bluuebunny/crossref_metadata_2025_split huggingface dataset:
1514-P: Serum Amylase (AMY) Level and Its Chronological Change as a Predictor of Incident Type 2 Diabetes Mellitus (T2DM)
Authors: ISHII DAI , FUJIHARA KAZUYA , NEDACHI RINA , HARADA MAYUKO , MATSUBAYASHI YASUHIRO , SAITO KAZUMI , KODAMA SATORU , YAMAMOTO-HONDA RITSUKO , ARASE YASUSHI , SONE HIROHITO 
Published: June 2019

Low serum AMY is commonly observed in people with a history of pancreatitis, which is a well-known predictor of T2DM. However, few longitudinal studies investigated whether low AMY could be predictive of T2DM, especially considering the effects of baseline HbA1c. Also, it is unclear if a change in AMY is predictive of incident T2DM. Thus, we investigated the impact of AMY and its chronological change on the risk of T2DM considering baseline HbA1c. Analyzed were 5306 individuals who had health examinations yearly for 7 y. We monitored the change in AMY values between baseline 1 (first visit) and baseline 2 (2 y later) and ratio of baseline 2 to baseline 1. During the 5-y follow-up, T2DM occurred in 716 patients. Multivariate Cox analysis showed that both a lower AMY at baseline 2 (HR of Quintile 1, 1.44[1.11-1.88] vs. Q5 as ref.) and a larger AMY decline from baseline 1 (HR of &lt;85%, 1.37[1.01-1.87] vs. ≥115% as a ref.) were independent and significant predictors for incident T2DM. In a stratified analysis of 15 groups divided according to the combination of AMY at baseline 2 and chronological change, those with the lowest AMY at baseline 2 and the largest decline in AMY had a significantly increased risk for incident T2DM (Fig. 1 HR of Quintile 1, &lt; 89.9%, 1.57[1.11, 2.23] vs. Q3/≥100% as ref.). These findings imply the clinical relevance of using the AMY level and its chronological changes to assess risk of incident T2DM.

Disclosure
D. Ishii: None. K. Fujihara: None. R. Nedachi: None. M. Harada: None. Y. Matsubayashi: None. K. Saito: None. S. Kodama: None. R. Yamamoto-Honda: None. Y. Arase: None. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.
1519-P: A Study on Epidemiological Barriers in Usage of Insulin among Rural South Indians
Authors: MANDAVA PATALI , MUNGANDA HARIHARAN R.S. , UNDAVALLI VAMSI KRISHNA , CHOWDARY PONNAGANTI SATYANARAYANA , AMLE DNYANESH 
Published: June 2019

Introduction: Diabetes mellitus (DM) remains the iceberg disease in rural areas with large number of subjects remaining undiagnosed. India is the diabetes capital with home to 72.9 million diabetic people.
Methodology: Our cross-sectional observational and analytical survey studied 516 subjects with uncontrolled type 2 DM (HbA1c &gt;9%) in the 9 villages (having 35,000 population) at Rural health centre, Veleru of Dr. PSIMS and RF, Krishna district, Andhra Pradesh, South India which is a predominantly rice eating population and analyzed the socio-demographic factors influencing insulin administration. Participants were assessed through a pre-tested structured questionnaire to elicit awareness regarding insulin usage.
Results: Though 40.3% were prescribed insulin at some point of time, only 10.1% subjects were taking it. Awareness of diabetes was lacking in 67.8% and that of insulin in 54.1%. Commonest reason for avoiding insulin was fear of injections (31.8%), unawareness of insulin technique in 25.8%, lack of facilities to store insulin in 19.8% subjects, lack of access to pharmacy in 9.3%, unsure about correct timing in 20.2%, concerned about proper dosage measurements in 1.9%, but only 3.9% were concerned about cost.
Conclusion: Proper awareness programs can significantly increase effective and regular use of insulin in diabetes subjects.

Disclosure
P. Mandava: None. H.R.S. Munganda: None. V. Undavalli: None. P. Satyanarayana Chowdary: None. D. Amle: None.
152-OR: Changes in Consumption of Sugary Beverages and Artificially Sweetened Beverages and Risk of Type 2 Diabetes among U.S. Women and Men
Authors: DROUIN-CHARTIER JEAN-PHILIPPE , ZHENG YAN , LI YANPING , MALIK VASANTI , PAN AN , MANSON JOANN E. , WILLETT WALTER C. , HU FRANK 
Published: June 2019

Background: Whether changes in consumption of sugary beverages or artificially sweetened beverages (ASBs) are associated with type 2 diabetes (T2D) risk has never been evaluated.
Objective: We evaluated the association of changes in sugary beverage and ASB consumption over a 4-year period with subsequent 4-year risk of T2D among U.S. women and men.
Methods: We followed-up 78,357 women in the Nurses’ Health Study (1986-2012), 82,937 women in the Nurses’ Health Study II (1991-2013) and 35,148 men in the Health Professionals Follow-up Study (1986-2012). Beverage intakes were assessed using validated food frequency questionnaires every 4 years. Cox proportional regression models were used to calculate hazard ratios (HRs) for T2D regarding 4-year changes in beverage consumption, adjusted for initial beverage intake and BMI. Results of the 3 cohorts were pooled using an inverse variance-weighted, fixed-effect meta-analysis.
Results: During 2,849,389 person-years of follow-up, we documented 12,007 incident cases of T2D. Increasing sugary beverage intake by &gt;0.5 serving/day over a 4-year period was associated with a 14% (95% CI: 7%, 21%) higher T2D risk compared with maintaining a stable consumption. Both beverages with added sugars (e.g., soft drinks) and 100% fruit juices were associated with higher T2D risk. Increasing ASB consumption by &gt;0.5 serving/day was associated with a 19% (95% CI: 12%, 27%) higher T2D risk. Substituting ASB for sugary beverages was not associated with subsequent T2D risk (HR: 0.99, 95% CI: 0.96, 1.02). However, decreasing sugary beverage consumption and increasing water, coffee or tea intake by 1 serving/day was associated with a 3% to 11% lower risk of T2D.
Conclusion: Increasing consumption of sugary beverages or ASBs was associated with a higher risk of T2D compared with maintaining a stable consumption of these beverages. Substituting water, coffee or tea but not ASB for sugary beverages was associated with lower T2D risk.

Disclosure
J. Drouin-Chartier: Other Relationship; Self; Dairy Farmers of Canada. Y. Zheng: None. Y. Li: None. V. Malik: None. A. Pan: None. J.E. Manson: None. W.C. Willett: None. F. Hu: None.

Funding
National Institutes of Health (UM1CA186107, UM1CA176726, UM1CA167552, DK112940, HL60712, HL118264); Canadian Institutes of Health Research (BPF-156628)
1532-P: Greater Type 2 Diabetes Risk among College Students in Egypt Is Alarming
Authors: EID ELSAYED MOHAMED , TOMAH SHAHEEN , ELDIB AHMED H. , ABOUELMAGD MEGAHED MOH , FAHMY EMAN M. , ELBADAWY AYMAN MOHAMAD , GHAZI HOSSAM ARAFA , HAMDY OSAMA 
Published: June 2019

Egypt, a country with a population of 100 million (60% of them younger than age 30 years old), is among the top 10 nations in number of patients with diabetes according to the International Diabetes Federation. Type 2 diabetes (T2D) risk among young adults in Egypt is unknown. We evaluated T2D risk among 377 college students with age ranging between 19-21 years using the Finish Diabetes Score (FDS); Female 61%, body weight 71.6±14.4 kg, BMI 25±4.5 kg/m2. The overall FDS of the entire cohort was 6 (range: 0-16). Low-risk group (LR) with FDS &lt;7 was observed in 52% of the sample (BMI 23±0.2 kg/m2, Female 54%) compared to 48% in the greater risk group (GR) with FDS ≥7 (BMI 27.6±0.3 kg/m2, Female 68%, p&lt;0.001, p&lt;0.01 respectively). Among GR group, there were variable T2D risk levels; slightly elevated in 36.3%, moderately elevated in 9.8%, and highly elevated risk in 1.9%. GR group had significantly higher total cholesterol versus LR group (189±2.4 vs. 179±2.3 mg/dL, p&lt;0.01) and higher LDL-cholesterol (115±2.2 vs. 107±2.2 mg/dL, p&lt;0.05), while HDL-C, VLDL-C, triglycerides, fasting serum insulin, fasting plasma glucose, and HOMA-IR were not different between the 2 groups. Higher proportion of subjects in the GR group reported frequent consumption of fast food (57% vs. 45%, p&lt;0.05). Among parameters not included in the FDS model was social stress, which was significantly higher in GR (45% vs. 35%, p&lt;0.05), and was an independent predictor of worsening FDS (β=-1.04, P&lt;0.01) in the total cohort. We conclude that increased T2D risk is notable among Egyptian college students, especially among females and those who are overweight. Having 48% of college students at greater T2D risk is alarming. This warrants urgent need for earlier-age screening and implementing diabetes prevention programs with specific aims of reducing body weight, improving lipid profile and reducing consumption of fast food. Social stress should be considered as an important risk factor in any future development of T2D risk model in Egypt.

Disclosure
E.M. Eid: None. S. Tomah: Stock/Shareholder; Self; Amarin Corporation. A.H. Eldib: None. M.M. Abouelmagd: None. E.M. Fahmy: None. A.M. Elbadawy: None. H.A. Ghazi: None. O. Hamdy: Advisory Panel; Self; AstraZeneca, Sanofi-Aventis. Consultant; Self; Abbott, Merck & Co., Inc. Research Support; Self; National Dairy Council. Stock/Shareholder; Self; Healthimation, LLC.
1535-P: An Insulin Resistance Genetic Risk Score (IR_GRS) Is Associated with Mortality in Type 1 Diabetes (T1D)
Authors: MILLER RACHEL G. , COSTACOU TINA , ONENGUT-GUMUSCU SUNA , CHEN WEI-MIN , RICH STEPHEN S. , ORCHARD TREVOR J. 
Published: June 2019

Many SNPs in multiple loci are associated with IR in the general population. IR itself is associated with increased complication and mortality risk in T1D. We thus assessed whether a genetic risk score derived from IR SNPs (IR_GRS) is associated with mortality in the T1D prospective Pittsburgh Epidemiology of Diabetes Complications (EDC) Study. In 422 participants of European ancestry, with available DNA, a weighted IR_GRS based on 16 published IR-associated SNPs was calculated. First, for each SNP, the effect size of the association between each SNP and estimated glucose disposal rate (eGDR, an inverse measure of insulin resistance) was estimated using a general additive linear model. This effect size was then multiplied by the risk allele count to obtain the IR-weighted count. The IR_GRS was calculated as the sum of the 16 weighted counts. All deaths were classified by a physician committee yielding underlying and contributing causes. IR_GRS was related to 25-year total, any mention of cardiovascular disease (CVD), and any end-stage renal disease (ESRD) mortality in Cox models adjusted for sex, principal components for ancestry, and T1D duration and baseline (1986-88) clinical risk factors, including HbA1c, lipids, blood pressure, albumin excretion rate (AER), estimated glomerular filtration rate, and white blood cell count. IR_GRS was associated with increased risk of mortality outcomes: total (99 deaths, p=0.003), any CVD (71 deaths, p=0.01), and any ESRD (49 deaths, p=0.01). Adjustment for clinical risk factors attenuated these associations: total mortality (p=0.04), CVD mortality (p=0.17), ESRD mortality (p=0.10), largely as a result of adjustment for log-transformed AER, which was significantly associated with the IR_GRS (p=0.0003). These results, while needing validation in other cohorts, suggest that an IR_GRS may help to identify individuals with T1D who are at increased risk of mortality and vascular damage (i.e., AER) due to IR.

Disclosure
R.G. Miller: None. T. Costacou: None. S. Onengut-Gumuscu: None. W. Chen: None. S.S. Rich: None. T.J. Orchard: Consultant; Self; Boehringer Ingelheim International GmbH.

Funding
National Institutes of Health; Rossi Memorial Fund; JDRF
1539-P: Assessing the Risk of Amputation with Canagliflozin in Middle-Aged Adults and Adults over 65 Years of Age: An Observational Study Using Three Nationwide Databases
Authors: FRALICK MICHAEL , KIM SEOYOUNG C. , SCHNEEWEISS SEBASTIAN , EVERETT BRENDAN M. , GLYNN ROBERT J. , PATORNO ELISABETTA 
Published: June 2019

Canagliflozin was associated with an increased risk of lower-limb amputation in the CANVAS trial. Prior trials of younger adults did not detect an increased risk of amputation, which raises the question of whether this was a chance finding or specific to older adults.
We conducted a new-user cohort study from March 29th, 2013 to September 30th, 2017 in three U.S. healthcare databases. Patients with diabetes mellitus type 2 newly prescribed canagliflozin were 1:1 propensity score-matched to patients newly prescribed a glucagon-like peptide-1 (GLP-1) receptor agonist. The primary outcome was lower-limb amputation requiring surgery. Hazard ratios (HR) and 95% confidence intervals (CI) were computed for the risk of subsequent amputation among patients &lt;65 and ≥65 years old.
We identified 464,827 patients who were newly prescribed canagliflozin or a GLP-1 agonist. Adults over age 65 prescribed canagliflozin had a 66% higher rate of amputation compared to adults prescribed a GLP-1 agonist (HR=1.66, 95% CI 1.33-2.07, I2=0%). For adults under 65 years of age, the rate of amputation was similar for canagliflozin compared to GLP-1 agonists (HR=1.09, 95% CI 0.89-1.34, I2=0%).
Canagliflozin may be associated with an increased rate of amputation compared to GLP-1 agonists among adults over the age of 65 years, but not among adults under 65 years of age.

Disclosure
M. Fralick: None. S.C. Kim: Research Support; Self; Bristol-Myers Squibb Company, Genentech, Inc., Pfizer Inc. S. Schneeweiss: Consultant; Self; Aetion, WHISCON, LLC. B.M. Everett: Advisory Panel; Self; American College of Cardiology. Consultant; Self; Abbott Laboratories, Amgen Inc., National Institute of Diabetes and Digestive and Kidney Diseases, Novartis Pharmaceuticals Corporation, Roche Diagnostic USA. Research Support; Self; Novartis Pharmaceuticals Corporation. Other Relationship; Spouse/Partner; Merck & Co., Inc. Other Relationship; Self; UpToDate. Other Relationship; Spouse/Partner; UpToDate. R.J. Glynn: Research Support; Self; AstraZeneca, Kowa Pharmaceutical Europe Co. Ltd., Novartis Pharmaceuticals Corporation, Pfizer Inc. E. Patorno: Research Support; Self; National Institute on Aging. Other Relationship; Self; Boehringer Ingelheim International GmbH.
155-LB: The Increase in Endogenous Glucose Production with SGLT2 Inhibition Is Unchanged by Renal Denervation but Highly Correlates to Urinary Glucose Excretion
Authors: SOLIS-HERRERA CAROLINA , ALATRACH MARIAM , AGYIN CHRISTINA , HONKA HENRI , PATEL RUPAL , TRIPLITT CURTIS L. , ADAMS JOHN M. , GASTALDELLI AMALIA , ABDUL-GHANI MUHAMMAD , CERSOSIMO EUGENIO , DEFRONZO RALPH A. 
Published: June 2019

Background: SGLT2 inhibition causes a “paradoxical” increase in EGP, indicating the presence of a “reno-hepatic axis.”
Aim: We measured EGP after SGLT2 inhibition in renal transplant subjects with and without type 2 diabetes to evaluate the role of renal nerves and SNS in mediating this “reno-hepatic axis.” Six T2D (A1c = 7.2±0.1) and 8 non-T2D (A1c = 5.6±0.1) with normal renal function and no history of rejection (prednisone ≤ 5mg/day) received two 6-hr measurements of EGP preceded by dapagliflozin or placebo.
Results: Following DAPA in T2D, FPG (143±15 to 112±9 mg/dl, p=0.01) and FPI (14±3 to 11±2, p=0.02) decreased while glucagon increased (45±13 to 54±14 pg/mL, p=0.09) (all p&lt;0.05 vs. placebo); plasma epinephrine and norepi did not change from baseline. Following placebo, EGP decreased (p&lt;0.01) in both T2D and non-DM. In contrast, after DAPA EGP increased (p&lt;0.01) in both T2D (by 0.4±0.1 mg/kg.min) and in non-T2D (by 0.1±0.1 mg/kg.min) compared to placebo. The DAPA-induced increment in EGP production was highly correlated (r = 0.824, p&lt;0.001) with the increment in urinary glucose excretion in all subjects (Figure).
Conclusions: (1) Renal denervation in renal transplant patients failed to block the DAPA-mediated stimulation of EGP; (2) DAPA-stimulated rise in EGP is strongly related to the increase in urinary glucose excretion blunting the decline in FPG.

Disclosure
C. Solis-Herrera: Advisory Panel; Self; Sanofi. M. Alatrach: None. C. Agyin: None. H. Honka: None. R. Patel: None. C.L. Triplitt: Consultant; Self; Abbott. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc. J.M. Adams: None. A. Gastaldelli: Consultant; Self; A. Menarini Diagnostics, Eli Lilly and Company, Genentech, Inc., Gilead Sciences, Inc., Inventiva Pharma. M. Abdul-Ghani: None. E. Cersosimo: None. R.A. DeFronzo: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Elcelyx Therapeutics, Inc., Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc. Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc. Speaker’s Bureau; Self; AstraZeneca, Novo Nordisk Inc.
1552-P: Relationship between Diabetes Status and Chronic Kidney Disease in New York City Chinese and Non-Chinese Populations
Authors: CHANG TA-MIN , LIU GEORGE , GEORGE JOHN D. , SHARP JAMES W. , HU ANTHONY 
Published: June 2019

Diabetes mellitus (DM) and prediabetes incidence have increased in the U.S. in recent years. In our center we have observed higher prevalence of diabetes/prediabetes in NYC Chinese-Americans than the general population. Diabetes patients are often associated with cardiovascular disease and chronic kidney disease (CKD).
Aim: To determine the relationship between diabetes status and CKD status in NYC Chinese population compared to the general population so that proper medical management can be achieved.
Method: Using A1C test to determine the diabetes status, with A1C value of &lt;5.7 classified as nondiabetics, 5.7-6.4 as prediabetics and &gt;6.5 as diabetics. Estimated glomerular filtration rate (eGFR) were determined and values &lt;60 mL/min/1.73 m2 were regarded as having CKD. The data of 274,784 NYC Chinese and 1,271,642 non-Chinese were reviewed and compared in 18-64 years and ≥65 years groups.
Results: In both populations the A1C levels tended to increase with increasing age, whereas their mean eGFR tended to decrease with age. The CKD prevalence was 8.9% in Chinese and 9.5% in non-Chinese. In 18-64 years groups CKD was 2.4% in Chinese and 2.7% in non-Chinese, whereas in ≥65 years group they were 29% in Chinese and 25.6% in non-Chinese. When A1C and eGFR were reviewed together, CKD prevalence was 3.1% of nondiabetics, 10.3% of prediabetics, 22.6% of A1C 6.5-6.9 DM, 24.1% of A1C 7.0-8.0 DM, 29.6% of A1C 8.1-8.9 DM and 27.6% of A1C &gt;9.0 in Chinese population. In non-Chinese population, the CKD prevalence was 5.3%, 13.2%, 21.1%, 23.5%, 23.8%, and 18.6%, respectively for the corresponding nondiabetics, prediabetics and various DM subgroups.
Conclusion: Significant prevalence of CKD were found in prediabetics of NYC Chinese and general populations. There is a high prevalence of CKD associated with diabetes mellitus in both populations. Prevalence of CKD in NYC Chinese is higher than the general population, particularly in the ≥65 years group and those having severer DM with A1C &gt;8.0.

Disclosure
T. Chang: None. G. Liu: None. J.D. George: None. J.W. Sharp: None. A. Hu: None.
1554-P: Real-Word Use of Insulin and Oral Antidiabetes Drugs in the Hospital
Authors: PASQUEL FRANCISCO J. , MAGEE MICHELLE F. , HOCHBERG IRIT , HAWTHORNE ROBERT B. , PENG LIMIN , UMPIERREZ GUILLERMO E. 
Published: June 2019

Insulin therapy is the preferred treatment for glycemic control in the hospital. Oral antidiabetes drugs (OAD) are commonly used despite the lack of safety and efficacy data. We analyzed individual patient-data of non-critically ill patients with T2D admitted to a teaching medical institution between 2008 - 2018 to determine the relative efficacy and safety of OAD. We did logistic regression analysis adjusting for relevant covariates. A total of 10,205 patients were included in the analysis, 970 patients (9.5%) were treated with OAD, 691 (6.8%) with OAD plus basal insulin, and 8,544 (83.7%) with basal insulin. Patients treated with OAD had lower admission BG and HbA1c and had less comorbidities compared to those receiving basal insulin. Hypoglycemia was less common with metformin (2.4%) and DPP-4i (0.0%) compared to sulfonylureas (13%) or insulin therapy (13%). After adjusting for age, gender, BMI, race, hospital setting, Charlson score, and admission creatinine, treatment with OADs was associated with better BG control and lower odds of complications compared to insulin use (Figure).
Conclusion: The use of OAD in the hospital appears to be safe and effective and is not associated with higher odds of complications, with the exception of sulfonylurea use that is associated with a high rate of hypoglycemia. Residual confounding due to selection assignment to basal insulin therapy to sicker patients is probable.

Disclosure
F.J. Pasquel: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Merck & Co., Inc. M.F. Magee: Consultant; Self; Mytonomy. Research Support; Self; Lilly Diabetes, Mytonomy, Sanofi. Speaker's Bureau; Self; PRIMED. I. Hochberg: None. R.B. Hawthorne: None. L. Peng: None. G.E. Umpierrez: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc. Research Support; Self; AstraZeneca, Merck & Co., Inc., Novo Nordisk Inc., Sanofi US.
1555-P: Differences in Oral Microbiota as Risk Factors for Periodontal Disease in Diabetic Subjects
Authors: MIZUSHIRI SATORU , DAIMON MAKOTO , MURAKAMI HIROSHI , MURABAYASHI MASAYA , MATSUHASHI YUKI , KAMBA AYA 
Published: June 2019

Objective: Periodontal disease, caused by infection with gram-negative anaerobic bacteria, is the biggest risk factor for losing teeth in most westernized countries. Recently, periodontal disease has been regarded as complication of diabetes, since it develops frequently and progress rapidly in diabetic subject. However, although association between diabetes and minimal chronic inflammation induced by periodontal disease has been reported, association between differences in microbiota and periodontal diseases in diabetic subject have not been well examined.
Research Design and Methods: Among participants of the population-based Iwaki study of Japanese held in 2016, those with information of oral cavity environment evaluated by the salivary multi-test, and microbiota of saliva samples evaluated using 16S rRNA sequencing were included in the study (n=1078). Diabetes: HbA1c levels ≧6.5% or FBG ≧126 mg/dl; normal glucose tolerance (NGT): HbA1c levels &lt;6.0% or FBG &lt;100 mg/dl.
Results: The number of dental caries-causing bacterium was significantly higher (3.15±1.61 vs. 2.61±1.61, p &lt;0.01), and the saliva buffer capacity was significantly lower (71.9±10.8 vs. 77.8±10.4, p &lt;0.01) in diabetic subjects compared to those with NGT. Further, proportion of the phylum Firmicutes was higher (41.3±12.4% vs. 37.2±11.6%, p &lt;0.01), and the phylum Bacteroidetes was significantly lower (18.9±8.5% vs. 20.9±8.3%, p=0.01) in diabetic subjects compared to those with NGT.
Conclusions: Abnormal glucose tolerance may change oral microbiota, induce dental caries, and be a risk factor for periodontal disease. We will further examine association between microbiota and diabetes in taxonomic category below phylum, and, also, in consideration with nutrients consumed.

Disclosure
S. Mizushiri: None. M. Daimon: None. H. Murakami: None. M. Murabayashi: None. Y. Matsuhashi: None. A. Kamba: None.