bluuebunny/crossref_metadata_2025_split huggingface dataset:
Projections of Prevalence of Diabetes With and Without CKD in Southwestern American-Indians
Authors: PAVKOV MEDA E. , HOYER ANNIKA , GREGG EDWARD W. , BRINKS RALPH , BENNETT PETER H. 
Published: June 2018

The combination of high diabetes prevalence, declining mortality trends and high chronic kidney disease (CKD) prevalence has raised concerns about the future burden of CKD in the American Indian population. We modeled the future prevalence of diabetes and CKD in a Southwestern American Indian population well-characterized for type 2 diabetes using data from research examinations conducted on 4,476 participants between 1965 and 2007. Diabetes was assessed by 2-hour glucose tolerance testing, CKD was defined by estimated GFR (eGFR) &lt;60 ml/min/1.72 m2. Estimates of age-specific prevalence of diabetes without CKD (p1) and with CKD (p2) were projected through 2030, using illness-death models of the observed prevalence, incidence and death rates for men and women (Figure). For women 40 years old, p1 is projected to decline from 42.2% in 2010 to 17.1% in 2030, whereas p2 is projected to increase from 3.3% to 34.9% in the same decades. Among 40 year-old men, p1 is projected to decline from 42.3% in 2010 to 29.8% in 2030, concurrent with an increase in p2 from 3.4% in 2010 to 8.2% in 2030. Similar trends were observed for older ages, whereas for those younger than 40 years, the increase in p2 was most prominent among women.
In conclusion, the model provides assessment of the future burden of diabetes and diabetes-related CKD, projecting a marked increase in the proportion of people with diabetes who will have CKD over the next two decades.

Disclosure
M.E. Pavkov: None. A. Hoyer: None. E.W. Gregg: None. R. Brinks: None. P.H. Bennett: None.
Prospective Study on Incidence of Cardiovascular-Renal Diseases, Severe Hypoglycaemia, and Death in Chinese with Latent Autoimmune Diabetes in Adults
Authors: LUK ANDREA , LAU ERIC S. , LIM CADMON K.P. , CHOW ELAINE , MA RONALD C. , KONG ALICE P. , CHAN JULIANA C. 
Published: June 2018

Objectives: Few studies have examined the progression to chronic complications in patients with latent autoimmune diabetes in adults (LADA). We compared incidence of cardiovascular-renal diseases, severe hypoglycaemia and death in patients with LADA and type 2 diabetes.
Methods: Between 1995-2012, 1569 Chinese with young-onset (age of diagnosis &lt;40 years) non-type 1 diabetes underwent comprehensive disease assessment at Prince of Wales Hospital, Hong Kong. LADA (n=124 [7.9%]) was identified by positive anti-glutamic acid decarboxylase antibodies measured from stored serum. Patients were followed for new events of cardiovascular disease (CVD), end-stage renal disease (ESRD), severe hypoglycaemia and all-cause death until June 2017.
Results: At baseline, patients with LADA (mean age: 43.4 years, median diabetes duration: 6.0 years) had lower serum C-peptide, BMI and triglyceride but higher HbA1c than patients with type 2 diabetes (mean age: 41.7 years, median diabetes duration: 8.0 years). Use of insulin was more frequent in those with LADA whilst use of non-insulin glucose lowering drugs was comparable. Over follow-up period of 10 years, incidence (in 1000 person-year) of CVD, ESRD, severe hypoglycaemia and death were 4.1, 8.0, 20.2 and 5.5 in LADA, and 10.4, 9.5, 10.8 and 8.8 in type 2 diabetes, respectively. Using Cox regression, patients with LADA had lower hazard to have CVD (hazard ratio [HR] 0.41 [95% CI 0.19-0.89], p=0.024), higher hazard to have severe hypoglycaemia (HR 1.74 [95% CI 1.15-2.62], p=0.008) and similar risks for ESRD and mortality compared with type 2 diabetes, adjusted for age, gender, disease duration, smoking, glycaemic and metabolic indices, and baseline insulin use.
Conclusions: Patients with LADA had lower risks of CVD but higher risks of severe hypoglycaemia than type 2 diabetes.

Disclosure
A. Luk: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc.. Research Support; Self; Sanofi. E.S. Lau: None. C.K.P. Lim: None. E. Chow: Research Support; Self; Sanofi. R.C. Ma: Research Support; Self; AstraZeneca, Bayer AG, Merck Sharp & Dohme Corp., Pfizer Inc.. Advisory Panel; Self; Boehringer Ingelheim GmbH, Nippon Boehringer Ingelheim Co. Ltd. A.P. Kong: Research Support; Self; AstraZeneca. J.C. Chan: Consultant; Self; Bayer AG. Other Relationship; Self; Bayer AG. Consultant; Self; Sanofi. Other Relationship; Self; Sanofi, Eli Lilly and Company, Amgen Inc.. Consultant; Self; AstraZeneca, Merck & Co., Inc., Pfizer Inc.. Other Relationship; Self; Pfizer Inc.. Board Member; Self; Asia Diabetes Foundation. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; Merck Sharp & Dohme Corp.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novartis AG, Eli Lilly and Company.
Cutaneous Reactions to Continuous Glucose Monitoring and Continuous Subcutaneous Insulin Infusion Devices in Type 1 Diabetes
Authors: SEVERIN RACHEL K. , GANDICA RACHELLE , LEVIN LAURA E. , BELSITO DONALD V. , GARZON MARIA C. , WILLIAMS KRISTEN M. 
Published: June 2018

Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) are the standard of care for type 1 diabetes (T1D). There is little reported on skin complications related to these devices. This study documents cutaneous reactions to CGM and CSII devices in children and young adults with T1D.
121 subjects (3-25 years) with T1D and CGM and/or CSII use were recruited over a 3-month period from the Naomi Berrie Diabetes Center at Columbia University Medical Center. A 5-question survey was completed for each subject detailing demographic data and device-related skin problems.
60% of subjects reported skin problems related to CGM and/or CSII use. Terms most frequently used to describe their reactions were red, itchy, painful, and rash. Subjects who used both CGM and CSII were more likely to report skin problems than those who used only CSII (OR [2.9]; p=0.015; 95% CI [1.2, 6.7]). There were no associations between skin problems and age, sex, or race/ethnicity.
22% of subjects with an adverse skin event discontinued use of their device due to their skin problem. 7% were evaluated by a dermatologist. 81% used a range of products to treat their symptoms, with variable perceived clinical effects.
Skin complications related to CSII or CGM devices are common, and may lead to interruption or discontinuation of treatment. Future studies to elucidate the causes are needed.
Table 1Supplemental Products Used By Patients: Effects on Skin ProblemsProduct categoryPatients using products in category (n)Patients reporting clinical improvement (%)Patients reporting no change (%)Patients reporting clinical worsening (%)Patients reporting discordant effects (%)Adhesive barrier wipe2726% (7/27)48% (13/27)11% (3/27)15% (4/27)Transparent film dressing2733% (9/27)48% (13/27)11% (3/27)7% (2/27)Topical steroid2277% (17/22)18% (4/22)0% (0/22)5% (1/22)Adhesive bandage1315% (2/13)54% (7/13)23% (3/13)8% (1/13)Hydrocolloid adhesive pad1369% (9/13)15% (2/13)15% (2/13)0% (0/13)Topical antibiotic1182% (9/11)18% (2/11)0% (0/11)0% (0/11)Adhesive remover1050% (5/10)40% (4/10)10% (1/10)0% (0/10)

Disclosure
R.K. Severin: None. R. Gandica: None. L.E. Levin: None. D.V. Belsito: None. M.C. Garzon: None. K.M. Williams: None.
Nutrient-Dependent Association of Cdk5 Regulatory Associated Protein 1-Like 1 Gene with Insulin Secretion
Authors: MIZUSHIRI SATORU , DAIMON MAKOTO , MURAKAMI HIROSHI , KAMBA AYA , OTAKA HIDEYUKI , MURABAYASHI MASAYA 
Published: June 2018

Objective: Since type 2diabetes (DM) is a life-style related disease, life-style should be considered, when association between genetic factors and DM are examined. However, most studies did not examine genetic associations with such consideration, as the case of Cdk5 regulatory associated protein 1-like 1 (CDKAL1) gene, whose reduced activity in β-cell was shown to reduce insulin secretion. Only a study examined association of CDKAL1 polymorphism and glucose tolerance in consideration with a life-style related factor (energy intake) with significant interaction between them. We here examined the association in consideration with the interaction between the gene polymorphism and various nutrient factors including Zn and Mg.
Research Design and Methods: Among participants of the population-based Iwaki study of Japanese held in 2014 to 2016, those with information of nutrient factors evaluated by a self-administered diet history questionnaire and CDKAL1 genotype (rs9465871: C/T) were included in the study (n=1656).
Results: Mean HbA1c levels in subjects with the CC genotype were significantly higher than those with the TT genotype (5.87±0.66 vs. 5.77±0.53, p&lt;0.02). Stratification based on the amount of each nutrient intake showed association of the CC genotype with lower insulin secretion evaluated based on C-peptide (CPI) and higher prevalence of DM in the highest tertile alone of fat intake (CC vs. CT+TT: 1.15±0.36 vs. 1.27±0.55, p&lt;0.01, 17.4% vs. 9.9%, p=0.02, respectively), and with lower insulin secretion and higher HbA1c levels in the higher half alone of Zn and Mg intake.
Conclusions: Association of CDKAL1 gene with DM seems to be dependent of nutrient intake such as fat, Mg, and Zn, which indicates interaction between CDKAL1 and nutrient factors on pathophysiology leading to DM.

Disclosure
S. Mizushiri: None. M. Daimon: None. H. Murakami: None. A. Kamba: None. H. Otaka: None. M. Murabayashi: None.
The Impact of Obesity and Lifestyle Status on Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes (T1D)
Authors: LAMPOUSI ANNA-MARIA , DELIS DIMITRIOS E. , XATZIPSALTI MARIA , VAZEOU ANDRIANI 
Published: June 2018

Cardiovascular disease is more frequent in patients with T1D than the general population. The aim of the study was to examine the impact of obesity, diet and physical activity (PA) on common cardiovascular risk factors in youth with T1D. Cross-sectional analyses were performed using data from 96 T1D subjects [mean age 13.4 ± 2.7 years, (females 57%), median disease duration 5.3 (range 3.5-8.4) years]. Dietary intake was evaluated by a single 24-hour dietary recall and a food frequency questionnaire (FFQ). Diet quality was assessed with the KIDMED test. The ENERGY-child questionnaire was used for the assessment of PA. Systolic (SBP), diastolic (DBP) blood pressure, HbA1c levels and lipid profile were evaluated. The prevalence of overweight/obesity was 31%. Overweight/obese individuals were in higher SBP percentile, compared to those with normal weight (68.59 ± 26.58 vs. 51.77 ± 26.72, P = 0.006). In multiple regression analysis, higher BMI z-score, was associated with higher ηbA1c (standardized β = 0.334, P = 0.002, R2 = 0.268) and higher triglycerides (standardized β = 0.224, P = 0.05, R2 = 0.095). Most participants (80%) abstained from optimal Mediterranean Diet (MD). Lower KIDMED score was associated with higher ηbA1c (standardized β = - 0.432 P &lt; 0.001, R2 = 0.268). Partial correlation analyses after controlling for confounding factors revealed that BMI z-score was negatively correlated with low fat dairy portions/d (r = - 0.315, P &lt; 0.05), HbA1c was positively correlated with high fat dairy portions/d (r = 0.305, P &lt; 0.05) and SBP percentile was negatively correlated with total milk and yogurt portions/d (r = - 0.313, P &lt; 0.05). Moreover, higher participation in sports (hours/week), was associated with lower DBP percentile (standardized β = - 0.283, P = 0.015, R2 = 0.080). The maintenance of a healthy body weight and a physically active lifestyle, was accompanied by lower BP levels in the participants of this study. Greater adherence to MD was associated with lower HbA1c.

Disclosure
A. Lampousi: None. D.E. Delis: None. M. Xatzipsalti: None. A. Vazeou: None.
Correlation between Niacin and Iron Consumption and Diabetes Prevalence among Different Sex, Age, and Ethnic Groups in the U.S.
Authors: ZHOU YIMING , CHEN NANA , LI DA , SUN WUPING , ZHOU SHI-SHENG 
Published: June 2018

Grain fortification with B vitamins (thiamin, riboflavin and niacin) and iron caused a significant increase in niacin and iron, which affect the body’s redox status and induce insulin resistance at high levels. The purpose of the present study was to investigate the correlation between the U.S. per capita niacin and iron consumption and the prevalence of type 2 diabetes by sex, age, and race.
The data on the per capita nutrient consumption in 1909-2010 were from the Economic Research Service (ERS) of the U.S. Department of Agriculture. The ERS data showed that the per capita consumption of niacin and iron has increased from 16 mg/d and 12.5 mg/d to 34 mg/d and 24.5 mg/d, respectively from 1930s to 1990s, and thereafter remained fairly constant. This increase was mainly contributed by fortified grains or refined grains.
The data of diabetes prevalence were from the Center for Disease Control (CDC). The data showed that the prevalence of diabetes begun to increase from 1960s, with two rapidly increasing periods: from 1960s to early-1970s, and from 1990 to the early-2010, especially in some Southern States (e.g., Mississippi, Alabama, and Louisiana, where grain fortification is mandatory), while the prevalence of diabetes remains relatively stable during the 1980s.
We found that the prevalence of diabetes in the U.S. was strongly correlated with the per capita niacin and iron consumption (both r &gt; 9.0). We further analyzed the correlations by age, sex, and race, and also found close correlations between the nutrient consumption and the prevalence of diabetes among sex groups, different racial groups, and different age groups.
In conclusion, excess niacin and iron intake may play an important role in the increased prevalence of type 2 diabetes in the U.S.

Disclosure
Y. Zhou: None. N. Chen: None. D. Li: None. W. Sun: None. S. Zhou: None.
Dietary and Media Habits of Young Children in Mumbai
Authors: NIJJAR JASREENA , REVETTE ANNA C. 
Published: June 2018

LMIC are increasingly affected by the obesity pandemic and, it is estimated that by year 2030, there will be 80 million people with diabetes in India. Of concern is the emerging threat of obesity and type 2 DM among children. In 2010, World Health Assembly recognized food marketing as a key determinant of childhood dietary patterns, yet few studies in India have assessed exposure to media as a key NCD risk behaviors among children. This qualitative study explores children’s dietary and media use patterns, and aims to identify the ways in which young children in Mumbai are exposed to food marketing. Interviews and focus groups were conducted in June 2017 with purposively sampled dyads that included children aged 7-12 years and their mothers (n=34) from low to middle-income communities in Mumbai. Analysis of data found that children frequently consume packaged food, and characterized it as their favorite type of food. Television proved to be an influential source of information for most children, with most watching between two and four hours during the weekdays. Children reported learning about new food products primarily from TV advertisements. Most children could acquire their favorite food, either by purchasing it themselves or by convincing family members. Use of other forms of media, such as computers, were less prevalent, but most children did report using a mobile phone, which most often belonged to a family member. Parents identified children’s preference for unhealthy food, cost, limited time as barriers to a healthy diet and reported conflicts with their children about food requests. Additionally, most parents confirmed that TV played a significant and negative role in these arguments. Changing food environments and replacement of traditional diets have been found to have deleterious consequences for children. Investing in understanding dietary behaviors and communication activities of young children in Mumbai will support the development of appropriate context-specific intervention strategies at this crucial age.

Disclosure
J. Nijjar: None. A.C. Revette: None.
Skipping Breakfast and Eating Fast Could Be Associated with Metabolic Syndrome—Clinical Cohort Study in Japan
Authors: SENBA HIDENORI , MIYAKE TERUKI , KURIHARA WATARU , SAKIKO YOSHIDA , YAMAMOTO SHIN , FURUKAWA SHINYA , ABE MASANORI , MATSUURA BUNZO , HIASA YOICHI 
Published: June 2018

Metabolic syndrome (MetS) has been reported to promote the development of atherosclerotic diseases and lower quality of life. Recently, it has also been reported that MetS could be a risk factor for some types of cancer, such as colon and pancreatic cancer. Several studies have reported that lifestyle, especially eating habits, was closely associated with metabolic diseases. However, the evidence among Japanese subjects is limited. We therefore conducted the present study to perform a cross-sectional evaluation of the relationship between eating habits and the prevalence of MetS among Japanese subjects. The present study included 6,925 Japanese subject (3,532 men and 3,393 women) who had undergone annual health checkups and received a questionnaire that included items on lifestyles such as frequency of skipping breakfast, pace of eating, usual physical activity, sleeping hours, alcohol consumption, and current smoking habits. MetS was diagnosed according to the criteria of the Japanese Society of Internal Medicine. To investigate the association between eating habits and MetS, we used multiple logistic regression analysis. Adjustments were made for age, sex, usual physical activity, sleeping hours, alcohol consumption, and current smoking habits. The results showed that skipping breakfast was positively associated with MetS; the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for MetS in relation to skipping breakfast on the items “eating every day,” “skipping about 3 days per week,” and “skipping almost every day” were 1.00 (reference), 1.22 (0.93-1.60), and 1.41 (1.12-1.79), respectively. Eating fast was also associated with the prevalence of MetS; the adjusted ORs and 95% CIs in relation to an eating pace of “more than 20 min,” “10-20 min,” and “ less than 10 min” were 1.00 (reference), 1.27 (1.02-159), and 1.61 (1.26 2-2.06), respectively. These results suggest that eating breakfast every day and eating slowly would be beneficial to prevent MetS.

Disclosure
H. Senba: None. T. Miyake: None. W. Kurihara: None. Y. Sakiko: None. S. Yamamoto: None. S. Furukawa: None. M. Abe: None. B. Matsuura: None. Y. Hiasa: None.
Predictive Utilities of Blood Pressure Variables on Coronary Artery Disease in Type 1 Diabetes
Authors: GUO JINGCHUAN , ORCHARD TREVOR J. 
Published: June 2018

The relative importance of different blood pressure indices on cardiovascular risk in type 1 diabetes (T1D) has not been established. We thus compared the strengths of associations between different baseline and most recent blood pressure measures (systolic pressure [SBP], diastolic pressure [DBP], pulse pressure [PP], mean arterial pressure [MAP], and mid-blood pressure [Mid-BP, the average of SBP and DBP]) and the 25-year risk of coronary artery disease (CAD) in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study of childhood onset T1D (N=605, without baseline CAD). CAD was defined as fatal coronary artery event, non-fatal myocardial infarction, angina, revascularization, or ischemic ECG. Baseline mean age and diabetes duration were 27 and 19 years, respectively. In Cox Proportional Hazards modes, the baseline age-adjusted hazard ratios (HR) associated with one increment in SD for the risk of CAD events (n=219) were 1.49 (95% CI: 1.31, 1.70) for SBP; 1.46 (1.28, 1.67) DBP; 1.26 (1.09, 1.46) PP; 1.50 (1.32, 1.71) MAP and 1.51 (1.32, 1.71) for Mid-BP. There was an interaction between PP and HbA1c that the age-adjusted HR of PP was 1.20 (0.99, 1.45) and 1.38 (1.07, 1.77) in those with HbA1c ≤ 9 and &gt; 9%, respectively. Though area under the receiver operating characteristic curve (AUC) was significantly lower for PP compared with the other four BP indices in overall subjects, the predictive utility of PP for CAD becomes similar to that of other indices in those with higher HbA1c levels (&gt;9 %). Using the most recent data and adjusting for age, the predictive value of SBP was superior to DBP (∆ AUC=0.037, p=.006), MAP (∆ AUC=0.021, p=.018), and Mid-BP (∆ AUC=0.014, p=.031), but not PP (∆ AUC=0.007, p=.552). In sum, SBP appears to be the strongest determinant of CAD risk in T1D patients overall but PP becomes a determinant as strong as SBP in older age and in those with worse glycemic control, consistent with PP reflecting vascular stiffness.

Disclosure
J. Guo: None. T.J. Orchard: None.
Comorbidity of Diabetes and Chronic Sleep Disturbances and Consumption of a Mediterranean-Style Diet
Authors: GUYER HEIDI 
Published: June 2018

Objective: This study assessed whether comorbidity of diabetes and chronic sleep disturbances was associated with less healthy dietary consumption, defined as a Mediterranean-style Diet, compared to adults with only one or neither of the conditions.
Research Design and Methods: Participants were selected from the Health and Retirement Study (HRS). Diabetes status and chronic sleep disturbances were assessed during the 2010 interview. Participants were categorized into one of four groups: no sleep disturbances or diabetes, sleep disturbances, diabetes, or sleep disturbances and diabetes. 7,423 participants completed a food frequency questionnaire by mail from which the alternative Mediterranean Diet (aMedDiet) score was assessed. Logistic regression was used to determine the odds of consuming an aMedDiet based on comorbidity of diabetes and chronic sleep disturbances. Models were stratified by gender.
Results: After adjusting for age and caloric intake, men with diabetes were more likely to consume an aMedDiet in the highest quartile (OR 1.45; 95% CI 1.11-1.91) than men with neither chronic sleep disturbances nor diabetes. The magnitude of the association increased after adjustment for additional demographic and health variables (OR 1.70, 95% CI 1.25-2.29). Women with sleep disturbances were less likely to consume an aMedDiet than those without sleep disturbances. The reduction in the odds of consuming an aMedDiet was greatest among women with comorbidity of the two conditions (OR 0.53, 95% CI 0.37-0.77) yet was also significant among those with chronic sleep disturbances alone (OR sleep disturbances 0.71, 95% CI 0.56-0.90). The results in women were attenuated after multivariate adjustment.
Conclusion: Chronic sleep disturbances reduce healthy dietary intake in adults with diabetes.

Disclosure
H. Guyer: None.