bluuebunny/crossref_metadata_2025_split huggingface dataset:
2240-PUB: Healing Effect of Intracavernosal Platelet-Rich Plasma Transplantation in the Presence of Clopidogrel (Plavix) on the Progression of Erectile Dysfunction in Streptozotocin-Induced Diabetic Rats
Authors: GUR SERAP , YILMAZ-ORAL DIDEM 
Published: June 2019

Erectile dysfunction (ED) is one of the most neglected complications of diabetes. Platelet-rich plasma (PRP) is an autologous concentrate prepared from the collected blood and contains a high concentration of platelet growth factors which induce angiogenesis and provide the nerve regeneration. Clopidogrel is a platelet inhibitor or thienopyridine class inhibitor of P2Y12 ADP platelet receptors. In this study, we aimed to determine the effect of intracavernous injection of PRP and clopidogrel on ED in streptozotocin (STZ)-induced diabetic rats. A total of thirty Sprague-Dawley rats was divided into two groups: control and STZ-induced diabetic (45mg/kg, 8wk). In vivo erectile responses were measured after intracavernosal injection of PRP or clopidogrel and their combination in anesthetized rats. The relaxant effect of Clopidogrel in corpus cavernosum (CC) was obtained from in vitro study. The protein expression of endothelial and neuronal markers (eNOS, nNOS), HIF-1α and VEGF in the penile tissue was determined by Western blotting. Diabetic rats displayed significantly reduced in vivo erectile responses and basal intracavernosal pressure after were partially restored by intracavernosal administration of PRP and clopidogrel. Interestingly, combined intracavernosal administration completely improved decreased in vivo erectile responses. Clopidogrel caused marked relaxation in diabetic and control rat CC. In the diabetic group, increased HIF-1α protein levels and decreased eNOS, nNOS and VEGF protein levels were prevented by the combined treatment. These results may contribute to new insights in the management of ED linked to diabetes and encourage the development of novel therapeutic strategies in regenerative medicine. Further studies should need to focus on expanding combinations of PRP and an antiplatelet agent useful for clinical outcomes in diabetic men with ED.

Disclosure
S. Gur: None. D. Yilmaz-Oral: None.
225-OR: Key Role for Glucose-Alanine Cycling in the Regulation of Hepatic Mitochondrial Oxidation during Starvation in Humans
Authors: PETERSEN KITT , DUFOUR SYLVIE , CLINE GARY , SHULMAN GERALD I. 
Published: June 2019

We examined whether starvation alters rates of hepatic mitochondrial oxidation in humans by applying a novel 13C Positional Isotopomer NMR Tracer Analysis (PINTA) method to assess rates of hepatic mitochondrial oxidation in healthy volunteers (n=15) following an overnight (12h) and a 60h fast. A 3h intravenous infusion of [3-13C] lactate (4.3 μmol/Kg-min), [1,2,3,4,5,6,6-2H7] glucose (0.22 μmol/Kg-min), and [13C4]-β-hydroxybutyrate (BOHB) (0.01 mg/Kg-min) was administered and blood was collected for GC-MS, LC-MS/MS and 13C MRS PINTA analyses. Following the 60h fast rates of endogenous glucose production decreased by 27% (p=0.0002) and rates of hepatic mitochondrial oxidation decreased by 52% (p=0.0014) whereas rates of hepatic pyruvate carboxylase flux remained unchanged. To ascertain whether decreased rates of alanine turnover during starvation play a role in promoting decreased rates of hepatic mitochondrial oxidation we infused [3-13C] alanine in a subgroup (n=5) of subjects and found that 60h of fasting promoted a 28% reduction in alanine turnover (p=0.044 vs. 12h fast). In order to determine whether this reduction in alanine turnover was responsible for the reduced rates of hepatic mitochondrial oxidation we infused unlabeled alanine to a subgroup (n=9) of the 15 subjects in a repeat 60h fasting study to increase rates of alanine turnover to rates measured after 12h of fasting and found that this perturbation increased rates of hepatic mitochondrial oxidation by 63% (p=0.009 vs. 60h fast) to rates similar to the 12h fasting state (60h+ala: 232±21 vs. 12h: 295±44 μmol/min, p=0.303).
Conclusion: These studies demonstrate that 60h of starvation in humans induces marked reductions in rates of hepatic mitochondrial oxidation, which in turn can be attributed to reduced rates of glucose-alanine cycling.

Disclosure
K. Petersen: Advisory Panel; Spouse/Partner; Aegerion Pharmaceuticals, AstraZeneca, AstraZeneca, Janssen Research & Development, Merck & Co., Inc., Novo Nordisk A/S. Consultant; Spouse/Partner; Gilead Sciences, Inc. Consultant; Self; Merck & Co., Inc. Consultant; Spouse/Partner; Nimbus Discoverey. Consultant; Self; Novo Nordisk A/S. S. Dufour: None. G. Cline: None. G.I. Shulman: Advisory Panel; Self; AstraZeneca, Janssen Research & Development, Merck & Co., Inc. Advisory Panel; Spouse/Partner; Merck & Co., Inc. Board Member; Self; Novo Nordisk A/S. Consultant; Self; Aegerion Pharmaceuticals, IMetabolic BioPharma Corporation, Longitude Capital, Nimbus Discovery, Inc., Staten Biotechnology B.V.

Funding
National Institutes of Health
2262-PUB: Hypercortisolism as the Cause of Diabetes Mellitus Type 2
Authors: ISAZA ADRIAN 
Published: June 2019

According to the first global report of the World Health Organization, the number of adults with diabetes has increased to 422 million while causing 1.6 million deaths per year. This rise is largely due to type 2 diabetes mellitus. This study involved a literature search (PUBMED) which identified randomized controlled trials and systematic/literature reviews for interventions with an antidiabetic effect and risk factors that caused diabetes mellitus. Then studies were searched on the effect on cortisol for the interventions and risk factors. 71 natural interventions and 12 pharmaceuticals were found to decrease cortisol and exert an antidiabetic effect. On the other hand, 2 pharmaceuticals, 6 categories of pharmaceuticals and 20 risk factors increased cortisol and caused diabetes mellitus type 2. These results suggest that the hypothesis of diabetes mellitus type 2 being caused by chronic cortisol overproduction is plausible.

Disclosure
A. Isaza: None.
2263-PUB: Implementation of a Diabetes Self-Management Education (DSME) Program as Part of Discharge Counseling at a County Hospital
Authors: MULALA LISELI I. 
Published: June 2019

Implementation of a Diabetes Self-Management Education (DSME) Program as part of Discharge Counseling at a County Hospital.
The CDC reports 30.3 million people in the United States have diabetes. Adults with diabetes that received Diabetes Self Management Education (DSME) have been shown to have improved outcomes and reduced healthcare expenditures. Those that did not receive DSME are four times more likely to develop complications. The 2016 American Diabetes Association (ADA) Standards of Care in Diabetes recommends that every person receive DSME at diagnosis and as needed thereafter, such as during hospital discharge.
Diabetes education is most commonly provided by a Certified Diabetes Educator (CDE), most of whom are nurses or dietitians but about 8% of CDEs are pharmacists. At Zuckerberg San Francisco General Hospital and Trauma Center, there has not been a certified diabetes nurse educator (RN CDE) for the past 4 years. Pharmacists have the clinical training and counseling skills to be effective diabetes educators whether or not they are CDEs. Since August 2017, a pharmacist CDE along with the clinical pharmacy staff have been providing diabetes education along with discharge medication counseling to patients with diabetes prior to hospital discharge.
Currently, national rates of newly diagnosed patients that report receiving DSME in their first year ranges from 4-7%. The Center for Disease Control (CDC) reports that 57.4% of people with diabetes report ever attending a DSME class and that 59.8% report ever attending a DSME class within California. At ZSFG, the pharmacist CDE and clinical pharmacy staff provide DSME to patients with newly diagnosed diabetes, diabetic ketoacidosis and diabetic exacerbations. From May 2017 to September 2018 quarterly DSME rates increased from 0.6% in quarter 2 of 2017 to 97.8% in quarter 3 of 2018. Thus, showing that pharmacists can be a valuable resource to improve inpatient diabetes education rates in an institutional setting.

Disclosure
L.I. Mulala: None.
2268-PUB: Level of Physical Activity and Perceived Barriers to Exercise in Adults with Type 2 Diabetes in Argentina
Authors: MARTIN CAROLINA GOMEZ , POMARES MARIA L. , MURATORE CAROLINA M. , APOLONI SUSANA , AVILA PABLO J. , RODRIGUEZ MARTIN ,   ACTIGRAD STUDY GROUP
Published: June 2019

Physical activity (PA) is a mainstay in the management of type 2 diabetes (T2D) treatment. Data about level of PA and perceived barriers to exercise in adults with T2D is lacking in Argentina.
Objectives: Primary: To assess the percentage of adults with T2D who perform PA according to intensity level. Secondary: 1. To describe the barriers to exercise. 2. To describe the association between level of PA and metabolic control and other variables in the study population. 3. To evaluate sedentary time.
Methods: Multicenter, observational, cross-sectional study of data collection through 2 questionnaires: International PA Questionnaire (IPAQ) short form and the “Barriers to being Active Quiz” developed by Center for Disease Control (CDC). Clinical and biochemical data were also collected. We included adults with T2D age 18 to 65 years, in 17 Argentine diabetes centers, from May 2nd to July 15th, 2018.
Statistical Methods: Chi2, t student, Pearson and Spearman correlations, multiple logistic regression and multiple linear regression.
Results: 270 men (age 54.9 ± 9.8 years) and 225 women (age 55.3 + 9.6 years) were included. Diabetes duration: 8.2 ± 6.3 years. BMI men: 32.0 ± 10.6 Kg/m2 and women: 32.5 ± 7.2 Kg/m2. Two last HbA1c: 7.6 ± 1.7% and 7.5 ± 1.6%. 32.5% treated with insulin. 12.7% had cardiovascular disease; 13.7% nephropathy; 20.8% neuropathy; 6.1% diabetic foot and 14.1% retinopathy. The level of PA by IPAQ was low in 52.3% and moderate in 30.5%. The most frequent barriers were: "lack of will" (59.6%), "lack of energy" (37.2%) and "lack of time" (31.5%). Multivariate analysis: low level of PA was associated with age (OR: 1.05 per year of age, p &lt;0.001); A1c (OR: 1.16 per 1% p &lt;0.05); BMI (OR: 1.06 per kg/m2, p &lt;0.001) and sex (OR: 1.69 for women, p &lt;0.01). Sedentary time: median of 5 hours/day, with a 75th percentile of 6 hours/day. It was associated with HbA1c in the multivariate analysis (p = 0.02).
Conclusions: 52.3% showed a low level of PA and the main barriers are related to low personal motivation.

Disclosure
C. Gomez Martin: None. M.L. Pomares: None. C.M. Muratore: None. S. Apoloni: None. P.J. Avila: None. M. Rodriguez: None.
2271-PUB: Correlation of Glycaemic Control with pH and Buffering Capacity of Saliva in Patients with Fibrocalculous Pancreatic Diabetes
Authors: RADHAKRISHNAN CHANDNI , VADAKKEKUTTICAL ROSAMMA JOSEPH , KOZHITHODI SHAHNAS BEEGAM 
Published: June 2019

Fibrocalculous pancreatic diabetes (FCPD) is a form of diabetes secondary to chronic calcific pancreatitis. Microvascular and macrovascular complications of diabetes are reported in FCPD. Periodontitis is considered as the sixth complication of diabetes. Studies regarding the salivary pH, buffering capacity and periodontal health status of FCPD subjects are scarce in the literature. This Study comprised of 30 FCPD, 30 T2DM and 33 healthy controls. Study subjects were assessed for salivary pH and buffering capacity, modified gingival index, plaque index, OHI-s index, DMFT index, probing pocket depth and clinical attachment level and systemic parameters FPPG, PPPG, HbA1c, complete blood count, liver and renal function tests, FLP, ESR and CRP. The mean (±SD) salivary pH was 6.57 ± 0.63 in FCPD and 7.21±0.44 in T2DM groups (p&lt;0.05) and buffering capacity was 4.5± 0.6 in FCPD and 5.38± 0.96 in T2DM groups(p&lt;0.05). There was a significant negative correlation between HbA1c and salivary buffering capacity (Pearson correlation coefficient r=-0.46, p=0.012) and a weak negative correlation between HbA1c and salivary pH(r=-0.105, p=0.589) in FCPD group. The prevalence of periodontitis was 90% in FCPD and 100%T2DM groups respectively. The proportion of severe periodontitis was 56.7% in T2DM, 40% FCPD and 12.1% in control groups respectively. This study shows that the saliva is more acidic and buffering capacity is low in FCPD group compared to T2DM and control groups. As the glycaemic control worsens, salivary pH and buffering capacity decreased in FCPD subjects. The pathophysiologic mechanism responsible for the pancreatic gland destruction may also contribute to the changes in salivary pH and buffering capacity in FCPD subjects.

Disclosure
C. Radhakrishnan: None. R.J. Vadakkekuttical: None. S. Kozhithodi: None.
2278-PUB: Motivation and Attitudinal Assessment in Patients with T1D Using Multiple Daily Injections or Insulin Pump Therapy
Authors: ALFORD JORDIN , KOOBATIAN MAXWELL , DAIGLE BEN , MATHEWS KIERON , DIAS LOUIS 
Published: June 2019

Objective: To assess the attitudinal impact of patients living with T1D in the United States.
Methods: Between Sep 10th-Oct 21st, 2018, a representative sample of United States patients (n=600, 56% male, mean age 40.6 years, managing their T1D with multiple daily injections (MDI) or insulin pump therapy completed a 102-question online survey (5- or 7-point Likert scale) designed by Inspired Insight (Boston, Massachusetts, U.S.) in partnership with Medtronic. Respondent sample was identified and screened with standard methods. Analyses were conducted using Pearson’s correlation and quadratic equation modeling.
Results: Of the respondents, 47% agreed that T1D is a burden, 65% agreed that they wished they could escape their disease, 60% felt they were in control of their diabetes, and 57% agreed that their diabetes did not define them. Additionally, 60% of the respondents felt they were very knowledgeable about their disease, 71% were very motivated to manage their disease, and 72% were very interested in learning more about managing their disease. The longer that respondents had been living with diabetes, the less likely they felt in control of managing diabetes (Pearsons’ r=-0.108, p=0.008). While at the same time, motivation to manage their disease tended to increase (p=0.073, non-linear regression) and the overall level of knowledge tended to increase (r=0.071, p=0.067).
Conclusions: Not surprisingly, T1D is being perceived as a burdensome disease that many patients wish to escape from. Although patients who have been living with T1D longer feel that they lose control of diabetes management, they tend to become motivated to increase their knowledge toward better management of their diabetes.

Disclosure
J. Alford: Employee; Self; Medtronic. M. Koobatian: Employee; Self; Medtronic. B. Daigle: Research Support; Self; Medtronic MiniMed, Inc. K. Mathews: Other Relationship; Self; Medtronic. L. Dias: Employee; Self; Medtronic.
2279-PUB: Assessing the Impact of T1D in Patients on MDI or Insulin Pump Therapy
Authors: ALFORD JORDIN , KOOBATIAN MAXWELL , DAIGLE BEN , MATHEWS KIERON , DIAS LOUIS 
Published: June 2019

Objective: To assess patient attitudes, reactions, and motivations resulting from living with T1D.
Methods: Between Sep 10th-Oct 21st, 2018, a representative sample of United States patients (n=600, 56% male, mean age 40.6 years, managing their T1D with multiple daily injections (MDI) or insulin pump therapy completed a 102-question online survey (5- or 7-point Likert scale) designed by Inspired Insight (Boston, Massachusetts, U.S.) in partnership with Medtronic. Respondent sample was identified and screened with standard methods. Analyses were conducted using Pearson’s correlation and quadratic equation modeling.
Results: The survey showed that 58% of the respondents reported their disease as severe. Since the time of diagnosis, 44% of the individuals reported that living with diabetes has had a positive impact on their life, while 41% reported that it has had a negative impact on their life. Those respondents who felt that living with the disease negatively impacted their life, reported that the negative aspects were related to self-confidence (59%), achieving emotional wellbeing (58%), and the ability to be happy/optimistic (57%). Interestingly, those respondents who felt that living with the disease has positively impacted their life, reported that the positive aspects were related to having self-confidence (81%), being physically fit/active (80%), and achieving emotional wellbeing (80%).
Conclusions: Though the majority of patients who were assessed recognized the severity of their disease, they were polarized when it came to reporting how living with diabetes has impacted their life. Some found that their self-confidence and emotional wellbeing were positively impacted, while a proportionate number felt the opposite.

Disclosure
J. Alford: Employee; Self; Medtronic. M. Koobatian: Employee; Self; Medtronic. B. Daigle: Research Support; Self; Medtronic MiniMed, Inc. K. Mathews: Other Relationship; Self; Medtronic. L. Dias: Employee; Self; Medtronic.
2283-PUB: Association between Higher Health-Related Quality of Life Physical Component Score Measured by SF-8 and Lower All-Cause Mortality Risk among Japanese Patients with Type 2 Diabetes: A Prospective Cohort Study
Authors: HAYASHINO YASUAKI , OKAMURA SHINTARO , ISHII HITOSHI 
Published: June 2019

Health-related quality of life (HRQoL) was reportedly associated with mortality; however, these studies used questionnaires with relatively large number of items ranging from 20 to 30. We thus evaluated the prospective association between HRQoL measured by Short-Form (SF)-8, a short version of SF-36, in Japanese individuals with type 2 diabetes. Longitudinal data of 3,269 individuals with diabetes were obtained from a large Japanese diabetes registry. To assess the independent correlation between the 10-point increment of SF-8 physical component summary score (PCS) or mental component summary score (MCS) and all-cause mortality, the Cox proportional hazards model was used with adjustment for age, sex, body mass index, HbA1c, types of diabetes therapy, urinary albumin-creatinine ratio, history of diabetic retinopathy, symptomatic diabetic neuropathy, and past medical history (acute myocardial infarction, chronic stable angina, peripheral artery disease, leg ulceration, ischemic stroke, and hemorrhagic stroke). The mean age, body mass index, and HbA1c level were 64.9 years (SD 11.2), 24.6 kg/m2 (SD 3.9), and 7.5% (SD 1.2) [or 58.6 mmol/mol (SD 12.7)], respectively. We recorded 248 deaths during the median follow-up of 6.1 years (incidence ratio = 14.0/1,000 person-years). We observed significant association of PSC score and all-cause mortality, and multivariable-adjusted hazard ratio (HR) was 0.775 [95% confidence interval (CI), 0.668-0.899; p = 0.001] per 10-point increment of PCS score. We did not observe significant association between MCS score and all-cause mortality [HR = 0.864 (95% CI, 727-1.027; p = 0.097)].
In conclusion, higher PCS of SF-8, not MCS, was associated with lower risk of all-cause mortality in Japanese individuals with type 2 diabetes. SF-8 could be useful for predicting mortality in individuals with diabetes.

Disclosure
Y. Hayashino: Speaker's Bureau; Self; Astellas Pharma Inc., Kowa Pharmaceuticals, Kyowa Hakko Kirin Co., Ltd., MSD K.K., Ono Pharmaceutical Co., Ltd. S. Okamura: None. H. Ishii: None.

Funding
Manpei Suzuki Diabetes Foundation; Japan Society for the Promotion of Science (25460641)
2284-PUB: Food Insecurity and Autonomic Dysfunction among Latinos with Type 2 Diabetes
Authors: SENG KAGNICA , FEINN RICHARD , BERMUDEZ-MILLAN ANGELA , PEREZ-ESCAMILLA RAFAEL , WAGNER JULIE 
Published: June 2019

Aims: Food insecurity (FI) is higher among Latinos than non-Hispanic Whites and associated with risk for type 2 diabetes (T2D). Autonomic nervous system (ANS) dysfunction increases mortality in diabetes. We examined FI and ANS function among Low-income Latinos with T2D enrolled in a parent stress management trial.
Methods: Inclusion: age &gt; 18 years, Latino or Hispanic, Spanish speaking, ambulatory status, T2D &gt; 6 months, A1c&gt;7.0%. Exclusion: medical or psychiatric instability; pain or dysfunction in hands precluding handgrip testing.
Measures: FI was assessed with the 6-item U.S. household food security survey module; affirmative responses to &gt;=1 question was coded as FI. Six autonomic measures were scored 0=normal or 1=abnormal based on published cutoffs and then summed for a total ANS dysfunction index. ANS measures and their normal cutoffs were: 1) metanephrine &lt;350 ug/day; 2) normetanephrine &lt;600 ug/day; 3) cortisol 50-190 ug/day, all from 24-hour urine specimens; 4) 24-hour heart rate variability as reflected in standard deviation of the normal-to-normal (SDNN) heart rate acquired with 3-channel, 7-lead ambulatory electrocardiogram (holter) monitors, 149 +/-39; 5) difference between the highest diastolic blood pressure (DBP) during sustained handgrip and the average DBP at rest, &gt;15 mmHg; and, 6) difference between baseline supine and the minimal BP after standing up, normal = decline in SBP &lt;= 20 mmHg and DBP &lt;= 10 mmHg.
Results: N=35 participated, n=23 (65.7%) were women, age M=61.6 (SD=11.2) years, A1c M=8.5% (SD=1.6) and n=20 (57.1%) used insulin. N=22 (62.9%) reported FI and n=25 (71.4%) had at least one abnormal ANS measure. In t-tests, participants with FI had a higher ANS dysfunction index (M=1.5, SD=0.9) than patients who were food secure (M=0.7, SD=0.8), p=0.02. Total ANS index was not related to A1c or insulin use.
Discussion: In this Latino sample with T2D, FI was associated with greater ANS dysfunction. Increasing food security may confer autonomic benefits.

Disclosure
K. Seng: None. R. Feinn: None. A. Bermudez-Millan: None. R. Perez-Escamilla: None. J. Wagner: None.

Funding
American Diabetes Association (7-13-TS-31 to J.W.); National Institute on Minority Health and Health Disparities (R01MD005879)