bluuebunny/crossref_metadata_2025_split huggingface dataset:
2250-PUB: Fatty Acid Composition and Diabetic Kidney Disease in Type 2 Diabetes
Authors: KAWAI MIKI , ETO RUMA , AYAKO FUCHIGAMI , SATO GENKI , HIJIKATA MAI , YAMASHITA KAORU , ICHIJO TAKAMASA , HIGA MARIKO 
Published: June 2019

Aim: Elevated saturated fatty acid (SFA) and decreased polyunsaturated fatty acid (PUFA) levels, especially n-3 PUFAs levels are important in the development of obesity and metabolic syndrome, but there are few accounts of the relationship between fatty acid composition and diabetic kidney disease. We investigated whether serum fatty acid composition, especially SFA and PUFA, are associated with urine albumin excretion (UAE) and estimated glomerular filtration rate (eGFR) in obese type 2 diabetic patients.
Research Design and Method: The subjects were 85 patients (age: 60.3±13.9 years old, 47 male and 38 female) who were not taking EPA agents. They were divided into two groups, i.e., Obese group (n=54) with a BMI of more than 25 kg/m2 and non-Obese group (n=31) with a BMI below 25 kg/m2. Serum levels of fatty acids were measured by gas chromatography.
Results: In the Obese group, the serum levels of palmitic acids and stearic acids, which belong to SFA, and dihomo-gamma-linolenic acid (DGLA), which is an n-6 PUFA, were significantly higher than those in the non-Obese group. No significant differences were seen in the serum levels of n-3 PUFA. UAE in the Obese group was 218.8±88.9 mg/gCr, which tended to be higher than that in the non-Obese group (135.9±49.0 mg/gCr), but there were no significant differences in eGFR between the two groups. The serum levels of palmitic acids, stearic acids, and DGLA showed significant positive correlations with UAE and eGFR in the Obese group, while no significant correlation was seen in the non-Obese group. Palmitic acids and DGLA were correlated with serum adiponectin and leptin levels.
Conclusion: These results suggest that an excessive lipid intake may play an important role in the development of not only obesity but also diabetic kidney disease. The high levels of blood SFA and n-6 PUFA might contribute to the diabetic kidney disease progression via hyperfiltration and inflammatory effects in type 2 diabetes patients with obesity.

Disclosure
M. Kawai: None. R. Eto: None. F. Ayako: None. G. Sato: None. M. Hijikata: None. K. Yamashita: None. T. Ichijo: None. M. Higa: None.
226-OR: The Lipoprotein Insulin Resistance Index Is a Measure of Hepatic and Total Insulin Resistance: The Federal Women's Study
Authors: CRAVALHO CELESTE K. , MEYERS ABBY G. , MABUNDO LILIAN , SUMNER ANNE E. , CHUNG STEPHANIE T. 
Published: June 2019

The lipoprotein insulin resistance index (LPIR) is an emerging biomarker that correlates with peripheral insulin resistance (IR) derived from a composite score of 6 nuclear magnetic resonance (NMR) lipoprotein (LP) parameters. However, its ability to reflect hepatic and total body IR in women of African descent, who have low-normal triglyceride-rich LP particles, is unclear. Our objectives were to compare LPIR in black (BW) and white (WW) women and determine the association with insulin sensitivity index (SI), hepatic insulin sensitivity index (HISI), and hepatic and visceral fat content. In 127 federally employed women without diabetes (78 BW and 49 WW; age 44±10 (24-62y); BMI 30.2±5.7 (20.3-45.2 kg/m2); mean±SD (range)), LPIR was derived, SI was calculated by the minimal model, basal HISI using stable isotopes and hepatic and visceral fat measured by proton NMR. LPIR was lower in BW (18 (8-37) vs. 26 (14-41), median (IQR), P=0.04) but there was no difference by race in the correlation coefficients of LPIR with SI (r=-0.5), HISI (r=-0.6), hepatic fat (r=0.5), visceral fat (r=0.6), all P&lt;0.01. Compared to the 1st quartile, the 4th quartile of LPIR was associated with lower hepatic and total IR, and higher hepatic and visceral fat (Table). Overall, the LPIR index was a strong correlate of hepatic and total IR and may be a useful index for identifying individuals who are at risk for diabetes.

Disclosure
C.K. Cravalho: None. A.G. Meyers: None. L. Mabundo: None. A.E. Sumner: None. S.T. Chung: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases
227-LB: Sociodemographic and Lifestyle Factors Associated with Long-Term Weight Change among Low-Income Blacks and Whites
Authors: YANG JAE JEONG , SHU XIAO-OU , YU DANXIA 
Published: June 2019

Objective: American adults gain on average 1-2 lb/year. Sociodemographic and lifestyle factors have been shown to influence body weight. This influence has not yet been well characterized among blacks and low-income Americans, who are at high risk for obesity and related diseases.
Methods: Included in the study were 12,261 blacks and 6,307 whites, 40-69 years old, who participate in the Southern Community Cohort Study, had no history of diabetes, cardiovascular disease, or cancer, and reported ≥2 body weight measures, one at baseline and another during follow-up. Mixed model was used to evaluate 5-year weight change in relation to baseline factors and changes in factors during follow-up. Analyses were conducted among all subjects and stratified by sex and race and baseline obesity status. Differences in 5-year weight change&gt;1 lb with FDR-p&lt;0.10 were considered significant.
Results: During follow-up (median: 6 years; range: 0.5-15 years), participants gained 2.5 lb/year. After mutual adjustments, greater 5-year weight gain was seen among men (+1.61 lb) than women and associated with getting married (+1.67 lb), quitting smoking (+4.72 lb), and transition to menopause (+1.98 lb). The association for marital status change was most evident among white men (+5.80 lb) and the association for quitting smoking was most evident among subjects with baseline BMI&gt;35 (+8.95 lb). Diet and other lifestyle factors (e.g., physical activity) overall contributed modestly to 5-year weight change in this population, although associations were observed for per serving increase in greens and beans among white women (-4.61 lb) and dairy among white men (+3.30 lb) and Healthy Eating Index among subjects with BMI&gt;35 (-2.02 lb per 10 points increase).
Conclusion: Changes in smoking, marriage, and menopause status contribute to body weight change among low-income Americans. Certain dietary factors are also related to weight change, but the association may vary by sex, race, and obesity status.

Disclosure
J. Yang: None. X. Shu: None. D. Yu: None.
2274-PUB: Glycemic Index and Response of Plant-Based Nutritional Supplement and Its Subjective Satiety in Indian Adults
Authors: MOHAN VISWANATHAN , PARTHASARTHY VIJAYALAKSHMI , JEEVAN R. GANESH , VISWANATHAN GOPINATH , VASUDEVAN KAVITHA , NAGAMUTHU GAYATHRI , RAJAGOPAL GAYATHRI , KARTHIKEYAN PARKAVI , SHANMUGAM SHOBANA , ANJANA RANJIT MOHAN , UNNIKRISHNAN RANJIT , VASUDEVAN SUDHA , TOPPO ARCHANA , MEHTA SUYOG , ACHARYA SHIVANI A. , BHOITE RACHANA MAHESH 
Published: June 2019

Background: The major nutritional challenges faced by individuals with diabetes in South Asia is adhering to dietary advocacy and providing optimal nutrition with adequate protein and dietary fibre as they usually consume very high carbohydrate diet. This is particularly a concern in vegetarians.
Aim: The objective of the study was to assess the Glycemic Index (GI) and Glycemic Response (GR) of two different flavors of a plant based nutritional supplement specially designed with high protein and fibre. The subjective satiety was also assessed.
Methods: In all, fifteen overweight/obese subjects aged 18-45 years were recruited. After overnight fasting, blood samples were drawn at -5 and 0 minutes. Test and reference food providing available carbohydrates of 25g each was consumed by the participants. The capillary blood samples were drawn at 15, 30, 45, 60, 90 and 120 minutes. Participants underwent 3 days of reference food testing and 1 day of test food test in random order with 2 days of wash out period. The GI was assessed using validated ISO, 2010 protocol. Satiety index was measured using Visual Analog Scale (VAS). The dietary intake of the subjects for previous day and the test day was measured by 24-hour dietary recall. The Incremental Area Under the Curve (IAUC) was calculated using the trapezoid rule. The study was registered in the clinical trial registry of India, CTRI/2018/04/012979.
Results: The GI and GR of both flavors of the supplement was categorized as low GI. The GI and GR of Flavor 1 was 27.3±4.8 and 16.4 ±2.6 (Mean ± SEM) respectively. For Flavor 2 the GI and GR was 36.7±4.4 and 25.7 ± 2.3 (Mean ± SEM). For Flavor 1, 60% of participants reported feeling hungry only after 3 hours, showing good satiety.
Conclusion: The plant based high fibre high protein supplement, along with regular meal could help in reducing the postprandial glycemic response and improve satiety.

Disclosure
V. Mohan: None. V. Parthasarthy: None. R. Jeevan: None. G. Viswanathan: None. K. Vasudevan: None. G. Nagamuthu: None. G. Rajagopal: None. P. Karthikeyan: None. S. Shanmugam: None. R. Anjana: None. R. Unnikrishnan: None. S. Vasudevan: None. A. Toppo: Employee; Self; Dr. Reddys Laboratories. S. Mehta: Employee; Self; Dr. Reddys Laboratories. S.A. Acharya: Employee; Self; Dr. Reddys Laboratories. R.M. Bhoite: Employee; Self; Dr. Reddys Laboratories.
2282-PUB: Differences in Child Psychosocial Functioning According to Diabetes and Weight Status
Authors: GUSEMAN EMILY H. , ENGLERT MARIA K. , WHIPPS JONATHON , SCHULZE MEGHAN , BEVERLY ELIZABETH A. 
Published: June 2019

Children with diabetes may be expected to experience greater psychosocial difficulty than children without chronic diseases, however less is known about how this varies according to weight status.
Purpose: The purpose of this study was to evaluate differences in child psychosocial functioning among children with type 1 diabetes (T1D) in comparison to children with overweight and obesity.
Methods: Parents of children age 2-17 years were invited to participate in this online survey study. Parents reported child demographics, chronic disease diagnoses, body size, and completed the parent version of the 35-item Pediatric Symptom Checklist (PSC). Children were classified into 4 groups based on diagnosis of T1D, and then according to BMI percentile. ANOVA was used to compare PSC total score and internalizing, externalizing, and attention subscales between groups. Multiple regression was used to examine the contribution of T1D diagnosis, age, gender, and BMI percentile to PSC total score.
Results: A total of 133 children were included in the analysis (mean age 9.7 + 3.1 years, 48.9% girls). PSC total score was highest among children with T1D (54.25 + 17.9) followed by children with obesity (48.1 + 16.6), comparison (46.6 + 12.4), and overweight children (43.8 + 14.0); however, these differences did not reach statistical significance. Comparison children demonstrated higher externalizing and internalizing subscale scores than did overweight children, while the highest attention subscale score was found among children with obesity. The strongest predictor of PSC total score was T1D (unstandardized B = 9.4; p=0.03).
Discussion: No differences were found in psychosocial functioning among this sample. Trends in the data suggest that the presence of T1D, and potentially obesity, may be associated with worse psychosocial functioning among children. However, additional studies are needed to confirm.

Disclosure
E.H. Guseman: None. M.K. Englert: None. J. Whipps: None. M. Schulze: None. E.A. Beverly: None.
2288-PUB: Capturing the Emotional Burden of Gestational Diabetes
Authors: HARDING ANNA-JANE , MCGILL MARGARET , GAULD AMANDA , PECH CHRISTINE M. , O'CONNOR DANIEL , CONSTANTINO MARIA I. , ROSS GLYNIS P. , WU TED , WONG JENCIA 
Published: June 2019

Gestational diabetes (GDM) is increasingly common and the burden to healthcare services is well recognized. Less understood is the emotional burden associated with a diagnosis of GDM, from the women’s perspective. A qualitative study of women attending the Royal Prince Alfred Hospital, Sydney Antenatal Diabetes Service was undertaken during a 14-week period in 2018. Women were invited to complete an anonymous questionnaire which asked, “How do you feel about the diagnosis of Gestational Diabetes?” Women were included in the study at three time points, i) newly diagnosed with GDM ii) at 36 weeks gestation and iii) at 3-month follow-up post-delivery. Responses were received from 189 women; 121, 32 and 36 at diagnosis, 36 weeks and post-delivery time points respectively. Their free text responses were transcribed and a thematic analysis of content was undertaken. Results were visualized using a word cloud and tag cloud generator (www.wordclouds.com) with font size representing the prominence or frequency of words expressed. As demonstrated by the images generated, the predominant feelings expressed at diagnosis were ‘worried,’ ‘disappointed,’ ‘upset,’ ‘sad’ and ‘anxious.’ These negative emotions prevailed irrespective of previous GDM experience and maternal age. At 36 weeks the predominant feelings expressed were ‘frustrated,’ ‘disappointed,’ ‘worried,’ ‘upset’ and ‘anxious.’ The primary emotion expressed in diet treated women was ‘anxious’ and in insulin treated women ‘worried.’ Post-delivery, the predominant words were ‘relieved,’ ‘supported’ and ‘anxious.’
In conclusion, there was a high prevalence of negative emotion expressed by women with GDM at diagnosis which persisted throughout pregnancy and, for many, into the postnatal period. Clinicians need to be mindful of this high emotional burden with the aim to better support women with GDM and reduce associated distress.

Disclosure
A. Harding: None. M. McGill: None. A. Gauld: None. C.M. Pech: None. D. O'Connor: None. M.I. Constantino: None. G.P. Ross: Other Relationship; Self; Roche Diabetes Care Australia. T. Wu: Advisory Panel; Self; Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk A/S, Sanofi. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. J. Wong: Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; AstraZeneca, Lilly Diabetes.
2303-PUB: Efficacy of Dulaglutide (DU) as First Injectable Option for Patients with Type 2 Diabetes (T2D): A Post Hoc Pooled Analysis
Authors: PATEL HIREN , MUNIR KASHIF M. , SUTHERLAND SINDEE S. , KONIG MANIGE 
Published: June 2019

Background: ADA-EASD consensus report recommends using GLP-1RAs including DU as 1st injectable therapy prior to basal insulin in most patients with T2D not at their glycemic goals after oral antidiabetic medications (OADs).
Objective To assess the glycemic efficacy of DU 1.5 mg in patients with T2D when added on background of commonly used OAD regimens.
Methods: Patients from 7 Phase-3 trials where DU 1.5 mg was added to OADs were pooled and categorized based on OAD regimens into the following categories; Metformin (MET), sulfonylurea (SU), MET + SU, MET + Pioglitazone, MET + SGLT2i. DU 0.75 mg was assessed in only 5 studies and hence not included in this analysis. Change from baseline in HbA1c, fasting serum glucose and body weight, % patients with HbA1c &lt;7%, GI adverse events and hypoglycemia were assessed.
Results: Table 1 summarizes the glycemic and weight outcomes of DU at baseline and after 6 months for different OAD categories. HbA1c reduction of -1.3 to -1.6% and weight change of -0.8 to -2.9 kg was seen when DU was added to different OADs. Nausea, vomiting and diarrhea were reported by 10-35%, 4-19% and 6-28% patients respectively. Severe hypoglycemia occurred in 1 patient in MET+SU group.
Conclusion: In patients with T2D on different OAD regimens and requiring an additional glycemic control, DU demonstrated clinically meaningful glycemic control making it an effective first injectable option.

Disclosure
H. Patel: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. K.M. Munir: None. S.S. Sutherland: Other Relationship; Self; Eli Lilly and Company. M. Konig: Employee; Self; Eli Lilly and Company, Eli Lilly and Company.
2304-PUB: Liraglutide also Has Favorable Effects on Body Composition without Decrease in Lean Body
Authors: KANEKO SHIZUKA , UEDA YOUHEI , TAHARA YUMIKO 
Published: June 2019

Background/Objective: It has been known that liraglutide GLP-1 therapy produces a decrease in body weight with a concurrent decrease in appetite. However, we felt it was important to investigate this phenomenon more deeply in order to ascertain whether there were effects an leanness or body fat, especially visceral fat which may induce atherosclerosis.
Method: We conducted an observation study to investigate the effect of liraglutide therapy (n=53), a GLP-1RAg, on body composition in patients during hospitalization. These results were compared with those obtained from insulin therapy (n=130). Diet therapy (ideal BW x 27 kcal/day including &lt;25% fat and &gt;55% carbohydrate) and exercise therapy after every meal were provided. Body weight changes, body composition (i.e., lean body mass and % body fat) and were analyzed.
Result: We found the body weights of subjects receiving liraglutide decreased by 2.4 ± 2.0. However, for insulin therapy, subjects body weight only decreased by 1.6 ± 2.1 kg (p &lt; 0.05). In addition, lean body mass in the liraglutide and insulin groups showed no significant changes from the first day of therapy. However, regarding visceral fat area (VFA), we found that patients undergoing liraglutide and insulin therapy tended to experience a decrease (101±152.4 vs. 113±171.7 cm2).
Conclusion: Our study showed the administration of liraglutide reduced visceral fat, but not lean body mass. In addition, we found that diet and exercise therapy mostly contribute to decrease in visceral fat regardless of the medication.

Disclosure
S. Kaneko: Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Sumitomo Dainippon Pharma Co., Ltd. Y. Ueda: None. Y. Tahara: None.
2318-PUB: Patient Experience after Using a Medtronic Enhanced Hybrid Closed-Loop System
Authors: SADEGHZADEH MAHTA 
Published: June 2019

Objective: The prototype enhanced hybrid closed-loop (E-HCL) system has iterative changes from the current HCL system that include automated correction boluses to address hyperglycemia and improved usability. User experience with this system was qualitatively assessed after a 1-week supervised hotel phase and 3-week at-home phase.
Method: Twelve adults (median age 48 [39-57] years and HbA1c 6.8% [6.2-7.2%]) with type 1 diabetes were asked to complete a Medtronic-developed survey (5-point scale) after completing a hotel and at-home phase of E-HCL system use. In addition, they were interviewed for an hour after completing the study.
Result: After completion of both phases, 100% of respondents rated the E-HCL system 5.0±0.0, the best therapy they have ever been on, all rated their overall satisfaction as extremely satisfied or very satisfied (4.8±0.4) with a net promoter score (NPS) of 100%. Reasons for high satisfaction were improved overall time in range, reduced highs after meals, increased time in Auto Mode, and reduced daily effort required to manage diabetes. All participants stated that they trusted the system to take care of their glucose and that it significantly increased their flexibility and confidence in taking care of their diabetes.
Conclusion: All users reported a high level of satisfaction with the prototype E-HCL system and believed it improved their outcomes while reducing their day to day effort in managing diabetes.

Disclosure
M. Sadeghzadeh: Employee; Self; Medtronic.
2327-PUB: Real-World Patient-Reported Outcomes (PROs) with Insulin Glargine 300 U/ml (Gla-300) in Basal Bolus-Treated People with Type 2 Diabetes (T2DM): The MAGE Study
Authors: VERHAEGEN ANN A. , SCHEEN ANDRÉ , ALEXANDRE KATHY C. , BRUHWYLER JACQUES , COLIN IDES M. 
Published: June 2019

Fear of hypoglycemia and treatment satisfaction both influence therapy adherence. MAGE was a 6-month multicenter, prospective, single-arm, observational study with a 6-month extension conducted in Belgium, mainly assessing patient satisfaction with Gla-300 in people ≥18 years, with T2DM for ≥1 year, HbA1c 7.0-10.0%, receiving a basal-bolus insulin regimen for ≥6 months ± oral antidiabetic therapy, and naïve to Gla-300. Primary objective: change of ≥2 points in Diabetes Treatment Satisfaction Questionnaire Status Version (DTSQs) total score (TS) from baseline (BL) to month 6. Secondary objectives included change in: HbA1c, other DTSQs scores, and hypoglycemia fear scale II (HFS-II). The intent-to-treat population comprised 87 patients (Table). Primary endpoint was achieved; DTSQs TS increased by 2.80 (SD: 5.46; p&lt;0.0001; Table). Significant decreases were seen in total HFS-II scores and worry/behavior subscales (all p&lt;0.05). There was no change from BL in HbA1c (p&gt;0.05); however, more patients reached HbA1c &lt;7% at month 12 versus BL (11.5% vs. 0%). Hypoglycemia occurred at a mean (SD) 34.97 (48.28) events per patient-year.
Treatment satisfaction and fear of hypoglycemia significantly improved after switching to Gla-300 in people with T2DM on basal-bolus insulin therapy in a real-life setting.

Disclosure
A.A. Verhaegen: Advisory Panel; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Merck & Co., Inc., Sanofi. Speaker's Bureau; Self; Mylan, Novo Nordisk Inc. A. Scheen: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi, Servier. Research Support; Self; AstraZeneca, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi, Servier. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim, Eli Lilly and Company, Janssen, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi, Servier. K.C. Alexandre: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. J. Bruhwyler: Other Relationship; Self; Sanofi. I.M. Colin: None.

Funding
Sanofi