bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial Disparities in Cost of Diabetes for U.S. Medicare Beneficiaries
Authors: GLANTZ NAMINO M. , DUNCAN IAN , AHMED TAMIM , FAN LUDI , REED BEVERLY , KALIRAI SAMANEH , KERR DAVID 
Published: June 2018

Diabetes disproportionately impacts U.S. minority populations, with Hispanics almost twice as likely as non-Hispanic whites (nHW) to be diagnosed. We analyzed data from the Medicare 5% sample file by race/ethnicity for both type 1 (T1D) and type 2 diabetes (T2D). We identified 1,397,933 enrollees in fee-for-service without Medicare Advantage coverage during 2012-13.
Although nHW accounted for the majority of this population (81.3%), the prevalence of T1D and T2D was higher for Hispanics than nHW (3.4% vs. 1.8%, p=.0006 for T1D and 33.4% vs. 21.9%, p&lt;.0001 for T2D). Hispanics also had more acute hospital admissions (p=.0235 for T1D and p=.0009 for T2D) and longer length of stay (7.5 vs. 6.9 days for T1D, p=.0105 and 6.7 vs. 6.2 for T2D, p&lt;.0001). Allowed and paid costs per member per month adjusted for confounding were higher for nHW compared to Hispanics with T1D (both p&lt;.0001), and higher for Hispanics compared to nHW for T2D (both p&lt;.0001).
The burden of chronic disease was significantly higher in Hispanics than nHW (both T1D and T2D, p&lt;.0001). Hispanics with T1D were also more likely to have A1c and lipid tests (p=.0014 and p=.0011 respectively), although retinopathy and nephropathy screening rates were similar. For T2D, Hispanics were more likely to have A1c and lipid testing as well as retinopathy and nephropathy screening (all p&lt;.0001).
This highlights important racial disparities in the burden and cost of diabetes for Medicare recipients in the U.S.
Table: Adjusted costs per member per month by race and type of diabetesRace/Diabetes TypeAllowedPaidNon-diabetes Hispanic$626$548Non-diabetes nHW$572$490Hispanic T1D$2214$1933nHW T1D$2320*$2010*Hispanic T2D$1320$1158nHW T2D$1300**$1127***p&lt;.0001 vs Hispanics with T1D, ** p&lt;.0001 vs Hispanics with T2D

Disclosure
N.M. Glantz: Research Support; Self; Eli Lilly and Company. I. Duncan: Consultant; Self; Eli Lilly and Company. T. Ahmed: None. L. Fan: Employee; Self; Eli Lilly and Company. B. Reed: None. S. Kalirai: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. D. Kerr: Advisory Panel; Self; Glooko, Inc.. Research Support; Self; Eli Lilly and Company. Speaker's Bureau; Self; Sanofi-Aventis. Stock/Shareholder; Self; Cellnovo. Advisory Panel; Self; Novo Nordisk Inc..
Storage Conditions of Insulin in Domestic Refrigerators and Carried by Patients—Insulin Is Often Stored Outside Recommended Temperature Range
Authors: BRAUNE KATARINA , KRÄMER LAURA A. , ZAYANI AMIN , WEINSTEIN JEREMIAS , HEINEMANN LUTZ 
Published: June 2018

Objective: Not much is known about how patients with diabetes store their insulin in daily life. Objective of our study was to monitor temperature of refrigerated and carried insulin in industrialized countries to investigate how often storage conditions do not meet the manufacturers’ recommendations.
Method: Patients (n=338; 46% in the U.S., 41% in the EU) put a total number of 400 temperature loggers (MedAngel ONE, NL) next to their insulin into their refrigerator or diabetes bag. Temperature was measured every 3 minutes (up to 480 times/day). Measurements were sent to an app and stored in a protected online database. Whenever temperature exceeded the recommended range (2-8°C for refrigerated insulin, 2-30°C when opened/carried), the user was notified by an alarm. Data was collected from November 2016 to February 2018 with an average protocol length of 49 days.
Results: Temperature logs from individual sensors were analyzed (230 for refrigerated, 170 for carried insulin). Deviations were found in 315 (78.8%) logs (230 (100%) refrigerated, 85 (50%) carried). For refrigerated insulin, temperature recorded by an average sensor was out of the 2-8°C range 11.31% of the time (10.10%-13.10%; 2 hours 43 minutes/day) with an average deviation of 3.68K (SD 5.02K). For carried insulin, temperatures were out of 2-30°C range 0.54% of the time (0.48%-0.64%; 8 minutes/day) with an average deviation of 1.11K (SD 1.24K). 17% of sensors measured temperatures &lt;0°C (57 refrigerated, 9 carried).
Conclusion: Long-term storage conditions of insulin are known to have an impact on its blood-glucose lowering effect. These observational data showed that in a significant number of cases insulin was exposed to temperatures outside the recommended range, especially when refrigerated. Thus, domestic refrigerators may pose an underestimated risk for insulin quality. The extent of how temperature deviations in storage affect insulin efficacy and patient outcomes needs further systematic investigation.

Disclosure
K. Braune: None. L.A. Krämer: Employee; Self; Med Angel BV. A. Zayani: Stock/Shareholder; Self; Med Angel BV. Employee; Self; Med Angel BV. J. Weinstein: Employee; Self; Med Angel BV. L. Heinemann: Stock/Shareholder; Self; Profil Institute for Metabolic Research, ProSciento. Consultant; Self; Roche Diabetes Care Health and Digital Solutions.
IGFs and IGF-Binding Proteins in Pregnancy and Gestational Diabetes Mellitus
Authors: ANDERLOVÁ KATEřINA , SIMJAK PATRIK , CINKAJZLOVA ANNA , KLOUCKOVA JANA , KRATOCHVILOVA HELENA , LACINOVÁ ZDENA , KAVÁLKOVÁ PETRA , KREJCI HANA , MRAZ MILOS , HALUZIK MARTIN , KRSEK MICHAL 
Published: June 2018

The insulin-like growth factor (IGF) axis is involved in the regulation of growth and metabolism; however, little is known about its role in the development of gestational diabetes mellitus (GDM). The aim of our study was to determine serum IGF-1, IGF-2 and selected IGF binding protein (IGFBP) levels and their mRNA expression in subcutaneous (SAT) and visceral adipose tissue (VAT) and placenta in the context of pregnancy and GDM. Thirty-seven pregnant females - 21 with GDM (GDM group) and 16 without GDM (P group) - and 15 age-matched non-pregnant control females (NP group) were included into the study. Blood samples were taken in 28th-32th and 36th-38th gestational week and 6-12 months after delivery (GDM and P group) or before diagnostic laparoscopy (NP group). SAT, VAT and placental samples were obtained during delivery or surgery, respectively. Compared with NP group serum IGF-1, IGFBP-1 and 3 were increased in both GDM and P subjects reaching maximum levels in 38th-39th gestational week. IGF-2 was elevated only in GDM group culminating 6 months after delivery (745.1±24.7 vs. 909.2±62.8 vs. 998.7±92.7 ng/ml, p=0.017 for GDM and 726.9±28.4 vs. 791.2±44.2 vs. 748.9±58.4 ng/ml, p=0.341 for P group, respectively). IGFBP-3 was higher and IGFBP-4 was decreased in GDM vs. P group during the whole study (IGFBP3: 631.0±22.9 vs. 536.9±15.4 ng/ml, p=0.003 for GDM vs. P group; IGFBP4: 14.79±2.71 vs. 22.78±2.94 ng/ml, p&lt;0.001 for GDM vs. P group). mRNA expression of IGF-1, IGFBP-3, 4 and 5 was increased in SAT, while IGF-2 and IGFBP-4 mRNA was elevated in VAT in GDM and P relative to NP group. Placental mRNA expression of IGF-2, IGF-2 receptor, IGFBP-3 and 4 was higher in GDM compared with P group.
In conclusion, females with GDM had increased serum IGF-2, IGFBP-3 and reduced IGFBP-4 levels and elevated placental mRNA expression of several components of IGF axis compared with pregnant women without GDM. These changes might play a role in the development of GDM.

Disclosure
K. Anderlová: None. P. Simjak: None. A. Cinkajzlova: None. J. Klouckova: None. H. Kratochvilova: None. Z. Lacinová: None. P. Kaválková: None. H. Krejci: None. M. Mraz: None. M. Haluzik: None. M. Krsek: None.
The Association between Free Fatty Acid Level at Midpregnancy and Postpartum Glucose Intolerance in Women with Gestational Diabetes Mellitus
Authors: KIM KYUNG-SOO , KIM SOO-KYUNG , CHO YONG-WOOK , PARK SEOK WON 
Published: June 2018

Free fatty acid (FFA) is correlated with fetal growth during pregnancy and with neonatal fat mass in women with gestational diabetes mellitus (GDM). However, there are few studies between FFA level and postpartum glucose metabolism in women with GDM. The aim of this study was to evaluate the association between FFA level at mid-pregnancy and postpartum glucose intolerance in women with GDM. We enrolled 769 pregnant women diagnosed with GDM from February 2009 to October 2016. FFA levels (fasting and postprandial 2-h) were measured during 24-32 gestational weeks and 75-g OGTT was performed at 6-12 weeks after delivery. High FFA was defined by more than the median level of FFA at mid-pregnancy. Postpartum glucose intolerance was defined as fasting plasma glucose (FPG) ≥ 100 mg/dL or 2-h plasma glucose (2-h PG) ≥ 140 mg/dL. Mean age was 33.1 years and mean pre-pregnancy BMI was 22.4 kg/m2. The prevalence of postpartum glucose intolerance was 48.0% (n = 369). Although postprandial 2-h FFA level and FFA difference (between fasting and postprandial 2-h FFA) were not significantly different between two groups, women with postpartum glucose intolerance had higher fasting FFA level at mid-pregnancy than those with normal glucose tolerance (733.7 μEq/L vs. 700.6 μEq/L, P = 0.049). Compared to women with low fasting FFA, women with high fasting FFA had higher postpartum glucose intolerance (51.8% vs. 44.1%, P = 0.033). After adjustment for maternal age, pre-pregnancy BMI, parity, family history of diabetes, FPG, and lipid measures (total cholesterol, triglyceride, HDL-cholesterol), women with high fasting FFA were 1.47 times (95% CI 1.07-2.01) more likely to have postpartum glucose intolerance than those with low fasting FFA. In women with GDM, high fasting FFA level at mid-pregnancy is associated with elevated risk of postpartum glucose intolerance.

Disclosure
K. Kim: None. S. Kim: None. Y. Cho: None. S. Park: None.
CGM Shows Islet Transplantation Prevents Hypoglycemia, Correcting Time in Range and Reducing Glycemic Variability, Despite Subnormal Beta-Cell Function
Authors: FORBES SHAREEN , OLATEJU TOLU OLUTOYIN , LAM ANNA , CASEY JOHN , CAMPBELL JOHN , REID LAURA , ORAM RICHARD A. , MALCOLM ANDREW J. , SHAPIRO A.M. JAMES , SENIOR PETER A. 
Published: June 2018

The impact of clinical islet transplant (CIT) on glycemic variability compared with type 1 diabetes (T1D) subjects and nondiabetic controls has not been explored.
Aim: To evaluate the relationship between glycemic variability (by CGM) and islet graft function in CIT vs. T1D subjects on Continuous Subcutaneous Insulin Infusions (CSII), using healthy, nondiabetic subjects as reference.
Methods: CIT recipients n=39, (insulin independent vs. dependent: n=15 vs. n=24) and subjects on CSII therapy (n=10) all with T1D were assessed at 1 year post-intervention with CGM. Published data from nondiabetic controls were used for comparison. Fasting glucose, C-peptide and HbA1c concentrations and insulin dose were recorded (including in a control cohort, n=28) where applicable; BETA-2 scores were calculated in those with endogenous C-peptide.
Results: CIT recipients had decreased coefficient variation of glucose and lower time in hypoglycemia vs. those on CSII therapy; BETA-2 scores were ∼20% lower in CIT recipients vs. controls (p&lt;0.05).
Conclusion: Islet transplant recipients have diminished glycemic variability with abrogation of hypoglycemia vs. CSII at 1 year. Normalisation of time in range and glycemic variability was observed in insulin independent CIT recipients despite beta cell function ∼20% lower than in nondiabetic subjects.

Disclosure
S. Forbes: None. T. Olateju: None. A. Lam: None. J. Casey: None. J. Campbell: None. L. Reid: None. R.A. Oram: Other Relationship; Self; Randox. A.J. Malcolm: None. A. Shapiro: Consultant; Self; Viacyte, Inc., Protokinetix. P.A. Senior: Consultant; Self; Abbott, AstraZeneca. Research Support; Self; AstraZeneca, Prometic Life Sciences Inc., Novo Nordisk Inc., Sanofi. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company, Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc., Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; AstraZeneca, Merck & Co., Inc., Abbott. Research Support; Self; Viacyte, Inc..
Knowledge of Gestational Diabetes Mellitus among Women of Reproductive Age in Rivers State—Implications for Prevention and Control
Authors: OGU ROSEMARY , MADUKA OMOSIVIE , AGALA VETTY R. , PORBENI IBIMONYE ,   TE MEDICAL WOMEN'S ASSOCIATION OF NIGERIA, STA RIVERS 
Published: June 2018

Background: Diabetes mellitus has attained the status of an epidemic in slow motion. Gestational diabetes mellitus (GDM) is a sub-type which occurs in pregnancy. As part of a baseline assessment, the researchers sought to determine knowledge of GDM among women of reproductive age in the state.
Methods: The study was a descriptive cross-sectional household survey involving 2595 women of reproductive age residing in five local government areas in the state. It employed a multi-stage sampling technique to collect data using an interviewer-administered questionnaire built using Open Data Kit (ODK) software uploaded on android mobile phones.
Results: The response rate was 100%. Mean age was 29.25 ± 7.11 years. The majority (2,351;90.6%) had heard about diabetes Mellitus but only 991 (38.2%) knew that diabetes can occur for the first time in pregnancy. Only 747 (28.8%), 929 (35.8%) and 790 (30.4%) respondents had good knowledge scores for GDM definition and risk factors, GDM screening diagnosis and treatment and GDM complications respectively. Only 681 (26.2%) had good overall knowledge of GDM. The major sources of knowledge of GDM were from friends (49.8%), health workers (34.6%) and mass media (10.4%). Residence in two urban LGAs (AdjO.R=1.79; 95% CI=1.36-2.34) and (AdjO.R=1.89; 95% CI =1.37-2.61), being married (AdjO.R=1.50; 95% CI=1.16-1.95) and having been pregnant (AdjO.R=2.69; 95% CI= 1.99-3.64) positively predicted good overall knowledge of GDM.
Conclusion: These results underscore the need for information, education and communication (IEC) activities on a large scale targeted at women of reproductive age and their partners for prevention and control of GDM.

Disclosure
R. Ogu: None. O. Maduka: None. V.R. Agala: None. I. Porbeni: None.
Intensive Metabolic Control of T1D Pregnant Women in CSII vs. MDI—A Retrospective Analysis
Authors: PARRETTINI SARA , GIARDINA IRENE , CARDINI FRANCESCA , TORLONE ELISABETTA 
Published: June 2018

Diabetes-complicated pregnancy requires intensive gluco-metabolic monitoring. There is no clear evidence that insulin pump therapy (CSII) is superior to multiple daily injections with insulin analogs (MDI) in achieving tight glycemic control. We conducted a retrospective analysis on 72 (69 singles and 3 twins) T1D pregnant women, followed at the Diabetes and Pregnancy Unit (University Hospital, Perugia) since the first weeks of gestation or before conception. Maternal metabolic parameters (HbA1c, mean BG, weight gain, prandial and basal insulin needs and percentage increase in insulin requirement, I:CHO ratio) at conception, and each trimester, were assessed. Finally, neonatal outcomes (birth weight, newborn age, neonatal complications-malformations incidence) were analyzed. We compared the data with regard to applied regimens (CSII vs. MDI). 28 women were on CSII (38.8%) and 44 on MDI therapy, with mean HbA1c at conception of 7.1 ± 0.7% vs. 7.2 ± 1.2%, respecively (P&gt; 0.05). Women who received pre-conceptional counseling (56% of CSII women vs. 13% of MDI), showed significantly lower HbA1c at conception (6.7 ± 0.6 vs. 7.3 ± 1.1, p &lt;0.05). Disease duration, previous abortion rate and prevalence of chronic complications (class D-G, White classification) were significantly higher in CSII group. In single pregnancies, no significant differences were observed, in CSII vs. MDI, as far as HbA1c, insulin (U/Kg), percentage increase of insulin requirement, I:CHO ratio, weight increase, gestation term, birth weight, prevalence of maternal and neonatal complications were concerned (p&gt; 0.05). CSII was not proved superior to MDI in the management of pregnancy, in terms of neither maternal insulin requirements nor of maternal-fetal outcomes. Intensive management of diabetic pregnancy ensures stringent glycemic control, regardless of treatment with CSII or MDI. The choice of treatment modality should be targeted on pre-gestational and individual parameters.

Disclosure
S. Parrettini: None. I. Giardina: None. F. Cardini: None. E. Torlone: Other Relationship; Self; Medtronic MiniMed, Inc., Novo Nordisk Inc., Eli Lilly and Company, Roche Diabetes Care Health and Digital Solutions, Sanofi-Aventis, Menarini Group.
Treatment of Gestational Diabetes and Offspring Early Childhood Growth
Authors: FEGHALI MAISA N. , ATLASS JACQUELINE , CARITIS STEVE , CATOV JANET M. , SCIFRES CHRISTINA M. 
Published: June 2018

Gestational diabetes mellitus (GDM) is associated with childhood obesity and there is concern that glyburide is associated with macrosomia and perhaps childhood overgrowth.
We sought to examine if GDM treatment type is associated with differences in early childhood growth using a retrospective cohort of 952 women with GDM and their offspring. We collected pregnancy and breastfeeding data as well as height and weight through age 3. We used bivariate and multivariable regression analyses to compare early childhood growth among maternal GDM treatment.
Treatment was divided into medical nutritional therapy (MNT), glyburide, and insulin. LGA at birth was more common in offspring exposed to insulin and glyburide compared to those treated with MNT (11.7 vs. 9.2 vs. 5.7%, p=0.03). Weight or BMI at 6 months, 1, 2 and 3 years of age did not differ among children born to women with different GDM treatments. GDM treatment type was not predictive of weight or associated with a higher risk for BMI &gt;85th percentile at age 2 or 3 years after adjusting for covariates including gender, age at recorded weight, birth weight category, pre-pregnancy BMI, gestational weight gain, and breastfeeding.
Our findings suggest that maternal pre-pregnancy BMI but not GDM treatment is associated with variations in early childhood growth. Further studies are needed to determine if these findings persist beyond 3 years of age and to explore differences in body composition.
Factors associated with offspring weight at 2 yearsFactors associated with offspring weight at 3 yearsBeta Coefficient (95% CI)PBeta Coefficient (95% CI)PMNT (n=344) Glyburide (n=490) Insulin (n=117)Ref -0.16 (-0.48-0.15) -0.27 (-0.74-0.21)n/a 0.30 0.27Ref -0.13 (-0.53-0.26) 0.35 (-0.22-0.93)n/a 0.50 0.23Female gender-0.48 (-0.75- -0.20)0.001-0.59 (-0.94- -0.25)0.001Prepregnancy BMI0.16 (0.06-0.27)0.0030.17 (0.02-0.31)0.026Pregnancy weight gain (lbs)0.0(-0.003-0.02)0.150.036 (0.011-0.061)0.004Any breastfeeding-0.30 (-0.06- -0.02)0.04-0.41 (-0.77- -0.04)0.03Birth weight category AGA SGA LGARef -1.16 (-1.6- -0.7) 0.88 (0.32-1.44)n/a &lt;0.001 0.002Ref -1.40 (-1.99- -0.82) 1.53 (0.91-2.15)n/a &lt;0.0 01 &lt;0.001

Disclosure
M.N. Feghali: None. J. Atlass: None. S. Caritis: None. J.M. Catov: None. C.M. Scifres: None.
Serum Sclerostin, Body Composition, and Physical Function in Postmenopausal Women with Type 2 Diabetes
Authors: BANDEIRA FRANCISCO , CHAVES CONCEIÇAO D. , BANDEIRA FARIAS MARIA ELBA , PIMENTEL LARISSA B. , FARIAS LEONARDO 
Published: June 2018

Backgound: Sclerostin (SCL), produced mainly by osteocytes, inhibits the Wnt pathway and bone formation, and may be influenced by skeletal muscle mass.
Objective: To evaluate serum sclerostin levels, body composition and physical function in postmenopausal women (PMW) with T2DM.
Methods: We studied 250 PMW (125 with T2DM and 125 PMW without diabetes) with HbA1c below 10%, estimated GFR above 60 ml/min/1.73m2, and compared body composition analysis by multifrequency-bioelectrical impedance, gait speed (GS) and serum sclerostin with metabolic parameters.
Results: Although there were no differences between cases and controls regarding age and years since menopause (62.9±8.3 vs. 61.8±7.5 years, p=0.11; 14.3 ± 12.1 vs. 12.1±8.2 years, p=0.12, respectively), high circulating SCL and sarcopenia (low GS and fat free mass index) were found in 76% / 89.6% of T2DM vs. 61.6% / 72.8% of controls; p=0.014 and p=0.001, respectively. T2DM had more adiposity than controls: BMI 31.0± 29.5 vs. 29.4±29 kg/m2, p=0.04; WC 102.2±12.8 vs. 95.5±11.6 cm, p&lt;0.001; fat mass 29.3±7.6 vs. 26.7±7.1% body weight, p=0.008; and serum triglycerides 153.8±74 vs. 128.3±50.0 mg/dl, p=0.004.
Conclusion: Serum sclerostin is high in PMW with T2DM, as well as the presence of sarcopenia. Since SCL is also involved in vascular endothelial remodeling and inflammation, adiposopathy may also be related to high SCL in T2DM.

Disclosure
F. Bandeira: Consultant; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Novo Nordisk Inc.. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. C.D. Chaves: None. M. Bandeira Farias: None. L.B. Pimentel: None. L. Farias: None.
Long-Term Effects of Lifestyle Intervention and Metformin during DPP on Appendicular Lean Mass
Authors: SCHWARTZ ANN V. , PAN QING , HAZUDA HELEN P. , HORTON EDWARD , HOSKIN MARY A. , KALYANI RITA RASTOGI , KNOWLER WILLIAM C. , KRISKA ANDREA , SCHLÖGL MATHIAS , FLOREZ HERMES ,   DPP RESEARCH GROUP
Published: June 2018

Weight loss prevents progression to diabetes but long term effects on lean mass are unknown. We determined if intensive lifestyle modification (ILS), metformin (MET) or placebo (PLB) treatment in the Diabetes Prevention Program (DPP) had differential effects on appendicular lean mass (ALM) and sarcopenic-obesity (SO) ∼16 years after DPP randomization in the DPP Outcome Study (DPPOS). During DPP, 3234 participants at high risk for diabetes were randomized to ILS, MET or PLB; 2779 continued in DPPOS and were offered modified group ILS. During DPPOS, ILS was offered additional lifestyle reinforcement semi-annually and MET received unmasked metformin. This analysis includes 1374 DPPOS participants who had dual-energy X-ray absorptiometry scans at year 12 for ALM (sum of lean mass in arms and legs). Low ALM was defined as ALM/BMI &lt;0.789 for men or &lt;0.512 for women. SO was defined as low ALM with BMI&gt;30. Prevalence of low ALM and SO was compared across the 3 groups using Pearson’s chi-squared test. Logistic regression models determined the associations between treatment and low ALM or SO and between weight loss and low ALM or SO. Mean age at Y12 was 66.5 (±9.5) years. Mean time since DPP baseline was 15.6 (±0.7) years. Weight loss (DPP baseline to DPPOS Y12) did not differ by group (-4.4 kg ILS; -3.5 kg MET; -3.1 kg PLB; p=0.114). Prevalence of low ALM differed by group in men (35.7% ILS, 28.3% MET, 22.5% PLB; p=0.049) but not women (20.9% ILS, 24.8% MET, 24.1% PLB; p=0.482). In men, low ALM prevalence was higher in ILS compared with PLB (P=0.024) but not in MET vs. PLB. Prevalence of SO did not differ across groups in men (23.1% ISL, 22.0% MET, 14.1% PLB; p=0.112) or women (17.3% ILS, 20.9% MET, 20.3% PLB; p=0.492). SO prevalence was not different in ILS vs. PLB or in MET vs. PLB in men or women. More weight loss was associated with higher risk of low ALM and SO in women and men (p&lt;0.001) independent of group. In men but not women at high risk of diabetes, lifestyle intervention to prevent diabetes may contribute to lower ALM.

Disclosure
A.V. Schwartz: None. Q. Pan: None. H.P. Hazuda: None. E. Horton: Advisory Panel; Self; PTS Diagnostics, Merck & Co., Inc., Theracos, Inc.. M.A. Hoskin: None. R. Rastogi Kalyani: None. W.C. Knowler: None. A. Kriska: None. M. Schlögl: None. H. Florez: Advisory Panel; Self; Sanofi. D. Research Group: None.