bluuebunny/crossref_metadata_2025_split huggingface dataset:
10-OR: Health-Care Costs and Utilization for Medicaid Patients with Diabetes in Accountable Care Communities (ACC)—A Natural Experiment for Translation in Diabetes (NEXT-D) 2 Study
Authors: MOIN TANNAZ , DURU O. KENRIK , MANGIONE CAROL 
Published: June 2019

Background: Diabetes costs account for 20% of all health care spending in the U.S. The Accountable Care Communities (ACC) Program was developed by a large U.S. insurer to provide practices with community data analytics for population management and nurses to support care improvement for Medicaid patients. We examined changes in costs and utilization for Medicaid patients with diabetes in ACC compared to non-ACC practices.
Methods: We used interrupted time series (ITS) analysis of mean costs per person-month between 2009-2015. We used data from patients with diabetes in practices with &gt;1000 Medicaid patients. ACC was implemented in 14 states and comparison non-ACC practices were matched on state to control for state-level variation in Medicaid generosity. Separate ITS models were used for costs, ER visits and hospitalizations adjusted for age, gender, race/ethnicity, seasonality, and state by year fixed effects. Results are presented as differences-in-post-intervention monthly changes-in-expenditures (DID) by Medicaid category (TANF, SSI, Expansion and Duals).
Results: The sample included 899,273 ACC-person months from 54,721 Medicaid patients with diabetes. Over 29 months follow-up, ACC assignment was associated with significant increases in total costs at the time of implementation for all Medicaid patients except for those eligible for both Medicare/Medicaid (Duals); increases in total costs at implementation ranged from $65-143/person-month based on Medicaid category, p&lt;0.05. There were no significant differences in ER use or hospitalizations over time for Medicaid patients with diabetes assigned to ACC practices.
Conclusions: Medicaid patients in ACC practices had increases in costs but not utilization over 2 years follow-up, compared to patients in non-ACC practices. Our findings suggest that this ACC program may not reduce costs of care or utilization for Medicaid patients with diabetes.

Disclosure
T. Moin: None. O. Duru: Advisory Panel; Self; Healthwise. C. Mangione: None.

Funding
Centers for Disease Control and Prevention; National Institutes of Health (U18DP006128)
1026-P: Dipeptidyl Peptidase-4 Inhibitor Treatment and the Risk of Bullous Pemphigoid and Other Skin-Related Adverse Events: A Meta-analysis
Authors: YANG WENJIA , CAI XIAOLING , ZHANG SIMIN , HAN XUEYAO , JI LINONG 
Published: June 2019

Background: There were several case reports on the association between dipeptidyl peptidase-4 inhibitors (DPP-4is) and bullous pemphigoid (BP). The aim of this meta-analysis was to evaluate the risk of BP and other skin-related adverse effects (AEs) in patients with type 2 diabetes receiving DPP-4i treatment in randomized controlled trials (RCTs).
Methods: In this meta-analysis, we searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to November 10, 2018. The study included RCTs assessing the effects of DPP-4is treatment compared with placebo in type 2 diabetic patients with reports of skin-related events. The odds ratio (OR) was calculated by Peto's methods.
Results: 46 randomized placebo-controlled trials with reports of skin-related events were included (n = 59,332) in this meta-analysis. Compared with placebo, the risk of BP significantly increased in DPP-4i treatment (OR = 7.39, 95% CI 2.59-21.07, I2=0%, P = 0.0002) (Figure 1), and the overall risk of skin-related AEs also increased in DPP-4i treatment (OR = 1.31, 95% CI 1.08-1.59, I2=38%, P = 0.006) (Figure 2).
Conclusions: This meta-analysis suggested that DPP-4i treatment was associated with a significant increase in the risks of BP and skin-related AEs.

Disclosure
W. Yang: None. X. Cai: None. S. Zhang: None. X. Han: None. L. Ji: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck KGaA, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Roche Pharma, Sanofi.
1027-P: A Phase 1, Open-Label, Single-Dose Study to Evaluate Pharmacokinetics of MEDI0382 in Patients with Renal Impairment
Authors: KLEIN GERNOT K. , PETRONE MARCELLA , YANG YE , HOANG THUONG , DICOSTANZA SHEILA , HANSEN LARS , FLOR ARMANDO 
Published: June 2019

MEDI0382, an oxyntomodulin-like peptide with targeted GLP-1 and glucagon receptor activity, is in development for T2DM. This open-label, parallel-group study (NCT03235375) evaluated PK of SC MEDI0382 (100 µg; single dose) in subjects (N = 37) grouped by renal function: Group 1, ESRD or severe renal impairment (RI; CrCl &lt; 20 mL/min); Group 2, severe RI (CrCl ≥ 20 mL/min to &lt; 30 mL/min); Group 3, healthy controls (CrCl ≥ 90 mL/min); Group 4a, moderate RI (CrCl ≥ 30 mL/min to &lt; 45 mL/min); and Group 4b, moderate RI (CrCl ≥ 45 mL/min to &lt; 60 mL/min). Coprimary endpoints were geometric mean ratio AUC48h and Cmax of MEDI0382 (Table 1). MEDI0382 had similar PK profiles across all groups (Table 2). This suggests that PK of MEDI0382 is unaffected by renal function, allowing dosing in subjects with RI in future trials.

Disclosure
G.K. Klein: None. M. Petrone: Employee; Self; MedImmune. Y. Yang: Employee; Self; MedImmune. T. Hoang: Employee; Self; MedImmune. S. DiCostanza: Employee; Self; AstraZeneca. L. Hansen: Employee; Self; AstraZeneca, MedImmune. Stock/Shareholder; Self; Bristol-Myers Squibb Company, Novo Nordisk A/S. A. Flor: Employee; Self; AstraZeneca.
1028-P: Is Once-Weekly GLP-1 Receptor Agonist a Reasonable Option for Glucocorticoid-Induced Hyperglycemia? Twelve-Week Efficacy and Safety of Dulaglutide vs. Sitagliptin in Patients with Diabetes on Routine Glucocorticoid Treatment
Authors: YOSHIJI SATOSHI , IWASAKI YORIHIRO , IWASAKI KANAKO , AIZAWA-ABE MEGUMI , HONJO SACHIKO , WADA YOSHIHARU , FUJIKAWA JUN , HAMASAKI AKIHIRO 
Published: June 2019

Background: The efficacy and safety of incretin-based therapies for glucocorticoid-induced hyperglycemia, for which insulin is often used, remain to be established in real-world clinical settings. We aimed to study whether a once-weekly GLP-1 receptor agonist improves glycemic control in patients on glucocorticoid therapy compared with a DPP-4 inhibitor.
Methods: We retrospectively compared the 12-week efficacy and safety of dulaglutide versus sitagliptin in patients with diabetes on prednisolone treatment (4-40 mg/day) who visited our hospital from 2015 to 2018.
Results: Among 73 patients who started dulaglutide or sitagliptin for glucocorticoid-induced hyperglycemia while on prednisolone treatment (4-40 mg/day), 40 patients continued dulaglutide or sitagliptin along with prednisolone (4-40 mg/day) for the entire treatment period of 12 weeks (n =16, 24, respectively). The baseline characteristics and change in prednisolone doses from baseline to 1-12 weeks were comparable between the two groups. Dulaglutide significantly reduced the HbA1c and total daily insulin doses per bodyweight from baseline to 12 weeks (-0.78, p = 0.034; -0.29, p = 0.001, respectively), whereas neither was achieved by sitagliptin (-0.26, p = 0.088; -0.12, p = 0.105). A significantly higher proportion of patients were insulin-free at 12 weeks in the dulaglutide group than in the sitagliptin group (61.5% vs. 20.0%, p = 0.046). As for adverse events, nausea and vomiting were observed in 11.1% of the dulaglutide group. Hypoglycemia was not observed in either group.
Conclusions: Compared with sitagliptin, dulaglutide can be an effective option for glucocorticoid-induced hyperglycemia with acceptable tolerability in real-world clinical settings.

Disclosure
S. Yoshiji: None. Y. Iwasaki: None. K. Iwasaki: None. M. Aizawa-Abe: None. S. Honjo: None. Y. Wada: None. J. Fujikawa: None. A. Hamasaki: None.
1029-P: Teneligliptin Significantly Reduces Liver Fat Content (LFC) and Delays Progression of NASH in Type 2 Diabetes Mellitus Patients
Authors: GUPTA VISHAL KUMAR 
Published: June 2019

Nonalcoholic steatohepatitis (NASH) can result in liver cirrhosis and hepatocellular carcinoma (HCC). Several studies have shown that some DPP-4 inhibitors alleviate hepatic steatosis or steatohepatitis in type 2 diabetic mice or rats. We investigated effect of teneligliptin, a DPP-4 inhibitor on patients of type 2 diabetes with NASH.
Methods: 64 patients between ages 18 to 80 years were selected for study. Participants were identified as type 2 Diabetes with biopsy confirmed NASH. All enrolled patients randomized into 2 main groups, on the basis of drugs prescribed to them. GROUP A (n= 34): Teneligliptin 20 mg- Once a day. GROUP B(n=30): Metformin 1000mg Once a day. Patients were analyzed for their fasting, post prandial blood glucose level along with HBA1C value as baseline and followed-up at regular interval of 12 weeks apart till 48 weeks. AST and ALT levels were measured at base line and 12 weeks interval till 48 week. Hepatic steatosis was measured by Transient Elastography (Fibroscan).
Result: As shown in Table.
Conclusion: Result of our study revealed that Teneligliptin significantly reduce serum transaminases and liver fat content (LFC) and delay progression of NASH in type 2 diabetes mellitus patients.

Disclosure
V.K. Gupta: None.
1033-P: Effects of Benaglutide on Weight Loss, Metabolic Changes, and Sexual Hormones in PCOS
Authors: CHEN JINGYAN , SUN QIN , ZHANG MIN , TIAN HAOMING , CHEN SHU 
Published: June 2019

Objective: Polycystic ovary syndrome (PCOS) is one the most common metabolic and endocrine disorders in women, which is always accompanied with obesity and insulin resistance (IR). Glucagon-like peptide-1 (GLP-1) has been investigated to decrease body weight and IR in PCOS, and it appears superior combined with metformin (MET) than MET alone. Benaglutide is the first human homologous GLP-1 drug. It had been shown in previous studies to reduce blood glucose and have effect on weight loss. The potential impact of preconception intervention with benaglutide on improving IR and weight loss in PCOS has not been evaluated yet.
Methods: This is a 12-week open-label randomized clinical study.88 overweight/obese (OW/OB) patients with PCOS, who had already received MET 1000 mg Bid treatment for more than 3 months. They were randomized into two groups, to receive either benaglutide (BEN) 0.2 mg ih tid and MET 1000 mg bid (N=35, age: 27.6±5.7, BMI: 28.33±3.36 kg/m2, mean±s.d.) or exenatide (EXE) 10ug ih bid and MET 1000 mg bid (N=33, age: 27.7±6.5, BMI: 28.82±3.44 kg/m2) per day. We observed BMI, OGTT 0- and 2-hour blood glucose, HOMAIR, blood lipids and sexual hormones, at 0 and 12 weeks. Lifestyle intervention was promoted in both groups.
Results: BMI had decreased in the BEN group 1.89±1.55 kg/m2 (p&lt;0.05) compared with 1.83±1.17 kg/m2 (p&lt;0.05) in the EXE group. OGTT 2-hour blood glucose was reduced 0.97±1.80 mmol/l (p&lt;0.05) in the BEN group with 1.43±2.86 mmol/l (p&lt;0.05) in the EXE group. In the BEN group, HOMAIR decreased 1.38±2.86 (p&lt;0.05) as well as in the EXE group 1.61±2.08 (p&lt;0.05), whereas measures of OGTT 0h blood glucose, blood lipids and sex hormones did not change. From all the indexes no significant between-treatment difference (p&gt;0.05) were found in the two groups.
Conclusions: Benaglutide combined with metformin treatment in overweight/obese women with PCOS appears superior decrease in BMI, OGTT 2-hour blood glucose and HOMAIR, the efficiencies were same as exenatide with metformin.

Disclosure
J. Chen: None. Q. Sun: None. M. Zhang: None. H. Tian: None. S. Chen: None.
1037-P: Glucose Control following Missed and Late Meal Boluses with a Medtronic Enhanced-Hybrid Closed-Loop (E-HCL) System
Authors: LEE MELISSA H. , VOGRIN SARA , PALDUS BARBORA , JONES HANNAH , OBEYESEKERE VARUNI R. , SIMS CATRIONA M. , WYATT SUE A. , WARD GLENN M. , MCAULEY SYBIL A. , MACISAAC RICHARD , KRISHNAMURTHY BALASUBRAMANIAN , SUNDARARAJAN VIJAYA , JENKINS ALICIA , O'NEAL DAVID N. 
Published: June 2019

Background: A missed or late meal insulin bolus can impact glycemia in type 1 diabetes (T1D).
Aim: To study glucose control after missed and late meal boluses in T1D adults using a prototype enhanced hybrid closed-loop (E-HCL) system (Medtronic) providing automated basal insulin and correction boluses.
Methods: Twelve T1D adults (median HbA1c 6.8% [IQR 6.2-7.2] | 51mmol/mol [44-55] participated. After 1-week run-in at home in Open Loop, E-HCL was activated during 1-week supervised hotel phase followed by 3 weeks free-living at-home. Participants consumed a standardized 40g carbohydrate dinner in the supervised phase. Four hours of post-prandial glucose data following a standard bolus pre-meal in E-HCL at home were compared in a pairwise manner to 1) Pre-meal bolus in Open Loop Run-In; 2) 20minute Late bolus in E-HCL supervised; 3) Missed bolus in E-HCL supervised using Wilcoxon Signed-Rank Test.
Results: Late bolus was associated with mild hypoglycemia and higher glucose variability; missed bolus was associated with hyperglycemia (Table). Overall time in CL was 99.98%. E-HCL at home vs. Open Loop (run-in) had greater time-in-70-180mg/dL range (85.3 vs. 75.0%, p=0.003). There was no severe hypoglycemia or ketoacidosis.
Conclusions: While glucose excursions were modest, the administration and timing of meal boluses influenced post-meal glycemia in well-controlled T1D adults using E-HCL.

Disclosure
M.H. Lee: Research Support; Self; Medtronic. Speaker's Bureau; Self; AstraZeneca. S. Vogrin: None. B. Paldus: Other Relationship; Self; Australian Diabetes Society, JDRF, Medtronic. H. Jones: None. V.R. Obeyesekere: None. C.M. Sims: Stock/Shareholder; Self; Medtronic. S.A. Wyatt: Other Relationship; Self; Animas Corporation, Medtronic. G.M. Ward: None. S.A. McAuley: Research Support; Self; JDRF, Medtronic. Speaker's Bureau; Self; Australian Diabetes Society, Eli Lilly and Company. R. MacIsaac: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk Inc. Speaker's Bureau; Self; AstraZeneca, Novo Nordisk Inc. Other Relationship; Self; AstraZeneca, Novo Nordisk Inc. B. Krishnamurthy: None. V. Sundararajan: None. A. Jenkins: Advisory Panel; Self; Abbott, Australian Diabetes Society, Medtronic. Research Support; Self; Abbott, GlySens Incorporated, Medtronic, Mylan. Speaker's Bureau; Self; Eli Lilly and Company, Novo Nordisk Inc. D.N. O'Neal: None.
1041-P: Feasibility Study of a Hybrid Closed-Loop System with Automated Correction Boluses
Authors: NIMRI REVITAL , GROSMAN BENYAMIN , KURTZ NATALIE , ROY ANIRBAN , NIR JUDITH , LOEWENTHAL NETA , KAUFMAN FRANCINE R. , PHILLIP MOSHE 
Published: June 2019

Background: Automated insulin delivery, or closed-loop (CL), systems are emerging as a management tool for individuals with T1D. The MiniMed™ 670G system is a single hormone hybrid closed-loop (HCL) system that adjusts basal insulin delivery based on sensor glucose (SG)levels and is already used in clinical practice. An enhanced HCL system (e-HCL) prototype with an automated correction bolus feature was developed and evaluated in a small feasibility study.
Methods: Subjects (n=12) aged a mean±SD of 17.6±2.9 years with T1D and an A1C of 7.3±0.7% (56.5±7.7 mmol/mol) completed a 6-day run-in period with the e-HCL system in open-loop (OL) (i.e., Auto Mode OFF and Suspend before low ON). Thereafter, a supervised hotel period (6 days/5 nights) with CL challenges (missed meal bolus, late meal bolus, and physical activity) was completed, and followed by a 3-week at-home period with Auto Mode and automated correction boluses ON, without restrictions. Glycemic control was compared between the OL run-in period and CL period.
Results: During the at-home period, subjects spent 93±4% of the time in Auto Mode. Time within target glucose range of 70-180 mg/dL (3.9-10.0 mmol/L) increased from 68.8±10.5% to 74±6.1%, time &gt;180 mg/dL reduced from 27.1±11.9% to 23.7±8.8%, and time &lt;70mg/dL dropped from 4.1±3.7% to 3±2.8%. Total daily insulin dose was 56.3±10.9 units and 53.4±12.5 units during the OL run-in and CL periods, respectively. A greater percentage of insulin was delivered as bolus than as basal, during the CL period (54.3±8.9% versus 41.7±4.36%). No serious adverse events occurred.
Conclusions: Incorporating automated correction boluses to an HCL system was safe and effective in controlling day and night glucose levels, during a 3-week at-home period.

Disclosure
R. Nimri: Employee; Self; DreaMed Diabetes. Research Support; Self; Dexcom, Inc., Glooko, Inc., Insulet Corporation, JDRF, Medtronic, National Institutes of Health. Speaker's Bureau; Self; Lilly Diabetes. Stock/Shareholder; Self; DreaMed Diabetes. B. Grosman: Employee; Self; Medtronic. N. Kurtz: Employee; Self; Medtronic MiniMed, Inc. A. Roy: Employee; Self; Medtronic MiniMed, Inc. J. Nir: None. N. Loewenthal: None. F.R. Kaufman: Employee; Self; Medtronic. M. Phillip: Consultant; Self; Qulab Medical, RSP Systems A/S. Research Support; Self; Bristol-Myers Squibb Company, Dexcom, Inc., JDRF, Lexicon Pharmaceuticals, Inc., Merck & Co., Inc., OPKO. Stock/Shareholder; Self; DreaMed Diabetes, Ltd., NG Solutions Ltd., Nutriteen Professional Ltd. Other Relationship; Self; AstraZeneca, Eli Lilly and Company, Insulet Corporation, Medtronic MiniMed, Inc., Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis.
1049-P: Towards Prolongation of Insulin Pump Catheters Wearing Time Using a Mixture of Insulin and a Nonsteroidal Anti-inflammatory Drug
Authors: ARDILOUZE JEAN-LUC , GOBEIL FERNAND , MENARD JULIE , BOVAN DANIJELA , MESSIER VIRGINIE , SAVARD MARTIN , BAILLARGEON JEAN-PATRICE , RABASA-LHORET RÉMI 
Published: June 2019

Recommendation to insulin pump users is to change catheters every 3 days. Convergent data point to inflammation for catheter-related insertion site problems. Objective: to explore if adding a tiny amount of non-steroidal anti-inflammatory drug (NSAID) into insulin solution increases catheter wearing time compare to insulin alone.
Methods: Double-blinded randomized study in insulin pump users with type 1 diabetes. Participants were instructed to keep catheters as long as glycemic control was acceptable and insertion site remained comfortable. Subjects performed 4 experiments: 2 testing lispro and 2 testing the mixed solution (lispro: 90 units/ml + ketorolac: 3 mg/ml), each experimental period separated by a 1-week washout. Safety parameters were measured at entry vs. end of study (including plasma ketorolac concentration). We defined responders as participants wearing catheter ≥ 1 day using lispro+ketorolac vs. lispro.
Results: Fourteen subjects completed the study (males: 7, age: 43.5±18.0 years, diabetes duration: 29.6±13.9 years, pump therapy: 9.0±4.5 years, A1c: 7.1±0.6%). There was no catheter wearing time difference (lispro+ketorolac: 7.45±2.99 vs. lispro: 7.82±2.64 days). The daily doses of insulin and ketorolac were respectively 46.44±12.39 units and 1.55±0.41 mg. Ketorolac plasmatic concentration was at 19.7±17.6 ng/ml (1000 times lower than after clinically indicated doses). From entry vs. end of study, creatinine increased (70±17 vs. 81±19 µmol/L, p=0.018) and glomerular filtration rate declined (119±33 vs. 109±34 ml/min/1.73m2, p=0.028). Wearing time improved in responders (n=7, 50%): 6.04±1.38 vs. 7.97±1.68 days (p=0.018).
Conclusions: While no difference was observed overall, a large sub-group of patients could be responders to the addition of some NSAID to insulin. Due to the small sample size, the true magnitude of kidney function deterioration is unknown and might not be clinically significant.

Disclosure
J. Ardilouze: None. F. Gobeil: None. J. Menard: None. D. Bovan: None. V. Messier: Other Relationship; Self; Eli Lilly and Company. M. Savard: None. J. Baillargeon: 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.

Funding
JDRF
1053-P: Automated Adaptation of the Bionic Pancreas while Transitioning from Multiple Daily Injection Insulin Regimens
Authors: SHERWOOD JORDAN , BALLIRO COURTNEY A. , EL-KHATIB FIRAS , EKHLASPOUR LAYA , HSU LIANA , BUCKINGHAM BRUCE A. , DAMIANO EDWARD , RUSSELL STEVEN J. 
Published: June 2019

In a random-order, outpatient crossover trial we compared automated glycemic control with the insulin-only bionic pancreas (BP) to usual care in subjects with T1D. Subjects transitioned directly to the BP from CSII or MDI (insulins glargine n=6, detemir n=1, or degludec n=5). The BP continuously adapts to individual insulin needs and was initialized based on body mass only, without information about the baseline insulin regimen. The first 24 hours of BP control was compared to days 3-7 (the 5-day period considered for the primary outcome) to examine the effect of having received long-acting insulin the day prior to initiation of the BP. As shown in the Table, the mean CGM glucose and time-in-range did not differ between the first 24 hours and days 3-7 after starting the BP in subjects on MDI at baseline, while there was a reduction in mean and an increase in time-in-range among those on CSII at baseline. Subjects on MDI at baseline did not experience more hypoglycemia in the first 24 hours despite having long-acting insulin on board. Both subjects on MDI and CSII at baseline achieved good glucose control on the BP (see Table). Surprisingly, there was no difference in the insulin total daily dose (TDD) between the first 24 hours and days 3-7 in the MDI users despite an average TDD of basal insulin at baseline of 15 u/day. These results suggest that BP therapy can be safely initiated directly from MDI regimens.

Disclosure
J. Sherwood: None. C.A. Balliro: None. F. El-Khatib: Employee; Self; Beta Bionics. Stock/Shareholder; Self; Beta Bionics. L. Ekhlaspour: None. L. Hsu: None. B.A. Buckingham: Advisory Panel; Self; ConvaTec Inc., Novo Nordisk Inc., Profusa, Inc. Consultant; Self; Medtronic MiniMed, Inc. Research Support; Self; Beta Bionics, ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Medtronic MiniMed, Inc., Tandem Diabetes Care. Other Relationship; Self; Insulet Corporation, Tandem Diabetes Care. E. Damiano: Advisory Panel; Self; Novo Nordisk A/S. Board Member; Self; Beta Bionics. Employee; Self; Beta Bionics. Stock/Shareholder; Self; Beta Bionics. Stock/Shareholder; Spouse/Partner; Beta Bionics. Other Relationship; Self; Ascensia Diabetes Care, Senseonics. S.J. Russell: Advisory Panel; Self; Companion Medical, Unomedical a/s. Consultant; Self; Flexion Therapeutics. Research Support; Self; Beta Bionics, MITRE Corporation, Novo Nordisk A/S, Zealand Pharma A/S. Other Relationship; Self; ADOCIA, Ascensia Diabetes Care, Ascensia Diabetes Care, Lilly Diabetes, Roche Diabetes Care, Senseonics.

Funding
National Institutes of Health (NIDDKUC4DK108612)