bluuebunny/crossref_metadata_2025_split huggingface dataset:
2395-PUB: Is Drug Treatment Required in All Youth with T2D Early in the Disease?
Authors: TAMBORLANE WILLIAM V. , CHENG PEIYAO , GAL ROBIN L. , BEAULIEU LINDSEY C. , KOLLMAN CRAIG , VAN NAME MICHELLE A. , ISGANAITIS ELVIRA M. , MASTRANDREA LUCY D. , KLINGENSMITH GEORGEANNA J. 
Published: June 2019

Background: While consensus guidelines indicate that all youth with T2D should be treated with metformin ± insulin at diagnosis, &gt;10% of patients were treated solely with diet/lifestyle on enrollment in the Pediatric Diabetes Consortium (PDC) T2D Registry.
Methods: Clinical data was collected on 1,324 Registry patients (age 6 to &lt;21 years) from medical records and interviews. Data in patients not receiving drug treatment were compared to those receiving antidiabetic drug treatment using logistic regression models.
Results: Of the 1,324 Registry patients, 163 (12%) were treated with diet/lifestyle alone on enrollment. Of these, 73% of were initially treated with metformin ± insulin at diagnosis. The diet/lifestyle and drug-treated groups did not differ by age, gender, diabetes duration, or BMI (Table). However, mean A1c was lower and the proportion of patients with A1c &lt;7.5% was higher in the diet/lifestyle alone group compared to the drug-treated group at enrollment and diagnosis (p&lt;0.001, Table). There were site differences in prescribing drug-treatment (p&lt;0.001) and a greater proportion of patients in the diet/lifestyle alone group were without health insurance.
Conclusion: These data indicate that a substantial proportion of youth with T2D can maintain target A1c levels &lt;7.5% despite being weaned off glucose lowering drugs during the first 1-2 years after diagnosis

Disclosure
W.V. Tamborlane: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic MiniMed, Inc., Novo Nordisk Inc., Sanofi, Takeda Pharmaceutical Company Limited. P. Cheng: None. R.L. Gal: None. L.C. Beaulieu: None. C. Kollman: None. M.A. Van Name: Research Support; Self; Novo Nordisk Inc. E.M. Isganaitis: None. L.D. Mastrandrea: Advisory Panel; Self; Pediatric Diabetes Consortium. Research Support; Self; AstraZeneca, JDRF, Novo Nordisk Inc., Sanofi-Aventis, T1D Exchange. Other Relationship; Self; Novo Nordisk Inc. G.J. Klingensmith: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Takeda Pharmaceutical Company Limited. Research Support; Self; Novo Nordisk Foundation. Stock/Shareholder; Spouse/Partner; Dexcom, Inc.

Funding
Boehringer Ingelheim; Novo Nordisk; Takeda Pharmaceutical Company Limited
2401-PUB: High Rates of Unrecognized Ketosis in Youth with T1D and Elevated A1c Levels
Authors: NALLY LAURA M. , ELAHI SHABNAM , VAN NAME MICHELLE A. , STEFFEN AMY , TICHY EILEEN M. , URBAN ANDREA DANN , WEYMAN KATE , TAMBORLANE WILLIAM V. 
Published: June 2019

Youth with type 1 diabetes (T1D) who have A1c levels ≥ 9% have a 13-fold higher rate of diabetic ketoacidosis (DKA) than youth with A1c &lt;7.5% and the rate of DKA is 2-fold higher with multiple daily injections (MDI) than with pump therapy. However, the frequency of mild to moderate ketosis (the gateway to DKA in these high-risk patients) is largely unknown and such knowledge is essential to evaluate strategies aimed at DKA prevention.
Methods: Youth ages 8-18 years with uncontrolled T1D (A1c&gt; 8.5%) on MDI treatment were enrolled in the study. Blood glucose (BG) and blood β-hydroxybutyrate (BHB) levels were measured by school personnel in the AM on arrival to school.
Results: 14 patients (age 15 ± 2.3 years) enrolled in the study had A1c 10.7 ± 1.5% (range 8.8 - 14.0%). BHB or urine ketones were measured on 125 school days; ketone levels were small (0.6-0.9 mmol/L) on 6.4% of days (mean BHB 0.7+0.1 mmol/L) and moderate/large (&gt;0.9 mmol/L) on 10.4% of days (mean BHB 2.1+1.4 mmol/L) (Figure). BG ranged between 147 to &gt;600 mg/dL on days with elevated BHB levels; all were without other signs or symptoms of DKA.
Conclusions: Unrecognized mild to moderate ketosis during regular school attendance is common in youth with uncontrolled T1D on MDI therapy. Novel strategies, such as having school personnel supervise injections of long-acting basal insulin, are needed to support reliable insulin dosing to prevent ketosis in youth with uncontrolled T1D at risk for DKA

Disclosure
L.M. Nally: None. S. Elahi: None. M.A. Van Name: Research Support; Self; Novo Nordisk Inc. A. Steffen: None. E.M. Tichy: None. A.D. Urban: None. K. Weyman: None. W.V. Tamborlane: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic MiniMed, Inc., Novo Nordisk Inc., Sanofi, Takeda Pharmaceutical Company Limited.

Funding
Novo Nordisk
2417-PUB: High-Risk of Metabolic Syndrome after Delivery in Pregnancies Complicated by Gestational Diabetes
Authors: HU GANG , LI WEIQIN , LENG JUNHONG , SHEN YUN , ZHANG SHUANG , LIU HUIKUN , LI WEI , WANG LEISHEN , TIAN HUIGUANG , CHEN JINBO , QI LU , YANG XILIN , YU ZHIJIE , TUOMILEHTO JAAKKO 
Published: June 2019

The objective of this study was to investigate the risk of postpartum metabolic syndrome in women with GDM compared with those without GDM in a Chinese population. Tianjin GDM observational study included 1263 women with a history of GDM and 705 women without GDM. Multivariate logistic regression was used to assess risks of postpartum metabolic syndrome between women with and without GDM. Postpartum metabolic syndrome was diagnosed by two commonly used criteria. During a mean 3.53 years of follow-up, 256 cases of metabolic syndrome were identified by using the NCEP ATPIII criteria and 244 cases by using the IDF criteria. Multivariable-adjusted odds ratios of metabolic syndrome in women with GDM compared with those without GDM were 3.66 (95% confidence interval [CI] 2.02-6.63) for NCEP ATPIII criteria and 3.90 (95% CI 2.13-7.14) for IDF criteria. Women with GDM had higher multivariable-adjusted odds ratios of central obesity, hypertriglyceridemia, and high blood pressure than women without GDM. The multivariable-adjusted odds ratios of low HDL cholesterol and hyperglycemia were not significant between women with and without GDM, however, the multivariable-adjusted odds ratio of hyperglycemia became significant when we used the modified criteria. The present study indicated that women with prior GDM had significantly higher risks for postpartum metabolic syndrome, as well as its individual components.

Disclosure
G. Hu: None. W. Li: None. J. Leng: None. Y. Shen: None. S. Zhang: None. H. Liu: None. W. Li: None. L. Wang: None. H. Tian: None. J. Chen: None. L. Qi: None. X. Yang: None. Z. Yu: None. J. Tuomilehto: Advisory Panel; Self; Novo Nordisk A/S. Board Member; Self; AstraZeneca. Research Support; Self; Bayer AG.

Funding
European Foundation for the Study of Diabetes; Chinese Diabetes Society; Lilly Program for Collaborative Diabetes Research between China and Europe; Tianjin Women’s and Children’s Health Center; Tianjin Public Health Bureau; National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100790 to G.H.); National Institute of General Medical Sciences (U54GM104940 to G.H.)
2420-PUB: Demographics of Women with Type 2 Diabetes Attending a Diabetes and Pregnancy Clinic, 2000-2002, 2010-2012, and 2014-2016
Authors: CHOW LINDSEY , ANUKAM KINGSLEY , KHANNA PARUL , BRYDGES EVAN , LIU SELINA L. , MAHON JEFFREY , JOY TISHA R. , MCMANUS RUTH M. 
Published: June 2019

Background: The numbers of women attending Diabetes and Pregnancy Clinics (DPC) are increasing. Some of the increase may reflect obesity effects on GDM prevalence, but numbers and characteristics of women with type 2 (T2DM) diabetes are unknown. The DPC in London Ontario sees all pregnant women with diabetes within the catchment area with stable clinic structures and procedures. Longitudinal characteristics of women with T2DM were documented for demographic insights.
Methods: DPC pregnancy charts were assessed for 2000-2002, 2010-2012 and 2014-2016. Data were abstracted for: age; weight, A1C and medication use. Continuous results were analyzed by one-way analysis of variance (ANOVA); non-parametric results by Chi-square testing; p≤ 0.05 signifying significance.
Conclusions: Numbers of pregnant women with T2DM increased significantly by 40% with time. Mean weights were lower in the second and third time interval. A1C values were lower by final visit in all time periods. Oral agent use increased in the final time period coincident with increased clinical comfort using metformin.

Disclosure
L. Chow: None. K. Anukam: None. P. Khanna: None. E. Brydges: None. S.L. Liu: Consultant; Self; Novo Nordisk Inc., Sanofi. Research Support; Self; Physicians' Services Inc. Foundation. J. Mahon: None. T.R. Joy: Speaker's Bureau; Self; Amgen Inc., Novo Nordisk Inc., Sanofi. Other Relationship; Self; Amgen Inc., AstraZeneca, Novo Nordisk Inc. R.M. McManus: None.
243-OR: ADA Presidents' Select Abstract: Dapagliflozin Reduces Measured GFR by Reducing Renal Efferent Arteriolar Resistance in Type 2 Diabetes
Authors: VAN BOMMEL ERIK J. , MUSKIET MARCEL A. , VAN BAAR MICHAEL JACOBUS , KRAMER MARK H. , NIEUWDORP MAX , JOLES JAAP A. , VAN RAALTE DANIËL H. 
Published: June 2019

Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) improve hard renal outcomes in type 2 diabetes (T2D) patients. An acute and reversible drop in eGFR that stabilizes over time, as with RAS inhibitors, suggests involvement of a beneficial renal hemodynamic mechanism. In hyperfiltering T1D patients, SGLT2i lowered GFR by increasing afferent arteriolar resistance, possibly by activating tubuloglomerular feedback. We studied the renal hemodynamic effects of SGLT2i dapagliflozin in T2D patients like those included in recent outcome trials.
Methods: Forty-four T2D patients on metformin monotherapy, (62.9±7.0 years, HbA1c 7.38±0.63%, GFR 113±19 mL/min) were randomized to 12 weeks dapagliflozin 10mg (DAPA, n=24) or gliclazide 30mg (GLIC, n=20) QD to achieve glycemic equipoise. At baseline and week 12, GFR and renal plasma flow (RPF) were measured by gold-standard inulin and para-aminohippurate clearances. The measurements were performed 1) in the fasting state, 2) during clamped euglycemia (90 mg/dL) and 3) hyperglycemia (270 mg/dL). Renal vascular resistance (RVR) and filtration fraction (FF) were calculated using GFR, RPF, Ht and MAP. Afferent and efferent arteriolar resistances were estimated by Gomez’ equations.
Results: HbA1C decreased similarly (0.47% with DAPA and 0.65% with GLIC; p=ns), while only DAPA significantly reduced MAP by approximately 6 mmHg. DAPA reduced GFR during all three conditions by 8.9 (p&lt;0.01), 9.0 (p=0.01) and 13.4 mL/min (p&lt;0.001), respectively, without altering RPF, thus also reducing FF. Importantly, DAPA lowered RVR and efferent arteriolar resistance. GLIC did not alter any renal hemodynamic variables.
Conclusion: We confirm that SGLT2i induces beneficial renal hemodynamic changes in T2D beyond glycemic control that are characterized by reduced GFR and FF. However, in contrast to standing opinion, this is mediated by efferent arteriolar dilation rather than afferent arteriolar constriction.

Disclosure
E.J. van Bommel: None. M.A. Muskiet: Consultant; Self; Eli Lilly and Company, Novo Nordisk A/S, Sanofi. M.J. van Baar: None. M.H. Kramer: None. M. Nieuwdorp: Advisory Panel; Self; Caelus health. J.A. Joles: None. D.H. van Raalte: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Merck Sharp & Dohme Corp., Sanofi. Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Merck Sharp & Dohme Corp., Sanofi.

Funding
AstraZeneca Nederland BV
2439-PUB: Ethnic Differences in Plasma Glucose on Emergency Admission to Hospital in People with No Prior Diagnosis of Diabetes
Authors: GHOSH SANDIP , SUSARLA RADHIKA , ROUND RACHEL A. , NIGHTINGALE PETER , WILLIAMS JOHN A. , STRATTON IRENE M. , GKOUTOS GEORGIOS , WEBBER JONATHAN , HANIF WASIM , ROBERTS GRAHAM , MANLEY SUSAN E. 
Published: June 2019

Objective: Glucose is measured on hospital admission as an emergency as elevated glucose is associated with an eight-fold risk of dying in hospital. This study reports on admission plasma glucose by ethnicity in people without prior diabetes.
Research Design and Methods: A clinical audit CARMS-12031 of electronic patient records for 113,097 admissions to hospital over 1 year from April 2014 to March 2015 identified 43,201 emergency admissions with glucose unavailable for 11,274 (26%). Of 5,867 admissions with prior diabetes coding, 5,523 (94%) had glucose recorded. First attendances were analyzed for emergency admissions with no record of diabetes.
Results: Of these 18,965 people admitted, 75% were White Europeans WE who were older than South Asians SA 12%, unknown/other ethnic groups U 9%, and Afro-Caribbeans AC 4%. 1,003 people admitted as an emergency had glucose in ‘diabetes range’ (≥11.1mmol/L) and 3,042 in ‘at risk’ range (7.8 to 11.0mmol/L). More SA 8% had glucose in diabetes range than WE 5% and also than U 5%; there were significantly more WE 17% in ‘at risk’ range than U 14% or AC 11%. Higher glucose was observed in SA and U men than women, p = 0.005 and p = 0.018, respectively.
Conclusions: Protocols should target people requiring additional HbA1c testingto diagnose undiagnosed diabetes on hospital admission especially younger SA and AC individuals, and outline appropriate clinical intervention.

Disclosure
S. Ghosh: Advisory Panel; Self; Abbott. Other Relationship; Self; Mylan. R. Susarla: None. R.A. Round: None. P. Nightingale: None. J.A. Williams: None. I.M. Stratton: Consultant; Self; Novo Nordisk A/S. Research Support; Self; Bayer AG, Boehringer Ingelheim International GmbH. G. Gkoutos: None. J. Webber: None. W. Hanif: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Consultant; Self; Novo Nordisk A/S. Research Support; Self; AstraZeneca, Janssen Diagnostics, Sanofi. Speaker's Bureau; Self; AstraZeneca, Novartis AG, Novo Nordisk A/S. G. Roberts: None. S.E. Manley: None.
2444-PUB: Bone Mineral Density and Bone Biomarkers in Women with Type 2 Diabetes Mellitus of Buryat Ethnic Group
Authors: BARDYMOVA TATIANA , MISTIAKOV MAKSIM , BEREZINA MARINA , TSYRETOROVA SESEG , VELM VLADIMIR 
Published: June 2019

There is a difference of bone tissue state of women belonging to various ethnic groups. We have conducted a study of bone tissue state among postmenopausal women of Buryat origin. Buryats are a main northern group of Mongolians, they are a core population of Siberia with a compact residence close to Lake Baikal. We have examined the associations between bone mineral density (BMD), trabecular bone score (TBS) and bone biomarkers in 17 postmenopausal women with T2D (59 years, diabetes duration 5.2 years, A1c &lt;8.0%) and 21 postmenopausal women without diabetes (56 years). Collagen type 1 cross-linked C-telopeptide (CTX), 25-hydroxyvitamin D, ionized calcium (iCa), femoral neck BMD were similar between two groups. T2D postmenopausal women had lower osteocalcin (OC), procollagen type 1 N propeptide (P1NP), TBS and higher BMD total hip, BMD lumbar spine 1-4 (L1-L4) compared to the controls (Table). Total hip BMD in women with T2D was associated with body mass index (BMI). TBS was positively correlated with iCa. Twenty-five-hydroxyvitamin D was associated with lower OC, P1NP and CTX. Total hip BMD and BMD L1-L4 were positively correlated with BMI in women without diabetes. Femoral neck BMD was positively correlated with P1NP and inversely correlated with women’s age. T2D in Buryat women is associated with low levels of osteosynthesis markers, TBS and higher BMD. TBS was positively correlated only with iCa.

Disclosure
T. Bardymova: None. M. Mistiakov: None. M. Berezina: None. S. Tsyretorova: None. V. Velm: None.
2448-PUB: A Diagnostic Data-Based Comparative Analysis of Patterns of Uropathogens and Their Antimicrobial Sensitivity Status against Commonly Used Antibiotics
Authors: SINGH MANMOHAN , THAKUR RAJAT 
Published: June 2019

Background: Urinary tract infections are common among diabetic patients. High antimicrobial resistance of urinary pathogens against commonly used antimicrobial agents made it very difficult to treat these infections. This analysis was conducted to assess patterns of urinary pathogens among diabetes and nondiabetes patients and to assess their antimicrobial sensitivity patterns against commonly used antibiotics.
Methods: Big diagnostic data of urinary cultures from 56 diagnostic labs across 21 states in India was analyzed to assess patterns of urinary pathogens among diabetic and nondiabetic patients. Diagnosis of diabetes was ascertained by using ADA criteria. Culture positivity rate and overall antimicrobial resistance status are compared between diabetics and nondiabetics.
Results: There were 51,907 urine samples, in which culture and sensitivity test was done. Proportion of diabetics was 24.8%. Culture positivity rate was 15.0% overall. Diabetes patients have statistically significant (p&lt;0.05) high positivity rate (20.3%) in comparison to nondiabetics (13.2%). Urinary isolates (overall) from diabetics have low sensitivity than nondiabetics against common antibiotics. Sensitivity of isolates among diabetics was significantly (p&lt;0.05) low than nondiabetics for amoxicillin, amoxicillin-clavulanic acid, ampicillin, meropenem, imipenem, nitrofurantoin, cotrimoxazole, ciprofloxacin, levofloxacin, ampicillin, cefepime, cefixime, cefotaxime, cefuroxime, ceftriaxone and norfloxacin but not for fosfomycin and cotrimoxazole. Overall sensitivity for carbapenems and fosfomycin was &gt;80% among both categories of patients, while it was &lt;80% for all other antibiotics mentioned above.

Disclosure
M. Singh: None. R. Thakur: None.
2454-PUB: Hypoglycemic Symptoms in the Absence of Diabetes: Pilot Evidence of Clinical Hypoglycemia in Young Healthy Women
Authors: MONGRAW-CHAFFIN MORGANA , MCCLAIN DON , BEAVERS DANIEL P. 
Published: June 2019

Background: Hypoglycemic symptoms in the absence of diabetes remains a common complaint in endocrinology practices, but remains understudied and lacks clinical definition and evidence-based recommendations for diagnosis or treatment. Our goal was to pilot test the concordance of hypoglycemic symptoms with low glucose values in young healthy individuals.
Methods: We recruited 8 individuals who reported regularly experiencing symptoms consistent with hypoglycemia to wear a blinded Dexcom continuous glucose monitor and report symptoms for seven days. We excluded individuals with diabetes or other known causes of hypoglycemia.
Results: All participants experienced glucose values &lt;70mg/dL and half (4/8) experienced glucose &lt;50mg/dL for at least 15 minutes or 3 consecutive readings. Lower glucose values were significantly associated with higher odds of experiencing hypoglycemic symptoms (OR=1.15 (1.06-1.24) for every 5mg/dL, p&lt;0.001) from mixed effects models for repeated measures (Figure). All participants also reported reduced quality of life and engaging in potentially obesogenic behaviors in order to avoid symptoms.
Conclusions: Individuals with hypoglycemic symptoms in the absence of diabetes experience clinical hypoglycemia, indicating the need to understand the etiology, behavioral responses, and other health risks that might be associated with this condition.

Disclosure
M. Mongraw-Chaffin: None. D. McClain: None. D.P. Beavers: None.

Funding
National Center for Advancing Translational Sciences (UL1TR001420)
2488-PUB: The Role of GLP-1 in Metabolic Responses during Sepsis
Authors: DAVIS ELLEN M. , HUTCH CHELSEA , KIM KI-SUK , MAERZ BASMA , LEHRKE MICHAEL , SANDOVAL DARLEEN A. 
Published: June 2019

Sepsis is characterized by a dysregulated immune response that can result in end organ damage and is the number one cause of death in the ICU. Among the hormones that are altered by sepsis, there is an increase in the gut peptide glucagon-like peptide-1 (GLP-1). Traditionally, GLP-1 is important for regulating glucose homeostasis and has previously been linked to appetite inhibition. However, its function during sepsis remains unknown. GLP-1 is coded by the preproglucagon gene (Gcg) and is expressed not only by intestinal endocrine cells but also in pancreatic α-cells. Previously, we have shown increases in plasma GLP-1 in response to LPS are contributed to by both pancreatic and intestinal sources and that either pancreatic or intestinal sources of GLP-1 are sufficient to maintain glucose responses to LPS. Because T2DM patients have an increased susceptibility to sepsis, the goal of this study was to determine if high-fat diet and impaired glucose tolerance change the metabolic or appetitive inhibition response during sepsis. To model sepsis, we administered lipopolysaccharide (LPS) to C57BL/6 mice who had been on high-fat diet (HFD) or chow for 12 weeks. We observed that compared to vehicle treatment, LPS significantly increased plasma levels of GLP-1 in both HFD and chow-fed mice, but plasma GLP-1 was significantly higher in HFD mice compared to chow-fed. HFD mice also had a greater decrease in glucose in response to LPS. Furthermore, we observed that HFD mice had increased and prolonged appetite inhibition in response to LPS. Future directions will explore tissue-specific changes in GLP-1 response, source, and effectiveness during sepsis under the conditions of high-fat diet and impaired glucose control.

Disclosure
E.M. Davis: None. C. Hutch: None. K. Kim: None. B. Maerz: None. M. Lehrke: Consultant; Self; Boehringer Ingelheim International GmbH, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi-Aventis. D.A. Sandoval: Research Support; Self; MedImmune, Novo Nordisk A/S, Zafgen, Inc.
251-LB: Identification of Antibodies to Hybrid Insulin Peptides (HIPs) in T1D
Authors: GU YONG , WENZLAU JANET M. , MICHELS AARON W. , REWERS MARIAN , HASKINS KATIE , YU LIPING 
Published: June 2019

Hybrid insulin peptides (HIPs) are unique post-translationally modified antigens whereby derivatives of proinsulin (PI) form peptide bonds with endogenous granule peptides. HIPs have been identified in mouse β-cell extracts and human islets by mass spectrometry. Diabetogenic CD4 T cell clones in NOD mice and CD4 T cells from T1D patients are stimulated by HIP ligands and imply that HIPs may also serve as epitopes for humoral immunity. To identify and characterize antibodies (Abs) targeting HIPs among T1D individuals and evaluate their utility as biomarkers, a sensitive and specific ECL-based HIP Ab assay was adapted from the hallmark ECL-IAA protocol. The key determinant for the HIP-Ab assay was design and implementation of a conformational HIP protein probe reflecting derivatives of the HIPs capable of eliciting an antigenic response in CD4 T cell lines from T1D individuals and NOD mice. Sera from a new onset T1D cohort using a PI/IAPP HIP probe showed the presence of anti-PI/IAPP Abs (32.2%, 58/180). However unexpected prevalence was measured among control (18.8%, 18/96) and T2D (25.9%, 29/112) sera samples even when the data was stratified according to HLA genotype. These HIP-Ab epitopes are both conformation and HIP-sequence specific as they are pre-absorbed only with refolded PI/IAPP, but not alternate or random HIPs, linear PI/IAPP HIPs or cyclic PI/IAPP peptides. In sera from prediabetic subjects from the DAISY cohort, 7 of 22 (31.8%) display a peak of HIP-Abs that appears prior to the peak of IAA autoAbs in most cases (87.5%, 7/8). Large number of individuals have PI/IAPP-specific Abs in their circulation, irrespective of T1D disease state or risk. Although HIP-Abs are pervasive and emerge early in the disease process in prospectively followed at risk prediabetic individuals, they are not predictive of disease. As the appearance of PI/IAPP HIP-Abs typically precedes IAAs, it is possible that Abs to other HIPs may serve as earlier biomarkers for ensuing disease.

Disclosure
Y. Gu: None. J.M. Wenzlau: None. A.W. Michels: Stock/Shareholder; Self; IM Therapeutics. M. Rewers: None. K. Haskins: None. L. Yu: None.