bluuebunny/crossref_metadata_2025_split huggingface dataset:
724-P: Timing of Basal Insulin Reduction to Prevent Hypoglycemia during Exercise in Adults and Adolescents with Type 1 Diabetes Using Insulin Pump Therapy: Preliminary Results
Authors: TAGOUGUI SEMAH , TALEB NADINE , HEYMAN ELSA , MESSIER VIRGINIE , SUPPERE CORINNE , BERTHOIN SERGE , RABASA-LHORET RÉMI 
Published: June 2019

Background We have shown that the reduction of basal insulin (-80%) 40-min before exercise is insufficient to reduce the time spent on hypoglycemia (Roy-Fleming et al., 2018. Diabetes and Metabolism). These results suggest that earlier basal insulin reductions need to be tested. We compared the efficacy of two timings to decrease basal insulin infusion rate to reduce exercise-induced hypoglycemia in patients with T1D using insulin pump therapy. Furthermore, we explored if decreased muscle vasoreactivity (secondary to decreased insulin levels) is associated with a reduced time spent in hypoglycemia.
Methods: 13 adults and adolescents (10 adults; 5 adolescents; mean A1C: 8,2±1,0%) practiced 60-min exercise sessions (ergocyle) at 60% VO2peak, 240 minutes after a standardized lunch. In randomized order, we compared an 80% reduction of basal insulin applied 40-min (T-40) and 90-min (T-90) before exercise onset. Near-infrared spectroscopy (NIRS) was used to investigate muscle hemodynamic at vastus lateralis. Venous blood samples for glycemia measurement were drawn every 10 min during exercise.
Results: T-90 strategy could reduce hypoglycemia risk during exercise: glycemic drop during exercise tend to be more important during T-40 vs. T-90 strategy (-41.44 ± 57.65 mg/dl vs. -14.05 ± 34.23 mg/dl respectively; p=0.09). This trend is confirmed by the repeated measures ANOVA test, which shows a significant interaction effects (blood glucose level during exercise × strategy “T90 vs. T-40”) (p = 0.01). However, contrary to our hypothesis, the estimation of local muscle perfusion measured by NIRS shows comparable results between 2-strategies.
Conclusion: Our preliminary results in 15 DT1 patients (planned 20) show that decreasing basal insulin infusion rate by 80% up to 90 minutes before exercise onset tend to reduce exercise-induced hypoglycemia. This drop does not seem to be related to a decrease in local muscle perfusion.

Disclosure
S. Tagougui: None. N. Taleb: None. E. Heyman: None. V. Messier: Other Relationship; Self; Eli Lilly and Company. C. Suppere: None. S. Berthoin: None. R. Rabasa-Lhoret: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck & Co., Inc., Novo Nordisk A/S, Sanofi. Research Support; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Novo Nordisk A/S.
726-P: Impaired Glucose Tolerance Blunts Exercise-Training Induced Improvements in Aerobic Exercise Capacity
Authors: MACDONALD TARA , PATHAK PRERANA , LESSARD SARAH 
Published: June 2019

Background: Low aerobic exercise capacity independently and strongly predicts metabolic disease and mortality. While aerobic exercise training can increase exercise capacity and reduce health risks, people with impaired glucose tolerance (IGT; i.e., prediabetes, T1D and T2D) have lower exercise capacity than glucose-tolerant subjects, even when exercise training “dose” is matched. We tested the hypothesis that low exercise capacity in IGT is caused by blunted exercise training-induced improvements in exercise capacity.
Methods: IGT was induced in CD-1 mice by a) diet-induced insulin resistance (Western Diet, WD; 40% kcal from fat), or b) streptozotocin injection (STZ; 2x 40 mg/kg) to reduce circulating insulin. Control and STZ mice consumed standard chow (10% fat). Eight weeks following treatment, mice were partitioned into sedentary or exercise-trained (voluntary wheel running) groups. Exercise capacity (meters, m) was measured before and after a 3-week training intervention, and the change (Δ) in exercise capacity was calculated. Body composition was measured (DEXA) and tissues were harvested to measure metabolic health outcomes.
Results: Baseline exercise capacity and total running distance were similar among Control, WD and STZ groups. Mice from all treatment groups displayed metabolic benefits from training, including increased muscle GLUT4 and mitochondrial content, and reduced adiposity. In contrast, exercise capacity only improved with training in Control mice (Δ124.82±40.25 m), whereas WD-trained (Δ29.69±24.11 m) and STZ-trained (Δ37.10±25.76 m) animals had no significant increase in exercise capacity. These data demonstrate that IGT can prevent improvements in exercise capacity with exercise training, despite the induction of other beneficial metabolic health outcomes.
Conclusions: Our data identify IGT as a negative regulator of improved exercise capacity with training and a novel mechanism underlying low exercise capacity in diabetes.

Disclosure
T. MacDonald: None. P. Pathak: None. S. Lessard: None.

Funding
American Heart Association (1-19-PDF-168)
731-P: Exercise Training Does Not Alter Resting Fatty Acid Mobilization from Adipose Tissue
Authors: SCHLEH MICHAEL W. , RYAN BENJAMIN J. , GILLEN JENNA B. , VARSHNEY PALLAVI , FOUG KATIE , LUDZKI ALISON , HOROWITZ JEFFREY F. 
Published: June 2019

Excessive fatty acid (FA) mobilization from subcutaneous adipose tissue into systemic circulation underlies many metabolic health complications associated with obesity, such as insulin resistance. Exercise is often used to help treat and/or prevent insulin resistance, but the direct effects of exercise training (without weight loss) on systemic FA mobilization are unclear. The aim of this study was to determine the effect of both high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on FA rate of appearance (FA Ra) into systemic circulation and factors regulating FA mobilization from subcutaneous adipose tissue. 18 obese adults (33±3 kg•m-2) were randomized to 12 weeks (4 d/week) of either HIIT (10 x 1 min at 90% HRmax with 1 min recovery; n=8) or MICT (45 min at 70% HRmax; n=10), and were required to maintain bodyweight throughout. Resting FA Ra (13C palmitate dilution) and abdominal subcutaneous adipose tissue samples were collected in the overnight fasted state before and after training (72h following their final exercise session). The abundance of key lipolytic and lipid storage proteins in adipose tissue were measured via immunoblot. Aerobic fitness (VO2peak) increased ∼10% after training (P = 0.002), with no difference between HIIT and MICT. Body weight remained unchanged after training (HIIT: 98±12 vs. 98±13 kg, MICT: 101±12 vs. 100±13), as did fat mass (HIIT: 40±5 vs. 39±5 kg, MICT: 42±8 vs. 41±9). Training did not affect resting FA Ra in either HIIT (16.5±3.2 vs. 15.3±1.8 μmol•kg FM-1•min-1) or MICT (16.5±2.6 vs. 15.8±1.4 μmol•kg FM-1•min-1). In line with this finding, neither HIIT nor MICT altered adipose tissue abundance or phosphorylation-state of the lipolytic enzymes ATGL and HSL, or other factors involved in FA mobilization and storage in adipose tissue (e.g., GPAT, DGAT, CGI-58, G0S2, CD36).
In summary, in the absence of weight loss, 12 weeks HIIT or MICT did not alter the regulation of resting FA mobilization from subcutaneous adipose tissue.

Disclosure
M.W. Schleh: None. B.J. Ryan: None. J.B. Gillen: None. P. Varshney: None. K. Foug: None. A. Ludzki: None. J.F. Horowitz: Research Support; Self; American Diabetes Association.

Funding
National Institutes of Health (R01DK077966, P30DK089503, T32DK007245); Canadian Institutes of Health Research (DFS146190)
735-P: Seasonal Variation in Vascular Function in People with Type 2 Diabetes Who Exercise Regularly
Authors: HONDA HIROTO , IGAKI MAKOTO 
Published: June 2019

The purpose of this study was to investigate seasonal variation in vascular function in people with type 2 diabetes (T2D) who exercise regularly. Fourteen Japanese adults with uncomplicated T2D (5 men and 9 women, age: 65.9 ± 0.9 years, HbA1c: 7.1 ± 0.1%, mean ± SE). All patients exercised at our hospital for 5 years (January 2010-December 2014). Moderate intensity aerobic exercise using a treadmill or bicycle ergometer was performed for 40 min/day (frequency: ≥ 2 days/week). Vascular function, including flow-mediated dilation (FMD), cardio-ankle vascular index (CAVI), and ankle-brachial pressure index (ABI) in each season (spring: March-May, summer: June-August, fall: September-November, winter: December-February) were compared. Variation in FMD throughout the year was 1.0%, and the level in winter was significantly worse than in spring and summer (winter vs. spring and summer: 3.5 ± 0.1% vs. 4.4 ± 0.1% and 4.6 ± 0.1%; p &lt; 0.01 and p &lt; 0.01, respectively) (Figure). However, CAVI and ABI showed no significant change throughout the year. These results suggested that FMD rather than CAVI and ABI might show seasonal variation, even in people with T2D who exercise regularly. It is important to consider these characteristics when managing T2D.

Disclosure
H. Honda: None. M. Igaki: None.
739-P: Type 2 Diabetes Is an Independent Predictor of Lowered Peak Aerobic Capacity in Patients with Reduced and Nonreduced Ejection Fraction Heart Failure
Authors: ABE TAKAHIRO , YOKOTA TAKASHI 
Published: June 2019

Background: Low aerobic capacity is a strong and independent predictor of all-cause mortality for both diabetic patients and chronic heart failure (CHF) patients. We tested the hypothesis that coexistance of type 2 diabetes lowers peak aerobic capacity in patients with CHF.
Methods: We retrospectively studied 276 CHF patients with or without type 2 diabetes who underwent cardiopulmonary exercise testing (CPET). All CHF patients had a history of hospital admission due to worsening HF with either non-reduced left ventricular ejection fraction (LVEF; ≥40%) or reduced LVEF (&lt;40%).
Results: Peak oxygen uptake (VO2) was significantly decreased in diabetic group compared to nondiabetic group not only in total CHF population (median 13.8 [interquartile range 11.8-16.4] vs. 16.4 [13.2-20.2] mL/kg/min) but also in CHF patients with LVEF ≥40% (14.1 [12.4-16.6] vs. 17.4 [13.9-20.7] mL/kg/min) and in CHF patients with LVEF &lt;40% (13.4 [10.3-16.3] vs. 16.0 [12.5-20.0] mL/kg/min). There was an inverse correlation between peak VO2 and glycosylated hemoglobin in total CHF population (r=-0.16, P=0.017). Multivariate analysis showed that the presence of type 2 diabetes was an independent predictor of the lowered peak VO2 in CHF patients with LVEF ≥40% and &lt;40%, respectively, after adjustment for age, gender, anemia, renal function, LVEF, and B-type natriuretic peptide.
Conclusions: Type 2 diabetes is an independent predictor of the lowered peak VO2 in CHF patients. The presence of type 2 diabetes has a negative impact on peak aerobic capacity in CHF patients with both reduced and non-reduced LVEF.

Disclosure
T. Abe: None. T. Yokota: None.
740-P: Cardiorespiratory Fitness and Heart Failure in Patients with Diabetes
Authors: FASELIS CHARLES , MYERS JONATHAN N. , NARAYAN PUNEET , KARASIK PAMELA , MOORE HANS , AHMED ALI , SHERIFF HELEN M. , NYLEN ERIC , KOKKINOS PETER 
Published: June 2019

Introduction: Patients with type 2 diabetes mellitus (T2DM), have significantly higher risk of cardiovascular events, including heart failure (HF). Cardiorespiratory fitness (CRF) has been shown to favorably modify comorbidities of HF and lower the risk of HF. However, the independent effect of CRF on HF incidence in patients with T2DM has not been assessed.
Methods: We identified 6,263 patients (aged 58.1+10.0 years) with T2DM and no HF or evidence of ischemia prior to an exercise treadmill testing (ETT). We established four fitness categories, based on age-stratified quartiles of peak metabolic equivalents (METs) achieved Least-Fit (4.7±1.1 METs; n= 1,547); Low-Fit (6.6±1.2 METs; n=2,104) Moderate-Fit (8.0±1.3 METs; n=1,454) and Fit (10.9±2.3 METs; n=1,160). Cox proportional hazards model was constructed to assess HF incidence risk associated with exercise capacity. The model was adjusted for age, BMI, race, comorbidities, and medications. The Least-Fit category served as the reference group. P-values &lt;0.05 using two sided tests were considered statistically significant for all test.
Results: During a follow-up of 12.9+7.1 years, 1,429 or 21.5% of these patients developed HF accounting for 13.5 events per 1,000 person-years of observation. The CRF-CHF risk association was inverse and graded. Risk decreased by 16% (HR: 0.84; CI: 0.82-0.87; p&lt;0.001) for each 1-MET increase in CRF. When CRF categories were considered, HF risk declined progressively by 38% (HR: 0.62; CI: 0.55-0.71; p&lt;0.001) for those in the Low-Fit; 49% in the Moderate-Fit (HR: 0.51; CI: 0.44-0.59; p&lt;0.001), and 64% (HR: 0.36; CI: 0.30-0.43; p&lt;0.001) for individuals in the Fit category.
Conclusions: High levels of CRF were protective against HF incidence in Veterans with T2DM. The CRF-HF association was graded and independent of other risk factors.

Disclosure
C. Faselis: None. J.N. Myers: None. P. Narayan: Research Support; Self; AstraZeneca, Eli Lilly and Company. P. Karasik: None. H. Moore: None. A. Ahmed: None. H.M. Sheriff: None. E. Nylen: None. P. Kokkinos: None.
755-P: A Plant-Based Meal Stimulates Incretin and Insulin Secretion More than an Energy- and Macronutrient-Matched Standard Meal in Type 2 Diabetes: A Randomized Crossover Study
Authors: KAHLEOVA HANA , TURA ANDREA , KLEMENTOVA MARTA , BELINOVA LENKA , HALUZIK MARTIN , PAVLOVICOVA RENATA , HILL MARTIN , PELIKANOVA TEREZIE 
Published: June 2019

Objective: We tested the effects of two energy- and macronutrient-matched meals: a standard meat (M-meal) and a vegan (V-meal) on postprandial incretin and insulin secretion in participants with type 2 diabetes (T2D).
Research Design and Methods: A randomized crossover design was used in 20 participants with T2D. Plasma concentrations of glucose, insulin, C-peptide, glucagon-like peptide -1 (GLP-1), amylin, and gastric inhibitory peptide (GIP) were determined at 0, 30, 60, 120 and 180 minutes. Beta-cell function was assessed with a mathematical model, using C-peptide deconvolution. Repeated-measures ANOVA was used for statistical analysis.
Results: Postprandial plasma glucose responses were similar after both test meals (p=0.64). An increase in the stimulated secretion of insulin (by 30.5%; 95% CI 21.2 to 40.7%; p&lt;0.001), C-peptide (by 7.1%; 95% CI 4.1 to 9.9%; p&lt;0.001), and amylin (by 15.7%; 95% CI 11.8 to 19.7%; p&lt;0.001) was observed following consumption of the V-meal. An increase in stimulated secretion of GLP-1 (by 19.2%; 95% CI 12.4 to 26.7%; p&lt;0.001) and a decrease in GIP (by -9.4%; 95% CI -17.3 to -0.7%; p=0.02) were observed after the V-meal. Several parameters of beta-cell function increased after the V-meal, particularly insulin secretion at a fixed glucose value 5 mmol/L, rate sensitivity, and the potentiation factor.
Conclusions: Our results indicate an increase in postprandial incretin and insulin secretion, following consumption of a single vegan meal, suggesting a therapeutic potential of plant-based meals for improving beta-cell function in T2D.

Disclosure
H. Kahleova: None. A. Tura: None. M. Klementova: None. L. Belinova: None. M. Haluzik: None. R. Pavlovicova: None. M. Hill: None. T. Pelikanova: None.

Funding
Ministry of Health of the Czech Republic (AZV15-27338A); Institute for Clinical and Experimental Medicine (MZCR00023001)
762-P: Association of Sleep Duration with Metabolic, Anthropometric, and Lifestyle Factors in Type 2 Diabetes: Analysis of Components of the U-shaped Relationship
Authors: NAKAYAMA HITOMI , YAMADA YASUSHI , YAMADA KENTARO , IWATA SHIMPEI , WADA NOBUHIKO , TAJIRI YUJI , NOMURA MASATOSHI 
Published: June 2019

Although accumulating evidence has shown that there is a U-shaped association between sleep duration and the risk of metabolic disorders related to obesity, its underlying mechanism is still not fully understood. In this study, we analyzed the association of sleep duration with metabolic, anthropometric, and lifestyle factors in patients with type 2 diabetes. Subjects were 280 patients with type 2 diabetes aged 60±14 years with BMI 25.9±5.1kg/m2, and A1C 9.0±1.8%. Patients with advanced complications were excluded from the study. Diets were evaluated by registered dietitians using software. Body composition was assessed by the multi-frequency bioelectrical impedance method. Habitual physical activity included all of leisure-time, occupational, and household ones. Self-reported nightly sleep duration was 6.4±1.4 h with no gender difference. Sleep duration was inversely correlated with A1C levels, total energy intake, and the intake of three major nutrients. Body fat ratio and skeletal muscle mass, but not body weight or BMI, were correlated positively and negatively, respectively, with sleep duration, even after the adjustment for age. When subjects were divided into three groups based on sleep duration, the intake of fat and carbs was highest in short sleepers (&lt;5.5 h). The percentage of patients who had habitual physical activity was lower in long sleepers (&gt;7 h) than in moderate or short sleepers (25.4%, 31.3%, and 44.0%, respectively). Thus, short sleepers ingested more energy, but %body fat was lower than other groups. This apparent paradox can be explained by the high ratio of habitual physical activity in short sleepers. Long sleep duration is likely a marker of low physical capacity in diabetic subjects. Hence, the U-shaped association may be attributable, at least in part, to excessive eating in short sleepers and a sedentary lifestyle in long sleepers.

Disclosure
H. Nakayama: None. Y. Yamada: None. K. Yamada: None. S. Iwata: None. N. Wada: None. Y. Tajiri: None. M. Nomura: None.
771-P: Protein Intake at Breakfast Contributes to Maintenance of Skeletal Muscle Mass in Japanese Elderly Patients with Type 2 Diabetes
Authors: KUBOTA SODAI , KUWATA HITOSHI , OKAMOTO SAKI , YABE DAISUKE , MUROTANI KENTA , HAMAMOTO YOSHIYUKI , SEINO YUTAKA 
Published: June 2019

Aim: The objective of this study is to investigate the relationship between meal habits and skeletal muscle mass (SMM) in elderly Japanese type 2 diabetes (T2D) patients.
Subjects and Methods: This is a retrospective study of the medical records of 68 elderly(≧65 years old) T2D patients who were admitted to hospital for diabetes conditions and received dietary instructions from January 2014 to September 2017. Upon release, we ascertained nutrition intake by self-administered 3-day food records calculated by Healthy Maker Pro 501. Baseline and post-12 month body composition was measured by BIA device (Inbody S10 or S20).
Result: The 68 patients were divided into 2 groups by variation of SMM after 12 months: Group A (n=45; ΔSMM &lt;0kg) and group B (n=23; ΔSMM≧0kg). There were no differences in age, baseline body weight, or T2D duration between the groups; baseline HbA1c and insulin use (%) were significantly higher in Group B (Table 1). Regarding meal habits, protein intake for breakfast and fat intake for lunch were significantly higher in Group B, suggesting an association with maintaining SMM (Table 2). Logistic regression analysis indicated that the variation of SMM was associated with protein intake for breakfast (OR 1.99 (95% CI; 1.21-1.90) (per 0.1g/kgBW)).
Conclusion: Protein intake for breakfast could be the key to maintain SMM in Japanese elderly T2D.

Disclosure
S. Kubota: None. H. Kuwata: Research Support; Self; Eli Lilly and Company. S. Okamoto: None. D. Yabe: Advisory Panel; Self; Abbott. Research Support; Self; Astellas Pharma Inc. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. K. Murotani: None. Y. Hamamoto: Speaker's Bureau; Self; Novo Nordisk A/S. Y. Seino: Research Support; Self; Arkray, Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation.
775-P: Significant Association of Food Group Intake with Obesity among Patients with Type 2 Diabetes Mellitus in Japan
Authors: HATTA MARIKO , FUJIHARA KAZUYA , TAKEDA YASUNAGA , NEDACHI RINA , ISHII DAI , MORIKAWA SAKIKO Y. , HORIKAWA CHIKA , KATO MITSUTOSHI , MAEGAWA HIROSHI , SONE HIROHITO ,   JDDM STUDY GROUP
Published: June 2019

Although obesity is closely associated with development and progression of type 2 diabetes mellitus (T2DM) and its complications, food group intake associated with obesity in diabetic patients has been very poorly investigated to date largely due to lack of large-scale databases with details on dietary intake. Thus, we aimed to determine intake of food groups by utilizing our nationwide database for people with diabetes with adjustment for confounders including energy intake. Analyzed were 1891 Japanese patients with T2DM (mean age, 62 y; men, 62%) who completed the Food Frequency Questionnaire. Obesity was defined by BMI&gt;25. The associations between obesity and food groups were determined by multivariate quartile analysis. Among 15 food groups, both green and yellow and light-colored vegetables had significant negative associations with the presence of obesity among both men and women (Table). In addition, fruit and beans in men and fish in women were also negatively associated with obesity. Conversely, confectionery had positive associations with obesity in both men and women. Other food groups such as rice, meat or eggs did not show significant trends toward the presence of obesity. These results identified favorable dietary patterns for people with T2DM, which could be used for effective nutritional education to prevent obesity.

Disclosure
M. Hatta: None. K. Fujihara: None. Y. Takeda: None. R. Nedachi: None. D. Ishii: None. S.Y. Morikawa: None. C. Horikawa: None. M. Kato: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. 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.