bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Social Networks and Physical Activity Performed in the Management of Patients at Risk for Diabetic Foot—A Pilot Study
Authors: FRANCIA PIERGIORGIO , TEDESCHI ANNA , GULISANO MASSIMO , IANNONE GIULIA , VITTORI ALESSANDRO , SANTOSUOSSO UGO , PATERNOSTRO FERDINANDO , ANICHINI ROBERTO 
Published: June 2018

Considering that the knowledge and control of the daily physical activity performed (PAP) is an important element in the management of patients with history of foot ulcers, peripheral neuropathy and/or peripheral vascular disease (at risk), the analysis of the social network map (SNM) perceived by themselves directly could also provide useful information to manage their diabetes. This study aimed to verify the possibility to evaluate the presence of a relationship between the characteristic of the SNM perceived and the PAP in addition to the metabolic control maintained in patients with longstanding diabetes mellitus at risk of foot ulcer. Interviews were conducted in 27 people: 10 patients: (males/females:6/4), mean age 56,2±16,7 years, duration of diabetes 18,3±10,3 years, mean HbA1c 8,0±1,1%, body mass index (BMI) 27,0±4,1 kg/m2, and in 17 age, sex and BMI matched nondiabetic controls. Participants were asked to fill in an egocentric SNM, which was divided into 5 areas: leisure and PAP, family, job, health care, and other. It was assigned a value ranging from 0 (none) to 5 (maximum) to define the importance and frequency of the relationships reported. The PAP was evaluated by the International Physical Activity Questionnaire-Short Form (IPAQ). In the patient group the duration of the disease was directly correlated with the health area (r = 0.83, p &lt;0.1) while the level of physical activity reported (IPAQ) was inversely correlated with the family area (r = -0.74; p &lt;0.01). The importance of friendly societies reported was lower in the patient group (1.0 ± 2 vs. 3.8 ± 1.5; p &lt;0.01) while the area of leisure activities was inversely correlated with metabolic control (r = -0.65; p &lt;0.05) and directly correlated with disease duration (r = 0.75; p &lt;0.01). The results of this pilot study showed that the analysis of patients’ SNM could improve knowledge and therefore provide additional information useful for better management of these patients.

Disclosure
P. Francia: None. A. Tedeschi: None. M. Gulisano: None. G. Iannone: None. A. Vittori: None. U. Santosuosso: None. F. Paternostro: None. R. Anichini: Advisory Panel; Self; Abbott. Speaker's Bureau; Self; Novartis Pharmaceuticals Corporation, Boehringer Ingelheim GmbH. Advisory Panel; Self; Eli Lilly and Company, AstraZeneca. Speaker's Bureau; Self; Merck & Co., Inc., Takeda Development Centre Europe Ltd.. Advisory Panel; Self; Sanofi, Janssen Pharmaceuticals, Inc.. Research Support; Self; Grünenthal Group.
Air Pollution Exposure during Pregnancy and Lactation Induces Obesity and Glucose Intolerance in the Offspring
Authors: ZORDÃO OLIVIA P. , CLARO LAÍS W. , SALDIVA PAULO , DONATO JOSE , VERAS MARIANA , PRADA PATRICIA O. 
Published: June 2018

Air pollution has been a very significant environmental cause of diseases globally. Fine particulate matter (PM2.5) is one of the most toxic substances in air pollution and is associated with type 2 diabetes mellitus risk. However, there is a gap in knowledge regarding the effects of air pollution exposure on insulin resistance and obesity development. We aimed to investigate whether 3 months of PM2.5 exposure induces obesity, hypothalamic leptin resistance and inflammation in adult mice. Also, we aimed to determine whether PM2.5 exposure during pregnancy and lactation changes food intake (FI), energy expenditure, body composition and weight, glucose, and insulin metabolism in the offspring. Three months of PM2.5 exposure decreased O2 consumption measured by CLAMS, and increased body weight and fat mass in adult mice without FI changes. These mice presented hypothalamic leptin resistance with decreased STAT3 phosphorylation and enhanced IKK epsilon (IKKe) expression measured by immunofluorescence and Real-Time PCR. Knocking down IKKe, partially reversed this phenotype. PM2.5 exposure during pregnancy and lactation increased body weight and fat mass of male offspring, observed by a MicroPet CT analysis, accompanied by decreased FI and increased respiratory exchange ratio. Male offspring presented higher serum insulin levels and glucose intolerance measured by GTT despite normal insulin tolerance measured by ITT. Female offspring had no phenotype alterations, except by the light reduced food intake.
In conclusion, PM2.5 exposure during adulthood induced obesity, partially due to a marked reduction in energy expenditure caused by hypothalamic leptin resistance. Elevated inflammation may explain that with a significant role of IKKe in the hypothalamus. Air pollution exposure during pregnancy and lactation had a remarkable effect inducing obesity in the male offspring due to an energy unbalance, which may lead to increased insulin levels and glucose intolerance.

Disclosure
O.P. Zord o: None. L.W. Claro: None. P. Saldiva: None. J. Donato: None. M. Veras: None. P.O. Prada: None.
Immunomodulation of Dendritic Cells Using Tannic Acid-Based Capsules
Authors: FEDUSKA JOSEPH , TSE HUBERT M. 
Published: June 2018

In type 1 diabetes (T1D), insulin-secreting β-cells are destroyed by autoreactive immune cells, for which tolerance to β-cell antigens is lost. Dendritic cells (DC) are potent antigen-presenting cells in the activation of autoreactive T cells during T1D progression. Activation of naïve CD4 T cells relies on three signals: 1.) binding of the T cell receptor with processed antigenic peptides presented by MHC-II complex, 2.) co-stimulatory molecule interactions, and 3.) synthesis of pro-inflammatory cytokines and reactive oxygen species. We previously demonstrated that dissipation of this third signal impairs autoreactive T cell activation. In this study, we tested the hypothesis that encapsulation of putative T1D autoantigens with an antioxidant-containing biomaterial would induce immune tolerance, following phagocytosis by activated DC. We generated bone marrow-derived DC and co-cultured these cells with LPS and microcapsules comprised of a neutral polymer and multilayers of tannic acid (TA), a known antioxidant. Induction of a tolerogenic DC phenotype was assessed by expression of pro-inflammatory cytokine mRNA by qPCR and secretion of cytokines by ELISA. Our data show that a subgroup of TA-based microcapsules can blunt DC responses, as shown by a significant decrease in mRNA accumulation of the pro-inflammatory cytokines Tnfa (p ≤ 0.01) and Il12b (p ≤ 0.01), as well as the chemokine Cxcl10 (p ≤ 0.01). We also observed a significant decrease in secreted IL-12p70 as measured by ELISA. Future studies will encapsulate autoantigens such as insulin and following phagocytosis, determine if a tolerogenic DC phenotype can abrogate autoreactive T cell responses.

Disclosure
J. Feduska: None. H.M. Tse: None.
Metagenomic and Functional Analysis of Athletes Identify an Exercise-Promoting Microbiome
Authors: KOSTIC ALEKSANDAR 
Published: June 2018

To characterize the athlete microbiome, we have sequenced stool samples from marathon runners, ultramarathon runners, Olympic-caliber rowers, and sedentary controls (n=50) with each individual providing on average 7 samples (∼350 samples total). We have identified substantial alterations to the microbiome associated with athletic performance. In particular, we identified a bacteria genus, Veillonella, that increases in abundance after exercise. Veillonella’s primary source of energy is lactate - a metabolite that accumulates in the blood after exercise and is associated with fatigue. Through de novo assembly of ∼40 million contigs, we have developed a novel reference database from our athlete metagenomic/metatranscriptomic data sets - which consists of &gt;2.5 million none redundant genes. Querying this database has yielded insights into potentially significant allelic variation, at the microbiome gene-level, involved in lactate related metabolic processes as well as multi’omic evidence of pathways that change between performance and recovery states. To validate this, we have isolated from our samples three species from this and introduced this cocktail of isolates to C57BL/6 mice prior to exhaustive exercise on a treadmill. Gavage of the Veillonella cocktail to mice four hours prior to exercise results in a significant decrease in serum lactate (lactate AUC of 40.31 mmol/L*hr relative to 66.07 mmol/L*hr in sham control mice; P &lt; 0.05). Follow-up work currently being conducted involves assessing the role of Veillonella’s primary metabolic end product, the short chain fatty acid propionate, on limiting exercise-induced inflammation, and the effects of these components on recovery from exercise. Taken together, our study encompasses both high-resolution metagenomic analysis and experimental validation to understand the role that the microbiome naturally plays in the performance of elite athletes.

Disclosure
A. Kostic: None.
Accelerate the Self Understanding of Blood Glucose through the Summary Screen (ACCESS STUDY)
Authors: SUZUKI KATSUNORI , HASEGAWA KAZUKI 
Published: June 2018

We previously assessed the effectiveness of a simple self-monitored blood glucose(SMBG) device with the function to display whether a blood glucose level is high or low in different colors (C device) (REFLECT STUDY, 2012 ADA), which reported that an interventional group using the C device and patient education materials showed a significant decrease in HbA1c compared to a group using a monochrome-display device. In our new ACCESS Study, we evaluated the effectiveness of a new SMBG device with an additional summary screen that shows past blood glucose patterns (device V) and a new educational material that advises on such blood glucose patterns. Outpaitients with diabetes mellitus (N=94, HbA1c 7.41 ± 0.85%) were randomly assigned to either an intervention group (N=50) where patients were switched from device C to device V with the new educational material, or to a non-intervention group (N=44) where patients were just switched from device C to device V and did not receive the new educational material. We evaluated the changes in HbA1c and patient satisfaction survey scores 8 weeks later. There was no significant difference in the change in HbA1c at 8 weeks between the intervention group (-0.06%; -0.165 to 0.045) and non-intervention group (-0.01%; -0.136 to 0.113). According to the results of the satisfaction survey, the intervention group showed a higher satisfaction in "Recognition of patterns/trends in blood glucose levels." There was a tendency in improvement of blood glucose pattern/trend recognition by patients by the intervention, there was no impact on HbA1c improvement. However, the outcomes of this study may have been affected by the short 8-week duration, as well as the fact that it was conducted during the period of seasonal change. Since device V and the new educational material improves blood glucose pattern/trend recognition, the results may have been different if a specific plan for blood glucose improvement tailored to each patient was further conveyed to each patient.

Disclosure
K. Suzuki: None. K. Hasegawa: None.
Development of a Glucose Sensor Using Palladium Electrode
Authors: HAN TAESUNG , NODA SAYAKA , HANEDA KEIGO , SHIGETOU NOBUYUKI 
Published: June 2018

An amperometric glucose sensor was introduced where glucose oxidase was immobilized on palladium electrode. This sensor based on the glucose oxidase catalyzed oxidation of glucose and electrochemical oxidation of hydrogen peroxide which was produced by enzyme reaction. Basic concept of the glucose sensor is composed of inner and outer membrane systems, immobilized glucose oxidase layer, and palladium electrode. Inner membrane prevents the access of electrochemical interfering substrates. Outer membrane works as a diffusion barrier of glucose. The glucose sensor can achieve a wide dynamic range with this outer membrane. In this research, to verify this concept especially the role of outer membrane, the glucose sensor which was made with palladium electrode, glucose oxidase layer, and outer membrane was tested on different glucose concentrations. The sensor showed a good correlation between sensor responses and glucose concentrations. In addition, the dynamic range of this sensor was enough for glucose monitoring of diabetic patients. This sensor also demonstrated stable sensor responses during several days. These results show that this sensor has a strong potential for application to continuous glucose monitoring, or CGM.

Disclosure
T. Han: Employee; Self; Panasonic Healthcare Co., Ltd. S. Noda: Employee; Self; Panasonic Healthcare Co., Ltd. K. Haneda: Employee; Self; Panasonic Healthcare Co., Ltd. N. Shigetou: Employee; Self; Panasonic Healthcare Co., Ltd.
Maternal Obesity Is Associated with Reduced Hippocampal Volume in Children
Authors: PAGE KATHLEEN A. , LUO SHAN , WANG XINHUI , ALVES JASMIN , MARTINEZ MAYRA P. , XIANG ANNY 
Published: June 2018

Offspring exposed to maternal obesity in utero are at increased risk for the development of metabolic disorders. Recent evidence also links exposure to maternal obesity with impaired cognition during childhood. While the underlying mechanisms are unclear, studies in animals have shown that fetal exposure to maternal obesity causes decreased neurogenesis in the dentate gyrus and impaired hippocampal learning. The hippocampus is important for memory, and its development is sensitive to the in utero metabolic environment. We tested the hypothesis that in utero exposure to maternal obesity would be associated with reduced hippocampal volume in children. Sixty-seven children (41 girls, 26 boys) ages 7 to 11 years participated in the study. Children were born at Kaiser Permanente Southern California. Maternal pre-pregnancy BMI was obtained from electronic medical records. Children’s height and weight were measured, and a high-resolution anatomical scan was performed using a 3 Tesla MRI. Total hippocampus volume and hippocampus subfield volumes were analyzed using FreeSurfer 6.0. Linear regression was used to investigate relationships between maternal pre-pregnancy BMI and child hippocampus volume. Maternal pre-pregnancy BMIs ranged from 19.0 to 50.4 kg/m2. Children’s BMI z-scores ranged from -1.8 to 2.6. Maternal pre-pregnancy BMI was negatively correlated with total hippocampus volume, adjusting for child age, sex, BMI-z score, intracranial volume (P=0.05). Results remained after further adjusting for maternal diabetes exposure (P=0.04). A 5-unit increase in maternal pre-pregnancy BMI was associated with 78 mm3 (95% CI:3.3-152.8 mm3) reductions in total hippocampus volume. The inverse correlation was also observed in CA3 (P=.04), CA4 (P=.03), dentate gyrus (P=.03) and subiculum (P=.01) subfields, adjusting for the same covariates. Our results suggest that exposure to maternal obesity adversely impacts hippocampus volume in children, and this impact is uniform across subfields.

Disclosure
K.A. Page: None. S. Luo: None. X. Wang: None. J. Alves: None. M.P. Martinez: None. A. Xiang: None.
Risk Factors for Hypoglycemia in Patients with Diabetes Mellitus
Authors: MIZOGUCHI ASAKO 
Published: June 2018

Aims/Introduction: We utilized a continuous glucose monitoring device to analyze risk factors for hypoglycemia (defined as a blood glucose level &lt;70 mg/dL) in outpatients with diabetes mellitus.
Materials and Methods: We utilized a continuous glucose monitoring device in 100 out patients (50 of whom were male, 19 of whom were type 1 diabetes, 73 of whom were type 2 diabetes)from April 2017 to October 2017. We use FreeStyle Libre for up to 14 days. We excluded CGM date within 24 hours because those data are not accurate.
Results: Hypoglycemia risk was higher in the patients whose body weight is lighter (72.3±18.0 vs. 57.0±11.3kg,P=0.001), and lower in patients who take more oral hypoglycemic agent (2.2±0.9 vs. 1.5±1.3 kind of medications,P=0.005) and higher in patients who use much insulin (0.27±0.20 vs. 0.41±0.22 units/kg/day,P=0.034) 70 patients have hypoglycemia and 30 of whom are unaware hypoglycemia. Patients with unaware hypoglycemia are significantly older (66.7±14.7vs73.6±11.2 years old P=0.035) and their body weight is significantly lighter (66.3±16.7 vs. 58.0±10.2kg,P=0.013) and their HbA1c is lower (7.5±1.2 vs. 7.0±0.7% P=0.048) and those with a lower average blood glucose level had a significantly higher risk (OR 1.09, 95% CI: 1.06-1.12, P &lt; 0.0001). Patients who has nocturnal hypoglycemia are significantly shorter (161.5±10.4 vs. 157.0±8.0cm,P=0.026) and their body weight are significantly lighter (69.3±16.1 vs. 55.2±10.4kg P&lt;0.001) and their standard deviation is bigger (45.4±18.3 vs. 56.9±20.0 mg/dl P=0.005)
Conclusions: In outpatients,77% patients have hypoglycemia (42% of whom are unaware). The hypoglycemia risk was higher in the patients whose body weight is lighter, and lower in patients who take more oral hypoglycemic agent and higher in patients who use more insulin. Therefore it is important to utilize a continuous glucose monitoring device in such patients and to ensure comprehensive blood glucose control in such patients to prevent hypoglycemia.

Disclosure
A. Mizoguchi: None.
Long-Term Use of Omnipod® Insulin Management System Associated with Lower A1c in Adults with Established Diabetes and A1c =8%
Authors: TINSLEY LIANE J. , LAFFEL LORI M. , GUO ZIJING , NAIK NISHA , LAYNE JENNIFER E. , LY TRANG T. , MEHTA SANJEEV N. 
Published: June 2018

Tubeless patch pumps may offer unique benefits enhancing long-term glycemic benefits seen in adults with diabetes starting continuous subcutaneous insulin infusion (CSII) therapy. We retrospectively evaluated adults with diabetes &gt;6 months to assess changes in A1c and weight 1 year after initiating the Omnipod® Insulin Management System (Insulet Corp., Billerica, MA). Changes were assessed by baseline A1c category (&lt;7.0%, 7.0-7.9%, 8.0-8.9%, and ≥9.0%) and then stratified by prior insulin regimen (MDI 65%, CSII 35%). At Omnipod initiation, 195 patients (39% male, 97% T1D) had (mean±SD) age 42±14 years and diabetes duration 21±14 years. Baseline A1c and weight were 7.9±1.3% and 175±36 lbs with no significant differences according to prior regimen. After 1 year, patients had 0.2% A1c reduction (p&lt;.05) and non-significant weight change (+0.8 lb). Significant A1c reductions were noted in adults with baseline A1c ≥8% (A1c 8.0-8.9%: -0.3% (p&lt;.05) and A1c ≥9.0%: -1.1% (p&lt;.005). Modest to no increase in A1c was found in patients with baseline A1c &lt;8% (A1c &lt;7.0%: +0.2% (p&lt;.05) and A1c 7.0-7.9% (p=NS). Weight did not change across all A1c categories. The Table shows changes in A1c by insulin regimen before Omnipod initiation. In adults with diabetes and A1c ≥8%, Omnipod initiation was associated with significantly lower A1c, most notably in those transitioning from MDI.Change in A1c 1 Year after Omnipod Initiation by Baseline A1c and Insulin RegimenBaseline A1c (%)n (MDI/CSII)MDI, Baseline A1c (%)MDI, ∆A1c (%)CSII, Baseline A1c (%)CSII, ∆A1c (%)&lt;7.023/146.4±0.40.4†6.3±0.6-0.047.0-7.949/307.5±0.30.17.4±0.30.3*8.0-8.929/108.4±0.3-0.3*8.6±0.3-0.2≥9.025/1510.0±1.3-1.5†9.6±0.6-0.4†p&lt;.005, *p&lt;.05

Disclosure
L.J. Tinsley: None. L.M. Laffel: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US, MannKind Corporation, Roche Diagnostics Corporation, Dexcom, Inc., Insulet Corporation, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Johnson & Johnson Diabetes Institute, LLC.. Z. Guo: None. N. Naik: None. J.E. Layne: Employee; Self; Insulet Corporation. T.T. Ly: Employee; Self; Insulet Corporation. S.N. Mehta: None.
Increased Prevalence of Diabetes Mellitus after Lung Transplantation
Authors: LEUNG JOSEPH M. , ALMEHTHEL MOHAMMED , PARTOVI NILUFAR , YEE JOHN , LEVY ROBERT , PATY BREAY 
Published: June 2018

Introduction: Cardiovascular (CV) disease is a significant cause of mortality after lung transplant. However, the prevalence of diabetes and CV risk factors has not been well-characterized in this setting.
Methods: Using an electronic database and chart review, we collected and analyzed retrospective data before and 12-months after lung transplant at our institution between 2010-2016 (n=172).
Results: Between pre-transplant and 12-months post-transplant, there were increases in diastolic BP (71.2 vs. 76.5 mmHg, p&lt;0.0001); weight (71.5 vs. 78.8 kg, p &lt;0.0001); BMI (24.5 vs. 27.0 kg/m2, p &lt;0.0001); prevalence of diabetes (21.5% vs. 41.4%, p &lt;0.0001); and prevalence of dyslipidemia (20.9% vs. 30.3%, p &lt;0.0001). Also, more post-transplant patients used long-acting insulin (6.43% vs. 12.90%, p=0.047) and beta-blockers (8.77% vs. 18.71%, 0.0087), but fewer patients took ACE/ARB (23.39% vs. 11.61%, p=0.0055). There were no differences in A1C (6.4% vs. 6.1%, p=0.29), fasting plasma glucose (FPG) (5.96 mmol/L vs. 5.49 mmol/L, p=0.35), or proportion of patients taking metformin (5.85% vs. 2.58%, p=0.15), sulfonylurea (3.51% vs. 0.65%, p=0.075), short-acting insulin (5.85% vs. 9.03%, p=0.27), statin (18.71% vs. 13.55%, p=0.21), any anti-hyperglycemic (13.45% vs. 16.77%, p=0.40), or any anti-hypertensive (36.84% vs. 30.97%, p=0.26).
Conclusion: The prevalence of diabetes and CV risk factors observed 12-months after lung transplant was increased compared to pre-transplant. The reasons for this are unclear, but may be related to immunosuppressive medication. Although the prevalence of diabetes is higher after transplant, the lack of differences in A1C and FPG may reflect the greater use of long-acting insulin in post-transplant patients with diabetes. Further study is needed to determine whether these risk factors contribute to an increased risk of adverse clinical outcomes and whether more systematic surveillance and management of these risk factors might mitigate this risk.

Disclosure
J.M. Leung: None. M. Almehthel: None. N. Partovi: None. J. Yee: None. R. Levy: None. B. Paty: None.
A Phase 1b/2a Study of Glutazumab for the Treatment of Type 2 Diabetes and Obesity
Authors: JING SHUQIAN , ZHANG CHENG , FAN KESUO , GUO YONG 
Published: June 2018

Glutazumab is a humanized anti-GLP-1 receptor monoclonal antibody carrying a GLP-1 fragment. Previous in vitro and in vivo studies showed that glutazumab possessed some biased activities toward different signaling pathways of GLP-1 receptor. As a result, glutazumab exhibited significantly better safety profiles than dulaglutide (Trulicity) in our preclinical cynomolgus and phase 1a clinical studies. Although the potencies or efficacies of glutazumab and dulaglutide appeared similar to each other in all studies, the maximum tolerable dose of glutazumab determined either in preclinical cynomolgus or in phase 1 clinical studies was 3 times higher than that of dulaglutide. A randomized, placebo-controlled, double-blind, semi-sequential dose escalation phase 1b/2a study was recently initiated to further evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of glutazumab in type 2 diabetes patients. Preliminary results further indicated the well-tolerated safety profile and the glucose lowering effects of glutazumab.

Disclosure
S. Jing: None. C. Zhang: None. K. Fan: None. Y. Guo: None.