bluuebunny/crossref_metadata_2025_split huggingface dataset:
2336-PUB: Treatment Effectiveness of Glimepiride Alone and in Combination with Other Oral Hypoglycemic Agents: Outcomes from Real Clinical Practice
Authors: SESHADRI KRISHNA G. , DWARAKANATH C.S. , MANIKANDAN R.M. , AYYAGARI USHA , BOOCHANDRAN T.S. , DAS SAMBIT , NARAYANAN N.K. , JAGANMOHAN BALAJI , REDDY HARINI , JAYAPRAKASHSAI JANA , TIPPISETTY SUREKHA , KOLUKULA VAMSI KRISHNA ,   APOLLO SUGAR RESEARCH GROUP
Published: June 2019

Aim: To assess the treatment effect of glimepiride monotherapy and combination with metformin, DPP-4 inhibitors (DPP-4i) and SGLT2 inhibitor (SGLT2i) in patients with type 2 diabetes mellitus (T2DM).
Methods: A retrospective cross-sectional data analysis of T2DM patients of Apollo Sugar Clinics, Pan India. An eligible glimepiride prescriptions with a diagnosis of T2DM from Jan 2016 to September 2018 were included in this analysis to assess the role of glimepiride as monotherapy and in combination therapy with metformin, DPP-4i and SGLT2i on glycemic variables- glycated haemoglobin (HbA1c), and fasting blood glucose (FBG), and on weight (Wt) and body mass index (BMI). Descriptive statistics were applied to analyze the data and paired t-test was used to identify the significant difference in the glycemic variable within groups.
Results: Total 7059 T2DM patients were included in the analysis. Mean age was 52.9 year, 62.6% were males and 37.4% were females. At initiation the mean (SD) HbA1c was 8.1(1.7)%, FBG 158(55) mg/dL, Wt 69.3(12.5) kgs, and BMI was 26.6(4.7)kg/m2. Of the total, a majority of the patients were on glimepiride and metformin combination (86.3%) followed by glimepiride monotherapy (8.3%), glimepiride and DPP-4i (5%) and glimepiride and SGLT2i (0.4%). The analysis shows significant reduction in HbA1c (0.4%; p &lt;0.001) and FBG (17mg/dL; p &lt;0.001) in glimepiride and metformin combination treatment only compared to other combinations. Further, there was a considerable reduction in BMI in glimepiride and SGLT2i combination.
Conclusions: Our current study shows glimepiride and metformin combination therapy is highly prescribed and is effective in glycemic control compared to monotherapy and other glimepiride combinations.

Disclosure
K.G. Seshadri: None. D. C.s.: None. M. R.m.: None. U. Ayyagari: None. B. T.s.: None. S. Das: None. N. N.k.: None. B. Jaganmohan: None. H. Reddy: None. J. Jayaprakashsai: None. S. Tippisetty: None. V.K. Kolukula: None.
2345-PUB: Exploring Patient Factors Contributing to Enhanced Efficacy of Incretin-Related Drugs with Add-On SGLT2 Inhibitor Therapy in Reducing Glycemic Variability (GV)
Authors: ONISHI TETSUROU , SHIODA YOSHINOBU , MORI YUTAKA 
Published: June 2019

Objective: We investigated the relationship between enhanced efficacy of incretin-related drugs with add-on SGLT2 inhibitor therapy in type 2 diabetic patients and their background characteristics.
Patients and Methods: 1) Add-on SGLT2i therapy was given to a total of 15 type 2 diabetic patients with insufficient glycemic control despite conventional therapy including DPP-4i for 2 months in an outpatient setting. 2) Likewise, add-on SGLT2i therapy was given to a total of 17 type 2 diabetic patients with insufficient glycemic control despite conventional therapy including GLP-1RA for 3 months in an outpatient setting. In both groups, the glycemic variability (GV) was compared before and after add-on SGLT2i therapy by using CGM. GV indices evaluated included the difference before and after SGLT2i therapy in SD of 24-hour glucose values (ΔSD), the 24-hour total GV area (ΔSQ), and MAGE (ΔMAGE). Both groups were further divided according to the GV results by over 50th %tile and under 50th %tile into high-responders (n = 8 and 9) and low-responders (n = 7 and 8).
Results: 1) Effect of add-on SGLT2i therapy on reductions in GV in those receiving DPP-4i: High-responders were shown to be associated with significantly higher mean glucose values, SD, SQ and MAGE than low-responders at baseline (P &lt; 0.05). 2) Effect of add-on SGLT2i therapy on reductions in GV in those receiving GLP-1RA: high-responders were shown to be associated with significantly lower BMI, as well as significantly higher SD and SQ than low-responders at baseline (P &lt; 0.05).
Conclusions: With 2-month SGLT2i therapy as add-on to DPP-4i, reductions were seen in GV among patients with higher mean glucose and greater GV at baseline, suggesting a role for add-on SGLT2i therapy particularly in those with poor glycemic control. In contrast, with 3-month SGLT2i therapy as add-on to GLP-1RA, reductions were seen in GV among those with less severe obesity and greater GV at baseline.

Disclosure
T. Onishi: None. Y. Shioda: None. Y. Mori: None.
235-LB: Time Course of Pancreatic Alpha-Cell Function in Fulminant Type 1 Diabetes
Authors: ZHANG LINGYU , SHI YUWEN , WANG JING , WANG XING , QIN YAO , ZHANG MEI 
Published: June 2019

Aim: We aim to investigate the time course of changes in pancreatic alpha-cells function in patients with newly-onset fulminant type 1 diabetes (FT1D).
Methods: Glucagon and C-peptide concentrations were determined in response to 100g steamed bread meal tests (SBMT) in 6 patients with newly-onset FT1D. SBMT were taken every 3 months thereafter until 6 months for 1 FT1D patient and 12 months later for 2 FT1D patients. The area under curve of C-peptide (tAUCc-peptide) and the incremental area under curve of glucagon (iAUCglucagon) were calculated with 0min glucagon as baseline during SBMT.
Results: (1) At the onset of disease, tAUCc-peptide in FT1D patients was significantly lower than that of typical autoimmune type 1 diabetes [(217.04 ± 67.47) vs. (1762.00 ± 255.84) pmol/L*h, P&lt;0.0001]. The iAUCglucagon of 4 FT1D patients were higher than patients with typical autoimmune type 1 diabetes [(21.55±8.88) pmol/L*h vs. (6.72±2.92) pmol/L*h, P=0.006], while iAUCglucagon of 2 FT1D patients were lower [1.09, 3.11 pmol/L*h respectively]. And iAUCglucagon of age-matched healthy control [ -(13.16±7.68) pmol/L*h] was much lower. (2) Glucagon secretion in FT1D patients conversely decreased after 12 months of diagnosis, even as early as 6 months. After 6 months of diagnosis, tAUCc-peptide of the FT1D patient did not decrease (456 vs. 692.1 pmol/L*h), while iAUCglucagon drop from 1.09 to (-4.11) pmol/L*h. After 12 months of diagnosis, with islet beta-cells function completely absent, the iAUCglucagon of 2 FT1D patients were 13.64 vs. 12.34 pmol/L*h, 16.52 vs. (-19.42) pmol/L*h at the onset of diabetes and 12 months later respectively.
Conclusions: The opposing directions of abnormal glucagon and C-peptide secretion support the dysregulated alpha-cells function in newly-onset FT1D patients. The impaired alpha-cells function may recover in the time course of disease.

Disclosure
L. Zhang: None. Y. Shi: None. J. Wang: None. X. Wang: None. Y. Qin: None. M. Zhang: None.

Funding
National Natural Science Foundation of China
2352-PUB: Level of Glycemic Control in Type 2 Diabetes (T2D) Patients with Established Cardiovascular Disease (eCVD) or Chronic Kidney Disease (CKD) Prescribed an SGLT2i
Authors: IGLAY KRISTY , BANSAL NEHA , GULATI TANIA , HANNACHI HAKIMA , FERNANDES GAIL , RAJPATHAK SWAPNIL 
Published: June 2019

The recent ADA/EASD consensus statement for management of hyperglycemia preferentially recommends the use of SGLT2i in patients with eCVD or CKD. However, no specific data exist on the level of glycemic control in this high-risk population currently receiving SGLT2i. Our study assessed glycemic control among adult T2D patients with eCVD/CKD on dual therapy (metformin+SGLT2i) at 3 different HbA1c targets (≥7%, ≥7.5%, ≥8%) using the GE Centricity Electronic Medical Record database (June 2015-June 2018). The index date was the most recent encounter for metformin+SGLT2i users. Patients were required to have ≥1 HbA1c measure in the 12 months prior to the index date and ≥1 year of medical history available. ECVD/CKD included patients with CVD only, CKD only, or both CVD and CKD. Results were examined in the overall study cohort and by subgroups of age, gender, and race. Of the 987 included study patients, 40% were female, median age was 62 years, and median A1c was 7.5%. Table 1 shows the level of glycemic control among the study population. 68%, 52% and 36% of patients had HbA1c ≥7%, ≥7.5%, and ≥8%, respectively.
In conclusion, many patients with eCVD/CKD on dual therapy of metformin and SGLT2i were observed to have inadequate glycemic control and should be evaluated for medication adherence and further pharmacological intensification if appropriate.

Disclosure
K. Iglay: Employee; Self; Merck & Co., Inc. Stock/Shareholder; Self; Merck & Co., Inc. N. Bansal: Consultant; Self; Merck & Co., Inc. T. Gulati: Consultant; Self; Merck & Co., Inc. H. Hannachi: Employee; Self; Merck & Co., Inc. G. Fernandes: None. S. Rajpathak: None.
2353-PUB: Efficacy and Safety of Ertugliflozin in Hispanic/Latino Patients (Pts) with Type 2 Diabetes Mellitus (T2DM)
Authors: LIU JIE , TARASENKO LISA , ELLISON MISOO C. , PONG ANNPEY , HUYCK SUSAN , MANCUSO JAMES P. , TERRA STEVEN G. , GANTZ IRA 
Published: June 2019

Ertugliflozin (ERTU), a SGLT2 inhibitor, improves glycemic control in adults with T2DM. T2DM is prevalent among adults of Hispanic ethnicity in the U.S. Here we report a post hoc analysis of ERTU efficacy and safety in Hispanic/Latino pts in the ERTU Phase 3 program. A1C, body weight (BW), and systolic blood pressure (SBP) were evaluated with ERTU 5 and 15 mg (vs. placebo [PBO] or glimepiride [GLIM]) and ERTU with sitagliptin 100 mg (ERTU 5 or 15 mg/SITA vs. PBO or SITA). Adverse events (AEs) were evaluated.
Among 4855 pts, baseline characteristics were generally similar across treatment groups and between the group of pts self-reported as Hispanic/Latino (n=1178, 24.3%) and the non-Hispanic/Latino group. No meaningful differences were observed between these ethnic groups in A1C reductions with ERTU 5 and 15 mg at week 26 in a pooled analysis of PBO-controlled studies, at week 52 in a GLIM-controlled study, or with ERTU 5 mg/SITA and ERTU 15 mg/SITA groups at week 26 in PBO- and SITA-controlled studies (Figure). Similarly, no meaningful differences between ethnic groups were observed in BW and SBP reductions with ERTU 5 and 15 mg across the program. ERTU was generally well tolerated. The incidence of AEs was similar between ethnic groups. ERTU efficacy and safety were similar between Hispanic/Latino and non-Hispanic/Latino groups. NCTs: 01958671, 02033889, 02036515, 01999218, 02226003, 02099110, 01986855.

Disclosure
J. Liu: Employee; Self; Merck & Co., Inc. L. Tarasenko: Employee; Self; Pfizer Inc. M.C. Ellison: Employee; Self; Merck & Co., Inc. A. Pong: None. S. Huyck: Employee; Self; Merck & Co., Inc. J.P. Mancuso: Employee; Self; Pfizer Inc. Employee; Spouse/Partner; Pfizer Inc. Stock/Shareholder; Spouse/Partner; Pfizer Inc. Stock/Shareholder; Self; Pfizer Inc. S.G. Terra: Employee; Self; Pfizer Inc. I. Gantz: Employee; Self; Merck & Co., Inc.

Funding
Merck Sharp & Dohme Corp; Pfizer Inc.
2367-PUB: Metabolic Abnormalities after Coronary Angiogram in Patients Taking Sodium-Glucose Cotransporter 2 Inhibitors
Authors: SHAHID MARWAH , PICKETT STEPHEN , JIA XIAOMING , ALAM MAHBOOB , BIRNBAUM YOCHAI 
Published: June 2019

Background: Some evidence suggests an association of SGLT2 inhibitors (SGLT2i) with an increased risk of euglycemic DKA (euDKA). The incidence and possible procedure-related triggers of metabolic abnormalities in patients taking SGLT2i after coronary angiography has not been well established.
Methods: All patients with diabetes mellitus on a SGLT2i undergoing coronary angiography at a single center from November 2017 to November 2018 were reviewed for periprocedural characteristics and post-procedural metabolic abnormalities. Metabolic abnormalities were defined as: euDKA, DKA with hyperglycemia, or elevated urine ketones without confirmed acidosis.
Results: A total of 44 patients with diabetes mellitus on a SGLT2i undergoing coronary angiogram were identified. There was one case of euDKA after angiography and one of hyperglycemic DKA. There was an additional two cases of patients with elevated urine ketones for whom DKA labs were not available. Baseline characteristics including age (p=0.71), type of SGLT2i (p=.20) and hemoglobin A1c (p=.49) were similar between the cases with metabolic abnormalities and those without. Similarly, procedural variables including indication for angiography (p=0.26), amount of contrast used (p=0.47), angiography outcome (p=0.87) and complications (p=0.40) were not statistically different between the groups.
Conclusions: With a rare incidence and subtle clinical presentation, cases of euDKA may be missed after angiography, especially if acidosis is attributed to the preceding procedure without further workup. Continued case identification may help determine if specific procedural variables contribute to the development of euDKA. As the fasting state and stress of angiography can be triggers for ketosis, protocols should be developed for post-procedural screening and management in this population.

Disclosure
M. Shahid: None. S. Pickett: None. X. Jia: None. M. Alam: None. Y. Birnbaum: Other Relationship; Self; AstraZeneca. Other Relationship; Spouse/Partner; AstraZeneca, Boehringer Ingelheim International GmbH.
238-OR: Long-Term Effects of Intensive Lifestyle Intervention on Cardiovascular Risk Factors in Patients with Diabetes in Real-World Clinical Practice: A 10-Year Longitudinal Study
Authors: ZHANG HONGXIA , TOMAH SHAHEEN , MOTTALIB ADHAM , ASHRAFZADEH SAHAR , HAMDY OSAMA 
Published: June 2019

We previously reported that maintenance of significant weight loss for up to 5 years was attainable in real-world clinical practice among patients with diabetes and obesity and had a positive impact on cardiovascular risk factors. This was predicted by the ability to achieve ≥7% weight loss at 1 year through intensive lifestyle intervention (ILI). In this longitudinal study of the same cohort, we report the 10-year follow-up results. The study included 129 patients with diabetes and obesity enrolled in a 12-week ILI program designed for real-world clinical practice. At 1 year, we divided participants into group A, who maintained &lt;7% weight loss (61 patients, 47.3%), and group B, who maintained ≥7% weight loss (68 patients, 52.7%). We prospectively followed them for 10 years. The total cohort lost on average 10.8±4.6 Kg (-9.7%) at 12 weeks and maintained an average weight loss of 7.7±10 Kg (-6.9%) at 10 years. Group A maintained 4.3±9.5 Kg (-4.3%) and group B maintained 10.8±9.3 Kg (-9.3%) of weight loss at 10 years (P&lt;0.001). In group A, A1C decreased from 7.5±1.3% to 6.7±0.9% at 12 weeks but rebounded to 7.7±1.4% at one year and 8.0±1.9% at 10 years. In group B, A1C decreased from 7.4±1.2% to 6.4±0.9% at 12 weeks and rose to 6.8±1.2% at one year and 7.3±1.5% at 10 years (P&lt;0.05 between groups). Despite weight regain, group A maintained significant improvements in LDL and HDL cholesterol, had no change in BP, but significant worsening of serum triglycerides (TG) at 10 years. Group B maintained similar improvements in lipid profile, had a non-significant increase in serum TG at 10 years, but lower BP for the initial 18 months.
In conclusion, significant weight reduction in patients with diabetes can be maintained for up to 10 years in real-world clinical practice. A1C and TG worsened with weight regain, while other lipid improvements were maintained. Sustained weight loss is associated with significantly better A1C at 10 years.

Disclosure
H. Zhang: None. S. Tomah: Stock/Shareholder; Self; Amarin Corporation. A. Mottalib: None. S. Ashrafzadeh: None. O. Hamdy: Advisory Panel; Self; AstraZeneca, Sanofi-Aventis. Consultant; Self; Abbott, Merck & Co., Inc. Research Support; Self; National Dairy Council. Stock/Shareholder; Self; Healthimation, LLC.
2386-PUB: Implications of Lymphoma and Diabetes Mellitus on Patient Outcomes and Care
Authors: KARLIN NINA , VERONA PATRICIA M. , AMIN SHAILJA , BURAS MATTHEW R. , KOSIOREK HEIDI E. , COOK CURTISS 
Published: June 2019

Background: We examined the impact of diabetes mellitus (DM) on survival in patients with lymphoma and the impact of lymphoma on glycemic control.
Methods: Patients with newly diagnosed lymphoma with DM (n=91) were identified from the Institutional Cancer Registry and matched to 91 lymphoma patients without DM according to age, gender and year of cancer diagnosis (2005-2016). The file was linked to the electronic medical record to obtain information on DM and lymphoma therapies and laboratory results. Overall survival (OS) and progression-free survival (PFS) were estimated with the Kaplan-Meier method and compared by Cox regression analysis using stratification for matched pairs. Mixed models were used to compare hemoglobin A1c (HbA1c), glucose and lactate dehydrogenase (LDH) during the year following cancer diagnosis.
Results: Mean age of the entire cohort at diagnosis was 73 (range 41-95) years, most (96%) were white. B cell lymphoma accounted for 86% of patients and T cell lymphoma 14%. No differences in race/ethnicity, marital status, alcohol or tobacco use were detected between patients with and without DM. Mean BMI was significantly different between DM and non-DM patients (30.2 (6.5) versus 26.9 (5.6); p=0.003). Among those with DM, mean HbA1c during the year following cancer diagnosis was 6.7%. Mean glucose was significantly different between DM and non-DM pts (140.1 (36.1) versus 107.7 (14.5); p&lt;0.001). Of the DM patients, 51/91 did not have good glycemic control. There was no difference in lactate dehydrogenase (LDH) values between groups. Five-year OS was estimated at 67% (95% CI 56-78%) for DM patients versus 64% (95% CI 53-76%) in non-DM pts. Hazard ratio was 0.64 (95% CI: 0.35 - 1.16; p=0.14). Five-year PFS was estimated at 64% for DM patients versus 57% for non-DM patients. Hazard ratio was 0.60 (95% CI: 0.33-1.08; p=0.09).
Conclusions: Lymphoma and its treatment did not affect glycemic control. DM did not adversely impact survival in patients with lymphoma.

Disclosure
N. Karlin: None. P.M. Verona: None. S. Amin: None. M.R. Buras: None. H.E. Kosiorek: None. C. Cook: None.
240-LB: Angiotensin-Converting Enzyme and Type 2 Diabetes Risk: A Mendelian Randomization Study
Authors: PIGEYRE MARIE , SJAARDA JENNIFER , CHONG MICHAEL , HESS SIBYLLE , BOSCH JACKIE , YUSUF SALIM , GERSTEIN HERTZEL , PARE GUILLAUME 
Published: June 2019

The causal relationship between angiotensin-converting enzyme (ACE) inhibition and protection from type 2 diabetes (T2D) remains uncertain. While three large randomized control trials (RCTs) suggested a protective effect of ACE inhibitors compared to placebo, three other RCTs failed to observe an effect, including the only trial dedicated to this question. We hypothesized that ACE concentration-lowering genetic variants could be used to infer the pharmacological effect of ACE inhibitors on T2D risk using a Mendelian Randomization (MR) approach. We first assessed the association between T2D prevalence and ACE serum level in the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial (N=8,197). We next investigated whether genetically lowered ACE level was causally linked to the risk of T2D using (i) a two-sample MR analysis applied to the DIAbetes Genetics Replication And Meta-analysis consortium (n=26,676 T2D cases; 132,532 controls), and (ii) an ACE concentration-lowering genetic risk score in the UK Biobank cohort (N=341,872). We then compared the genetically determined effect of lower ACE level on T2D risk to the pharmacological inhibition of ACE vs. placebo, which was evaluated through a meta-analysis of six RCTs (N=31,200). Lower ACE serum level was associated with reduced T2D prevalence (OR, 0.89; 95% CI, 0.82-0.96; P=3.50x10-3) in the ORIGIN trial. Through MR analyses, a 1 SD lower genetically determined ACE level predicted a lower risk of T2D (OR, 0.92; 95% CI, 0.89-0.95; P=1.79x10-7). This result was replicated in the UK Biobank (OR, 0.97; 95% CI, 0.96-0.99, P=8.73x10-4). RCT meta-analysis showed a reduction in T2D incidence on ACE inhibitors vs. placebo (OR, 0.76; 95% CI, 0.60-0.97; P=2.59x10-2), which was consistent with the findings from MR analyses (P for comparison=0.95). Our results support a protective effect of long-term ACE inhibition on T2D risk and suggest to consider patient's risk for T2D when prescribing blood-pressure lowering drugs.

Disclosure
M. Pigeyre: None. J. Sjaarda: None. M. Chong: None. S. Hess: None. J. Bosch: Advisory Panel; Self; Bayer AG. S. Yusuf: None. H. Gerstein: Advisory Panel; Self; Abbott, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk A/S, Sanofi. Research Support; Self; AstraZeneca, Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk A/S, Sanofi. Other Relationship; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Sanofi. G. Pare: Consultant; Self; Amgen Inc., Bristol-Myers Squibb Company, Lexicomp, Sanofi. Research Support; Self; Canada Research Chair in Genetic and Molecular Epidemiology, CISCO Professorship in Integrated Health Biosystems, Sanofi.

Funding
Sanofi; Canadian Institutes of Health Research
2405-PUB: Minimed 640G vs. Minimed 670G, a Comparison in Children and Adolescents with Diabetes Type 1
Authors: SCARAMUZZA ANDREA E. , RABBONE IVANA , BONFANTI RICCARDO 
Published: June 2019

Introduction: After a long lead-in period, artificial pancreas (AP) technology is well on its way to revolutionizing the treatment of diabetes, but no AP is currently approved. Recently data about the use of a hybrid closed-loop (CL) insulin delivery has been presented.
Aim: We compared two devices, Minimed 640G system, (Medtronic, CA, U.S.) in the market in Italy since mid-2015 vs. Minimed 670G system (Medtronic, CA, U.S.), just entered the market on October 24th, 2018, used by the same patients.
Methods: We prospectively analyzed data of 19 patients using 640G three months before switching to 670G. Main outcome is the time in range (TIR) compared to TIR while using 640G. Secondary outcomes are predicted A1c, time in hypo, time in hyper (&gt;160 mg/dl), insulin total daily dose (TDD), %bolus and %basal rate, coefficient of variation (CV).
Results: The 19 patients (mean age 13±4 years, range 7-20 years, diabetes duration 7±4 years) who switched to 670G, after 2 months observation had a TIR significantly lower when compared while using 640G (62.9±6.6% vs. 76.6±16.3%, p=0.03), with similar predicted A1c (6,8±0.3% vs. 6.8±0.7%, p=0.89). Time in hypo significantly increased (3.4±2.3% vs. 0.5±0.6%, p=0.001), while no difference has been observed about time in hyper (34.7±5.9% vs. 22.9±16.1%, p=0.38) and CV (40.4±8.5% vs. 43.2±6.5%, p=0.25). Interestingly, TDD is slightly, but not significantly, lower when using 670G, with a higher percentage of insulin given as bolus than as basal rate.
Conclusions: 670G system seems less effective than 640G system to achieve a higher TIR, at the expenses of a higher time in hypo. A systematic educational pathway, as the one used by 640G users, could help reach these results, as well as some constrains 670G system has (fixed glycemic target at 120 mg/dl, only simple bolus, etc.). It is solacing to know that we already have useful tools for the best possible care of our patients with type 1 diabetes while we wait for the commercial availability of an AP or a more performant hybrid CL system.

Disclosure
A.E. Scaramuzza: None. I. Rabbone: None. R. Bonfanti: Advisory Panel; Self; Abbott, Lilly Diabetes, Medtronic, Novo Nordisk A/S, Roche Diabetes Care, Sanofi.