes.

Disclosure
D. Mahendran: None. G. Hamilton: None. J. Weiss: None. J. Lew: None. K. Khoo: None. E.I. Ekinci: None.
Early Vascular Parameters in the Micro- and Macrocirculation in Type 2 Diabetes
Authors: SCHMIEDER ROLAND E. , KANNENKERIL DENNIS , KARG MARINA V. , BOSCH AGNES , HARAZNY JOANNA M. , OTT CHRISTIAN 
Published: June 2018

Background: In a large cross-sectional analysis we analyzed various vascular parameters in the renal, retinal and systemic circulation, with the goal to identify which vascular parameter of early organ damage is the earliest that can be clinically detected.
Methods: In 111 patients with type 2 diabetes (T2DM) and 54 subjects without T2DM we assessed urinary albumin creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR), retinal capillary flow (RCF), intercapillary distance (ICD) as parameters of capillary rarefaction, wall-to-lumen ratio (WLR) of the retinal arterioles [all assessed by Scanning Laser Doppler Flowmetry], and central systolic pressure(cSBP) and central pulse pressure (cPP) [measured by pulse wave analysis, Syphygmocor].
Results: Compared to subjects without T2DM, patients with type 2 diabetes (duration: mean 63.9 ± 56.4, range 1-271 months) were older (59.8 ± 7.3 vs. 43.4 ± 12.9 years, p&lt;0.001), more females (33.3 vs. 20.4 %, p&lt;0.001) but 24-hour systolic and diastolic blood pressure did not differ between the two groups (129±11/79±8 vs. 130±11/77±6 mmHg).
Non-T2DM-subjects (n=54)Patients with T2DM (n= 111)Unadjusted p-valueAge- gender- adjusted p-valueAdjusted p-value (potential confounders)ICD (µm)20.8 ± 3.523.9 ± 5.1&lt;0.001&lt;0.0010.001RCF (AU)310.4 ± 55.1297.8 ± 72.90.150.350.72WLR (-)0.35 ± 0.080.38 ± 0.110.040.670.90eGFR (ml/min/1.73m²)95.9 ± 17.391.7 ± 9.90.10&lt;0.001&lt;0.0017.9 ± 7.521.3 ± 86.6&lt;0.0010.550.91cPP (mmHg)34.8 ± 10.641.8 ± 11.70.0010.31&lt;0.001RCF (AU)310.4 ± 55.1297.8 ± 72.90.150.350.72
Conclusion: These data suggest that at similar blood pressure capillary rarefication in the retinal circulation (ICD), eGFR in the renal circulation and central pulse pressure (cPP) of large arteries are earlier detectable than vascular remodeling of the micro- (WLR, RCF, UACR) and macrocirculation (cSPB) in patients with T2DM.

Disclosure
R.E. Schmieder: Consultant; Self; AstraZeneca, Bayer AG, Berlin-Chemie AG, Boehringer Ingelheim GmbH. Other Relationship; Self; Boehringer Ingelheim GmbH. Speaker's Bureau; Self; Daiichi Sankyo Company, Limited. Other Relationship; Self; Novartis AG. Consultant; Self; Novartis AG. Speaker's Bureau; Self; Servier. D. Kannenkeril: None. M.V. Karg: None. A. Bosch: None. J.M. Harazny: None. C. Ott: None.
Comparative Cardiovascular Efficacy of SGLT2 Inhibitors, DPP-4 Inhibitors, and GLP-1 Agonists—A Network Meta-analysis
Authors: RODDICK ALISTAIR J. , ZHENG SEAN 
Published: June 2018

Background: Sodium-Glucose Cotransporter-2 inhibitors (SGLT2i), Dipeptyl Peptidase-4 inhibitors (DPP-4i) and Glucagon-Like Peptide-1 agonists (GLP-1a) effectively reduce HbA1c levels. Their long-term cardiovascular effects have been tested against placebo, but the comparative efficacy of individual drug types is unclear.
Aim: To compare the efficacy of SGLT2i, DPP-4i and GLP-1a for reducing cardiovascular outcomes by network meta-analysis.
Methods: Medline, Embase and the Cochrane Library Central Register of Controlled Trials were searched for randomised controlled trials (RCTs) of &gt;12 weeks’ duration enrolling patients with type 2 diabetes and comparing drugs of SGLT2i, DPP-4i or GLP-1a classes with another included class or control. Comparative point estimates were synthesised by random effects frequentist network meta-analysis.
Results: In all, 236 RCTs were included, accounting for 176,310 patients across 20 interventions (DPP-4i: 6; GLP-1a: 7; SGLT2i: 7). Empagliflozin and liraglutide reduced cardiovascular mortality compared to control (RR 0.63; 95% CI 0.51-0.79; P&lt;0.001; and RR 0.79, 95% CI 0.66-0.93, P=0.006, respectively). Empagliflozin was the highest-ranking drug for cardiovascular mortality (P-score=0.89) and significantly reduced fatal cardiovascular events compared to 5 other drug types in addition to control (DPP-4i: 2; GLP-1a: 2; SGLT2i: 1). Empagliflozin and canagliflozin reduced heart failure events compared to control (RR 0.66; 95% CI 0.51-0.86 and RR 0.70; 95% CI 0.54-0.90 respectively), while saxagliptin increased heart failure events (RR 1.23; 95% CI 1.04-1.46). Myocardial infarction and stroke were not affected by any drug of any class.
Conclusions: Empagliflozin and liraglutide demonstrate the greatest efficacy for cardiovascular mortality, while SGLT2i may exert additional benefits in heart failure. This study provides evidence to support clinical decisions in treatment of type 2 diabetes.

Disclosure
A.J. Roddick: None.S. Zheng: None.
High Prevalence of Asymptomatic Coronary Artery Disease (CAD) Evaluated by Intravascular Ultrasound (IVUS) in a Norwegian Cohort with Type 2 Diabetes (T2D) as Compared with Asymptomatic Controls without T2D—A Cross-Sectional Study
Authors: OFSTAD ANNE P. , ARORA SATISH , ULIMOEN GEIR R. , BIRKELAND KARE I. , ENDRESEN KNUT , GULLESTAD LARS L. , JOHANSEN ODD ERIK 
Published: June 2018

The prevalence of asymptomatic CAD in T2D is unclear. We investigated the CAD burden using the gold standard IVUS in an asymptomatic T2D-cohort compared to a reference population without T2D. Patients with T2D and ≥ 1 cardiovascular (CV) risk factor (n=56, 21% women, mean age/diabetes duration 65.2±7.8/13.1±5.8 years, HbA1c 7.2±1.1%, systolic BP 136±17 mmHg, LDL-cholesterol 2.3±0.8 mmol/L) underwent invasive coronary angiography with IVUS. Reference population comprised heart transplant donors free from T2D and CAD who had IVUS performed 7-11 weeks post-transplant (n=76). IVUS was described by maximal intimal thickness (MIT), percent atheroma volume (PAV) and normalized total atheroma volume (TAV). All indices of atherosclerosis were significantly increased in T2D (T2D cohort: MIT 0.75±0.27 mm, PAV 33.7±9.8%, TAV 277.0±137.2 mm3 vs. reference population: MIT 0.44±0.18 mm, PAV 20.1±7.4%, TAV 139.0±110.0 mm3, [p-values&lt;0.001]) and the proportion with CAD defined by MIT was significantly higher in the T2D population (Figure). Our data suggest that asymptomatic T2D patients have extensively diseased coronary arteries suggesting a need for more aggressive residual CV risk management.

Disclosure
A.P. Ofstad: Employee; Self; Boehringer Ingelheim GmbH. S. Arora: None. G.R. Ulimoen: None. K.I. Birkeland: Research Support; Self; AstraZeneca, Novo Nordisk A/S, Eli Lilly and Company, Sanofi, Boehringer Ingelheim GmbH, Merck Sharp & Dohme Corp.. K. Endresen: None. L.L. Gullestad: None. O. Johansen: Employee; Self; Boehringer Ingelheim GmbH.
Impact of Human vs. Analog Insulins on Occurrence of Death and Major Cardiovascular Events
Authors: SCHROEDER EMILY B. , O'CONNOR PATRICK J. , SCHMITTDIEL JULIE , REYNOLDS KRISTI , DESAI JAY R. , HO MICHAEL , BENITEZ GABRIELA VAZQUEZ , ANDERSON JEFFREY P. , PIMENTEL NOEL , LOES LINDA M. , NEUGEBAUER ROMAIN 
Published: June 2018

Background: This observational study uses rigorous causal inference methods of comparative effectiveness research to emulate a trial evaluating the cardiovascular safety of analog (AI) vs. human insulins (HI).
Methods:On date of first insulin use, 127,600 adults with type 2 diabetes were classified as using: AI with or without HI, or HI only. Separate analyses assessed occurrence of: myocardial infarction (MI), stroke (CVA), congestive heart failure hospitalization (CHF), cardiovascular (CV) death, or death, censored at disenrollment, start of pregnancy, or 12/31/2013. Marginal structural modeling (MSM) with Inverse Probability Weighting (IPW) was used to compare event free survival in per-protocol analyses in which follow-up data was right-censored for cross-over or interrupted insulin therapy. Adjusted and unadjusted effect estimates were based on two logistic MSM parameterizations for counterfactual hazards. To address potential residual confounding, we conducted four sensitivity analyses with three nested covariate adjustment sets and machine learning for data-adaptive selection of covariates.
Results:Mean follow-up time was 21 months. The Table shows hazard ratios (95% CI) of AI vs. HI users for events of interest.
Conclusions: We observed no statistically significant differences in 5 major clinical outcomes between users of AI and HI.

Disclosure
E.B. Schroeder: None. P.J. O'Connor: None. J. Schmittdiel: None. K. Reynolds: Research Support; Self; Amarin Corporation, Novartis Pharmaceuticals Corporation, Amgen Inc., CSL Behring. J.R. Desai: None. M. Ho: None. G. Vazquez Benitez: None. J.P. Anderson: None. N. Pimentel: None. L.M. Loes: None. R. Neugebauer: None.
Effect of Glucagon on Nocturnal Rates of Endogenous Glucose Production in Type 2 Diabetes
Authors: BASU ANANDA , ZHAI HUALING , CARTER RICKEY , BASU RITA 
Published: June 2018

The role of nocturnal glucagon on regulation of overnight endogenous glucose production (EGP) in T2D is unknown. We studied 13 T2D and 13 age, BMI matched nondiabetic subjects (ND) on two occasions at the Clinical Research Unit at Mayo Clinic. Deuterated water was provided to measure gluconeogenesis (GNG) and glycogenolysis (GGL) using the HMT (hexamethylenetetramine) method. A somatostatin pancreatic clamp was initiated at 10 PM with 0.25 mU/kg/min insulin infusion until 7 AM along with [3-3H] glucose to measure turnover in the presence of glucagon infusions at 0.65 ng/kg/min (basal) or 1.5 ng/kg/min (high) in random order. Blood was sampled periodically for the measurements of plasma glucose, [3-3H] glucose, hormones; EGP rates were measured at 7AM. Results are presented in the Table. Fasting glucose, insulin and c-peptide concentrations were not different in either group during either visit. Glucose infusion rates (GIR) required to maintain euglycemia were lower during high glucagon in both groups and lower in T2D vs. ND regardless of visit indicating insulin resistance. Rates of EGP at 7AM were higher in both groups with the high vs. basal glucagon (matched data shown for calculation). Partial GNG data that are available indicate increased rates of GGL at 7 AM in the presence of high glucagon. In T2D higher glucagon overnight could contribute to higher rates of GGL and EGP. Therapies to reduce GGL may help lower overnight EGP.{F280D615-E887-4E30-8C76-ED88282D5E23}All data are Mean +/- SD. Statistical analyses was not performed on EGP and HMT data as it is preliminary.Diabetes StatusBasal Glucagon 7 AMHigh Glucagon 7 AM7 AM p-value Basal vs HighGlucose (mmol/L)ND T2D5.4 ± 0.6 8.2 ± 4.0 (p &lt; 0.001)5.2 ± 0.6 8.2 ± 4.0 (p &lt; 0.001)0.4 0.9Glucagon (pg/ml)ND T2D82.0 ± 14.0 90.5 ± 12.5 (p = 0.56)138.3 ± 15.4 151.5 µ 17.2 (p = 0.20)p &lt; 0.01 p &lt; 0.01GIR (µmol/kgFFM/min)ND T2D23.0 ± 12.8 6.7 ± 8.4 (p &lt;0.001)21.0 ± 11.4 4.0 ± 6.8 (p &lt;0.001)p &lt; 0.01 p &lt; 0.01EGP (µmol/kgFFM/min)ND n=13 T2D n=138.0 ± 4.2 13.3 ± 4.710.3 ± 6.6 15.8 ± 4.3HMT data (EGP) (µmol/kgFFM/min)ND n=4 T2D n=710.3 ± 4.8 15.2 ± 5.615.1 ± 8.7 22.0 ± 5.0GluconeogenesisND n=4 T2D n=73.8 ± 1.3 5.6 ± 2.24.7 ± 3.4 9.4 ± 1.6GlycogenolysisND n=4 T2D n=76.5 ± 3.4 9.6 ± 3.310.4 ± 1.2 12.6 ± 3.5

Disclosure
A. Basu: Research Support; Spouse/Partner; AstraZeneca. Research Support; Self; Novo Nordisk A/S. Advisory Panel; Self; Voluntis France. H. Zhai: None. R. Carter: None. R. Basu: Research Support; Self; AstraZeneca.
Effect of Number of Achieved Targets for Risk Factors on Coronary Artery Disease (CAD) in Those With and Without Diabetes Mellitus (DM)
Authors: FUJIHARA KAZUYA , MATSUBAYASHI YASUHIRO , KITAZAWA MASARU , YAMAMOTO MASAHIKO , OSAWA TAEKO , KANEKO MASANORI , YAMANAKA NAUTA , SEIDA HIROYASU , KATO KIMINORI , KODAMA SATORU , SONE HIROHITO 
Published: June 2018

Although control of multiple risk factors is essential to prevent CAD in persons with and without DM, longitudinal studies are scarce that directly and quantitatively compared effects of such control in DM and non-DM. Thus, we investigated effects on subsequent CAD of the number of controlled risk factors among blood pressure, LDL cholesterol and HbA1c using a nationwide claim-based database (median follow-up 4.8 y) in Japan. Targets were based on ADA and Japanese guidelines. Of 207,029 non-DM persons, 42.8% and 37.9% were at target for 1 and 2 factors, respectively. Of 13,471 persons with DM, 39.5%, 32.1%, and 10.0% were at target for 1, 2, and 3 factors, respectively. Multivariate Cox analysis showed reduced CAD risk with increased numbers of risk factor targets reached in DM compared to non-DM (Table, upper). However, in DM, although fulfillment of the target for only 1 risk factor significantly elevated the hazard ratio (HR) (i.e., 1.98 (1.28-3.07)) to non-significance (i.e., 1.03 (0.68-1.66)), no further significant HR reduction below reference (i.e., non-DM with no target achieved) was found (Table, lower). These findings show that composite control of modifiable risk factors has a larger effect in DM compared to non-DM, but the effect was not sufficient to bring CAD risk in DM below that for non-DM persons with none of 3 risk factors being at target based on current target levels.

Disclosure
K. Fujihara: None. Y. Matsubayashi: None. M. Kitazawa: None. M. Yamamoto: None. T. Osawa: None. M. Kaneko: None. N. Yamanaka: None. H. Seida: None. K. Kato: None. S. Kodama: None. H. Sone: Research Support; Self; Novo Nordisk Inc., Eli Lilly and Company, MSD K.K., Chugai Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Development Center Asia, Pte. Ltd., Daiichi Sankyo Company, Limited, Ono Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Sanofi, Kowa Pharmaceuticals America, Inc., Eisai Inc..
Effects of Treatment-Achieved HbA1c on Incidence of Micro-/Macrovascular Complications in Patients with Diabetes Mellitus
Authors: HARADA MAYUKO , FUJIHARA KAZUYA , OSAWA TAEKO , YAMAMOTO MASAHIKO , KANEKO MASANORI , MATSUBAYASHI YASUHIRO , MATSUNAGA SATOSHI , YAMADA TAKAHO , YAMANAKA NAUTA , SEIDA HIROYASU , KODAMA SATORU , SONE HIROHITO 
Published: June 2018

Although a so-called “J”- or “U”-shaped relationship between treatment-achieved HbA1c values and risk of coronary artery disease (CAD) has often been reported, it is not yet clarified whether the association is maintained across various treatment modalities including diet only (D) for macro/microvascular complications of diabetes. Thus, we investigated effects of treatment-achieved HbA1c on CAD events and treatment-required diabetic eye disease (TRDED) in 4 treatment subgroups: D, insulin (I), sulfonylurea (S) and antihyperglycemic agents other than glinides, S or I. We utilized a nationwide claims database of 14,633 patients with diabetes in Japan (mean age 50.3 y, HbA1c 7.2%). Cox regression examined CAD and TRDED risk over a 5.1 y follow-up. A significant linear trend in the association between HbA1c and CAD events was only seen in the D group. Significantly higher risks for CAD were observed in the I and S groups whose HbA1c was ≤7.0% or S compared to D group patients with HbA1c ≤7.0%. Conversely, risk for TRDED was strongly dependent on achieved HbA1c regardless of treatment modalities. However, risks of TRDED did not differ significantly between categories of ≤7.0% and 7.1-8.0% among S and I groups. These results implied the necessity of setting different target HbA1c goals according to treatment modalities for prevention of micro-/macrovascular complications.

Disclosure
M. Harada: None. K. Fujihara: None. T. Osawa: None. M. Yamamoto: None. M. Kaneko: None. Y. Matsubayashi: None. S. Matsunaga: None. T. Yamada: None. N. Yamanaka: None. H. Seida: None. S. Kodama: None. H. Sone: Research Support; Self; Novo Nordisk Inc., Eli Lilly and Company, MSD K.K., Chugai Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Development Center Asia, Pte. Ltd., Daiichi Sankyo Company, Limited, Ono Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Sanofi, Kowa Pharmaceuticals America, Inc., Eisai Inc..
Treatment for Diabetes and Cardiovascular Risk Factors in a Predominantly Minority Urban Cohort of Kidney Transplant Recipients
Authors: TSOMOS EFFIE , ALEKSIC SANDRA , ANARAKI SARA ZAHEDPOUR , JAPP EMILY , UPADHYAY LAXMI , AJAIMY MARIA , ZONSZEIN JOEL , AKALIN ENVER 
Published: June 2018

Background: Given the increased incidence of post-transplant diabetes and the high cardiovascular burden in transplant recipients, glycemic control and other cardiovascular risk factors such as blood pressure and cholesterol should be targeted aggressively. We aimed to analyze management of predominantly Hispanic and non-Hispanic black kidney transplant recipients with type 2 diabetes (T2D) and new onset diabetes after transplant (NODAT).
Methods: We performed a retrospective chart review of all recipients of kidney transplant from June 01, 2012 until December 31, 2014 in a large university center. Recipients with type 1 diabetes or pancreas transplant were excluded. NODAT was defined by the ADA criteria.
Results: The study included 304 individuals. Fifty percent had T2D and another 36% developed NODAT during a follow-up of 37 (22-52) months. Individuals with T2D, compared to NODAT and non-DM, were more frequently treated with statins (76% vs. 65% vs. 39%, respectively, p&lt;0.001). At 6, 12, and 24 months posttransplant individuals with T2D, compared to NODAT, had higher levels of A1c (7.9 ± 1.8 vs. 6.5 ± 1.2%, 8.1 ± 1.8 vs. 6.6 ± 1.3%, 8.6 ± 2.1 vs. 6.6 ± 1.1%, respectively, p&lt;0.0001 for all comparisons) and less frequently reached goal of &lt;7% (33 vs. 80%, 26 vs. 71%, 14 vs. 79%, respectively, p&lt;0.0001 for all comparisons). Most frequent glucose-lowering treatment in T2D was insulin (92%), followed by metformin (20%), DPP-4 inhibitors (19%) and sulfonylurea (11%), while NODAT was treated most frequently with diet only (43%), followed by metformin (20%) and DPP-4 inhibitors (20%).
Conclusions: While metabolic control was better in NODAT than T2D, both groups were predominantly treated with older glucose-lowering medications and had a significant number of individuals with suboptimal glucose and lipid management. Earlier and more aggressive treatment with cardio-protective and newer glucose-lowering agents is warranted in this high-risk population.

Disclosure
E. Tsomos: None. S. Aleksic: None. S. Zahedpour Anaraki: None. E. Japp: None. L. Upadhyay: None. M. Ajaimy: None. J. Zonszein: Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; Merck & Co., Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. E. Akalin: None.
Effects of Hyperglycemia and Hyperinsulinemia on Glucose Turnover during Exercise in Type 1 Diabetes
Authors: ROMERES DAVIDE , BASU ANANDA , SCHIAVON MICHELE , COBELLI CLAUDIO , DALLA MAN CHIARA , BASU RITA 
Published: June 2018

Exercise (E) induced increase in glucose uptake (Rd) is offset by compensatory increase in endogenous glucose production (EGP) in health. To determine the extent to which this occurs in type 1 diabetes (T1D) and to assess the effects of hyperglycemia and hyperinsulinemia, we studied six T1D subjects (age 29±7 years, BMI 28.3±4.8 kg/m2, VO2 max 28.7±10 ml/kg/min) on three visits (V1: euglycemia, low insulin; V2: euglycemia, high insulin; V3: hyperglycemia, low insulin) in random order. Glucose fluxes were measured with tracer-tracee clamp using [6,6-2H2] glucose before, during and after, 60 min of E at 65% VO2 max. By design, plasma glucose concentrations were higher in V3 than V1 and V2 (9.7±0.5, 5.2±0.1, 5.2±.0.1 mM respectively, p&lt;0.05), while plasma insulin concentrations were higher in V2 than V1 and V3 (324.3±19.4, 129.3±9.3, 111.6±5.9 pM, p&lt;0.05). Rd increased with E in all visits (p&lt;0.05) and returned to pre-E values thereafter. EGP during E increased (p&lt;0.05) in V1 and to a lesser extent in V3, but was unchanged in V2. To summarize, hyperinsulinemia, but not hyperglycemia inhibits E induced compensatory increase in EGP; both hyperinsulinemia and hyperglycemia augments increase in Rd with E albeit to different extents; Rd returns to pre-E values when E stops. Taken together, euglycemia coupled with low insulin appear to be the most favorable milieu for T1D during E.

Disclosure
D. Romeres: None. A. Basu: Research Support; Spouse/Partner; AstraZeneca. Research Support; Self; Novo Nordisk A/S. Advisory Panel; Self; Voluntis France. M. Schiavon: None. C. Cobelli: Research Support; Self; Sanofi-Aventis. Advisory Panel; Self; Novo Nordisk Inc.. C. Dalla Man: None. R. Basu: Research Support; Self; AstraZeneca.