bluuebunny/crossref_metadata_2025_split huggingface dataset:
733-P: Circulating Vaspin Level Was Changed with Endothelial Function, but Not with Visceral or Ectopic Fat during Lifestyle Modification in Korean Type 2 Diabetes
Authors: HAN KYUNG AH , MIN KYUNGWAN 
Published: June 2019

Vaspin is an adipocytokine identified in visceral adipose tissues and has anti-inflammatory effects in vascular smooth muscle cells. We investigated the association between visceral or ectopic adiposity, insulin resistance, inflammatory markers and endothelial function including circulating vaspin, and the effects of lifestyle modification in Korean type 2 diabetes. Total 170 overweight women with type 2 diabetes (age 55.0±7.6 years; BMI 27.4±2.8 kg/m2) were randomly assigned to control (C), diet (D), aerobic exercise (AE) and resistance exercise (RE) and 82 completed the weight loss program for 12 weeks. We assessed BMI, total abdominal (TAF), visceral fat (VAF), liver and spleen attenuation ratio (LSR), and intramuscular adipose tissue (IMAT) at midthigh level using computed tomography, and FMD (Flow-mediated dilation), vaspin, adiponectin/leptin ratio (ALR), free fatty acid (FFA), hsCRP, and insulin sensitivity by homeostatic model assessment insulin resistance (HOMA-IR) at baseline, and 12 week. The log transformed variables are prefixed by 'ln' BMI decreased by 7.07% in RE, 6.42% in D and 3.28% in AE (p&lt;0.001 vs. control). TAF and VAF also decreased by 18.82% and 22.06% in RE, 11.96% and 14.12% in D, 8.30%and 8.38% in D (consecutively, p&lt;0.001 vs. control). ALR was increased comparably in 3 intervention groups. Percent changes (pc) of vaspin, FFA, hsCRP, HOMA IR, FMD, IMAT, LSR were not different among 4 groups. Within group analysis, vaspin was increased from 0.74 to 1.04 (p=0.096) in AE, FMD was increased in D and AE (p&lt;0.001, P=0.035). Crushed the groups, ln-vaspin pc was changed with ln-FMD pc (r=-0.246, p=0.016), but not with pc of ln-VAF, IMAT. Total fat was changed with ALR (r=-0.151, p=0.042). LSR with hsCRP (r=-0.217, p=0.038). These findings suggested that the circulating vaspin level was more related with vascular function rather than regional or ectopic adiposity during lifestyle modification in type 2 diabetes.

Disclosure
K. Han: None. K. Min: None.
736-P: Two Years Moderate Resistance Training Prevents Type 2 Diabetes but Does Not Reduce Cardiovascular Risk for Patients with Prediabetes
Authors: LOU QINGQING 
Published: June 2019

Resistance training can decrease blood glucose, reduce fat volume and increase muscle mass, but whether long term resistance training can prevent type 2 diabetes and reduce cardiovascular risk or not remains unclear.
248 prediabetes patients enrolled in this multicentered RCT study were randomized in to 3 groups: resistance training (RT, n=82), aerobic training (AT, n=83), and control group (n=83). The participants in RT and AT groups did moderate RT or AT 3 times a week (150minutes/week) with supervision in 3 research centers for 2 years.
Compared to the control group, participants in both RT group and AT group experienced a significant reduction in A1c at month 6, 12 and 24. After adjusted for age, sex, BMI, and statin use, Resistance training and aerobic training reduced type 2 diabetes risk by 58.2% (p=0.028) and 73.2% (p=0.004), respectively, but neither AT nor RT reduced cardiovascular risk (Framingham Score). In terms of remission to normal glucose tolerance (NGT), RT and AT increased the RR by 7.84 (p=0.008) and 6.68 (p=0.016), respectively.
The results of this study demonstrated that 2 years moderate resistance training has comparable effects on preventing type 2 diabetes and reversing to NGT for patients with prediabetes.

Disclosure
Q. Lou: None.
741-P: More Time-in-Range during Days with Structured Exercise vs. Sedentary Days in Adults with Type 1 Diabetes
Authors: RIDDELL MICHAEL , LI ZOEY , BECK ROY , GAL ROBIN L. , JACOBS PETER G. , CASTLE JESSICA R. , GILLINGHAM MELANIE B. , CLEMENTS MARK A. , PATTON SUSANA R. , DASSAU EYAL , DOYLE FRANCIS J. , MARTIN CORBY K. , CALHOUN PETER , RICKELS MICHAEL R. 
Published: June 2019

Structured exercise can help patients with type 1 diabetes (T1D) achieve physical activity targets, however the effects of exercise type on percent time in range (TIR) and glucose variability are unclear. The Type 1 Diabetes Exercise Initiative Pilot Study provided the opportunity to examine glycemic control on structured exercise days compared to sedentary days. Adults with T1D ([mean ± SD] age= 32 ± 14 years; HbA1C= 7.8 ± 1.6%), using a continuous glucose monitor, were assigned to complete twice weekly aerobic, interval or resistance exercise sessions, using study-developed instructional videos for a period of 4 weeks. TIR was higher (Figure 1) and mean glucose concentration was lower overall on exercise days compared with sedentary days (160 ± 52 vs. 176 ± 49 mg/dL, P&lt;0.001). Glucose variability was similar between exercise and sedentary days (coefficient of variation: 36 ± 12% vs. 37% ± 12%).
In summary, participants had lower 24-hour mean glucose levels and a greater percent time in range on active days compared with inactive days.

Disclosure
M. Riddell: Advisory Panel; Self; Xeris Pharmaceuticals, Inc. Research Support; Self; Dexcom, Inc. Speaker's Bureau; Self; Insulet Corporation, Medtronic MiniMed, Inc. Stock/Shareholder; Self; Zucara Therapeutics Inc. Z. Li: None. R. Beck: Other Relationship; Self; Abbott Laboratories, Ascensia Diabetes Care, Bigfoot Biomedical, Dexcom, Inc., Insulet Corporation, Lilly Diabetes, Roche Diabetes Care, Tandem Diabetes Care. R.L. Gal: None. P.G. Jacobs: Stock/Shareholder; Self; Pacific Diabetes Technologies. J.R. Castle: Advisory Panel; Self; Novo Nordisk Inc., Zealand Pharma A/S. Consultant; Self; Dexcom, Inc. Research Support; Self; Dexcom, Inc., Xeris Pharmaceuticals, Inc. M.B. Gillingham: None. M.A. Clements: Advisory Panel; Self; Glooko, Inc. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Medtronic. S.R. Patton: None. E. Dassau: Consultant; Self; Eli Lilly and Company, Insulet Corporation. Research Support; Self; Dexcom, Inc., DreaMed Diabetes, Ltd., Insulet Corporation, Roche Diabetes Care, Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Speaker's Bureau; Self; Roche Diabetes Care. Other Relationship; Self; ModAGC. F.J. Doyle: Consultant; Self; ModeAGC. Other Relationship; Self; Insulet Corporation. C.K. Martin: Advisory Panel; Self; EHE. Consultant; Self; ACAP Health, Florida Hospital, WW, Zafgen, Inc. Other Relationship; Self; Academy of Nutrition and Dietetics. P. Calhoun: Stock/Shareholder; Self; Dexcom, Inc. M.R. Rickels: None.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust
742-P: Magnitude of A1C Improvement in Relation to Weight Loss after Intensive Lifestyle Intervention in Real-World Diabetes Practice: Thirteen Years of Observation
Authors: ELDIB AHMED H. , TOMAH SHAHEEN , MOTTALIB ADHAM , ASHRAFZADEH SAHAR , HAMDY OSAMA 
Published: June 2019

The effect of intensive lifestyle intervention (ILI) on A1C in real-world clinical practice is inconsistent and is frequently underestimated. It is also presumed that the magnitude of A1C improvement is solely dependent on the amount of weight loss. In this study we report the magnitude of A1C change in a large cohort of patients with diabetes who underwent ILI over 13 years in relation to their baseline A1C and the amount of weight loss.
We evaluated 590 diabetic patients (age 52.5±11 years, 58.6% females, A1C 7.7±1.4%, weight 105.54±18.6 Kg, BMI 36.7±5.1 Kg/m2, diabetes duration 10.9±9.8 years, 83.7% with type 2 diabetes), who enrolled in the Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week multidisciplinary ILI designed for real-world clinical practice between September 2005 and May 2018. We stratified patients based on baseline A1C into three groups: group A with A1C 9% (16.95% of participants), group B with A1C from 8 to &lt;9% (19.15% of participants), and group C with A1C &lt;8% (63.9% of participants). After 12 weeks of intervention, body weight decreased by 8.5±4.6 Kg in group A, 8.0±4.6 Kg in group B, and 7.6±5.8 Kg in group C (p=0.22 between groups). A1C decreased by 2.5±1.3% in group A, 1.2±0.8% in group B and 0.5±0.6% in group C (p&lt;0.001 between groups). Pairwise comparisons of A1C changes between groups showed that: group A had 1.3% greater A1C reduction than group B (p=0.0001) and 2% greater A1C reduction than group C (p=0.0001), while group B had 0.7% greater A1C reduction than group C (p=0.0001).
Conclusion: ILI may decrease A1C by up to 2.5% in patients with diabetes. In patients with a similar magnitude of weight loss, A1C reduction was more prominent in those with higher baseline A1C levels. This may be valuable for clinicians to set realistic expectations of A1C reduction for their patients in response to ILI, which is usually the primary step in diabetes management.

Disclosure
A.H. Eldib: 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.
743-P: New Insulin Algorithm Reduces Carbohydrate (CHO) Requirements during Prolonged Outdoor Exercise
Authors: MUELLER-KORBSCH MICHAEL , FRÜHWALD LISA , HEER MICHAEL , FANGMEYER-BINDER MARIA , REINHART-MIKOCKI DAVID 
Published: June 2019

Individuals with T1D are generally advised to reduce basal rates and increase CHO intake during aerobic exercise. We assessed the effects of a different insulin regimen guided by rtCGM data on CHO intake and glucose levels in 17 T1D adults treated with insulin pumps (11 male, 42±8.8 years, 24±10 years DM duration, 6.6±0.8% A1C) vs. traditional insulin adjustment guidance during 2 consecutive days of extended biking activities (30 miles [49 km]). On day 1 (D1), subjects reduced their basal rate by 50% and consumed CHO as guided by their rtCGM (Dexcom G6) data to maintain target range (70-180 mg/dL). Basal insulin infusion was stopped 1 hour at the start of the day 2 activity (D2) then resumed at a minimal rate (0.23±0,1U/hour) during biking. All CHO from 1 hour before, during and 10 min after the activity was recorded. Times within/below target range, glycemic variability (GV) and mean glucose were calculated from rtCGM data. CHO intake was notably lower during D2 vs. D1 (36±32 vs. 40±27 g, p=NS), with slightly more time in range and &lt;70 mg/dL but no difference in time &lt;54 mg/dL (both p=NS). (Figure 1) Significant reductions in GV (34±7 vs. 47±13 mg/dL, p&lt;0.01) and slight reductions in mean glucose (124±24 vs. 110±14 mg/dL, p=NS) were seen. No severe hypoglycemic events occurred. T1D individuals using rtCGM in conjunction with insulin pump therapy can safely reduce their CHO requirements during prolonged exercise using the new algorithm.

Disclosure
M. Mueller-Korbsch: Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Menarini Group, Novo Nordisk Inc. L. Frühwald: None. M. Heer: None. M. Fangmeyer-Binder: None. D. Reinhart-Mikocki: None.
750-P: Oral Carbohydrate Demand during Endurance Exercise Is Dependent on Pre-exercise Blood Glucose Concentration in People with Type 1 Diabetes: A Randomized Crossover Trial
Authors: ECKSTEIN MAX L. , MOSER OTHMAR , MUELLER ALEXANDER , BIRNBAUMER PHILIPP , ABERER FELIX , KOEHLER GERD , SOURIJ CAREN , KOJZAR HARALD , PFERSCHY PETER N. , DIETZ PAVEL , BRACKEN RICHARD M. , HOFMANN PETER , SOURIJ HARALD 
Published: June 2019

Aim: To investigate the impact of moderate-intensity exercise and pre-exercise blood glucose concentrations (BG) on the demand of orally administered carbohydrates (CHO) to maintain euglycemia (&gt; 70 - 180 mg/dL) during endurance exercise sessions performed over 5 consecutive days on either a regular (100%) or reduced dose (75%) of insulin degludec (IDeg) in people with type 1 diabetes (T1D).
Methods: Nine participants with T1D (four women, mean age 32.1 ± 9.0 years, BMI 25.5 ± 3.9 kg/m2, glycated hemoglobin 55 ± 7 mmol/mol [7.2 ± 0.6%]) on IDeg were randomized to cycle for 55 minutes at moderate intensity (63 ± 7% VO2max) for 5 consecutive days on either 100% or 75% of their regular IDeg dose. The exercise accumulating effect was analysed via one-way-ANOVA for repeated measures (day x administered CHO). The influence of pre-exercise BG was analysed by one-way ANOVA or Kruskal-Wallis stratified for BG quartiles and Spearman correlation. The effect of IDeg dose (100% vs. 75%) on given CHO was calculated via Wilcoxon or student's t-test (p&lt;0.05).
Results: No exercise accumulating effect was found (p&gt;0.05) but CHO intake was significantly related to pre-exercise BG (r=-0.45; p&lt;0.0001).
Conclusion: Pre-exercise BG had a significant influence on the demand of orally administered CHO to maintain euglycemia during exercise over 5 consecutive days.

Disclosure
M.L. Eckstein: Research Support; Self; Novo Nordisk A/S. O. Moser: Research Support; Self; Abbott, Dexcom, Inc., Novo Nordisk A/S. A. Mueller: None. P. Birnbaumer: None. F. Aberer: None. G. Koehler: Advisory Panel; Self; Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk A/S. Speaker's Bureau; Self; Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk A/S, Sanofi-Aventis Deutschland GmbH. C. Sourij: None. H. Kojzar: None. P.N. Pferschy: None. P. Dietz: None. R.M. Bracken: None. P. Hofmann: None. H. Sourij: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi-Aventis. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Novo Nordisk A/S, Sanofi-Aventis. Speaker’s Bureau; Self; Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi-Aventis.

Funding
Novo Nordisk Pharma GmbH
752-P: Japanese Radio Calisthenics Prevents Reduction of Skeletal Muscle Volume in Patients with Type 2 Diabetes
Authors: KIMURA TOMONORI , OKAMURA TAKURO , HASHIMOTO YOSHITAKA , SENMARU TAKAFUMI , USHIGOME EMI , HAMAGUCHI MASAHIDE , ASANO MAI , YAMAZAKI MASAHIRO , FUKUI MICHIAKI 
Published: June 2019

Patients with type 2 diabetes often suffer from reduction in muscle mass and strength. Recent studies reported that high-intensity resistance training improves physical function, however, it was difficult for all patients to perform that. Radio calisthenics, which has been considered as a therapeutic exercise to promote health in Japan, is a simple exercise that can be done regardless of age and can move the muscles and joints effectively according to the rhythm of radio. Here we investigated the impact of Radio calisthenics for muscle mass in patients with type 2 diabetes. A total of 42 patients whom hospitalized in the Kyoto Prefectural University of Medicine were recruited. Skeletal muscle index (SMI) was defined as appendicular muscle mass(kg) divided by the square of the height (m). Change of SMI means the difference of SMI between the end and beginning of the hospitalization. Among 42 patients, 15 patients (11 males and 4 females) performed the Radio calisthenics. The change of SMI in Radio calisthenics exercisers was significantly lower than that in non-exercisers (-0.008±0.085 vs. -0.273±0.063, p=0.016). Radio calisthenics was positively associated with the change of SMI (standardized partial coefficient, beta = 0.395, p= 0.039) (Table). Radio calisthenics prevents the reduction of skeletal muscle mass and it could be one of the effective exercises for patients with type 2 diabetes.

Disclosure
T. Kimura: None. T. Okamura: None. Y. Hashimoto: Research Support; Self; Asahi Kasei Pharma. T. Senmaru: None. E. Ushigome: Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Johnson & Johnson, Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited. M. Hamaguchi: None. M. Asano: None. M. Yamazaki: None. M. Fukui: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Johnson & Johnson, Kyowa Hakko Kirin Co., Ltd., Merck & Co., Inc., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; AstraZeneca, Eli Lilly and Company, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Merck & Co., Inc., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited.
753-P: Protein vs. Carbohydrate in Gestational Diabetes
Authors: TROUT KIMBERLY K. , COMPHER CHARLENE , DURNWALD CELESTE P. 
Published: June 2019

Purpose/Aim: There has been little exploration on the effect of varied dietary intake on glycemic control in women with gestational diabetes (GDM). We evaluated the effects of diet with varying protein (Pro) and carbohydrate (CHO) with fat held constant on maternal glucose levels.
Methods: A random order cross over design was used in women diagnosed with GDM between 28-35 weeks gestation by Carpenter and Coustan criteria who were diet controlled for 3-10 days on standard GDM diet. In random order, women admitted to the research unit were allocated to one of two diets (30% kcal as Protein/35% kcal as CHO versus 15% Pro/50% CHO) using standardized meals and snacks and crossed over to the other diet treatment after a 3-7 day washout period. Maternal glucose was measured at 30” intervals post-meal via YSI analysis during 2 overnight admissions with weighed and measured meals and snacks provided.
Results: Twelve women were enrolled, 7 African-American; 3 non-Hispanic white; 1 Asian;1 Hispanic. Mean age= 33.9±5.4 years, pre-pregnancy BMI=28.7±5.3. At day 2 breakfast, mean glucose values were lower in the 30%Pro/35%CHO arm after 30 and 60” (90.7 vs. 101.6 mg/dL and 109.8 vs. 120.9 mg/dL), and 3-hour post-breakfast AUC was lower (17395.20 ±2493.47 vs. 19172.47 ±3484.31, p=0.01). The 3-hour post-lunch AUC was also lower in the 30% Pro/35% CHO arm (14365.81 ±1502.61 vs. 15077.30 ±2179.03, p&lt;0.03).
Discussion: The higher protein/lower carbohydrate dietary strategy ameliorated the expected post-prandial rise in glucose in these women with GDM and was well-tolerated by all subjects. Longer term outcomes of such an approach, including both maternal glycemic control, nitrogen balance and fetal growth outcomes are needed.

Disclosure
K.K. Trout: None. C. Compher: None. C.P. Durnwald: None.

Funding
National Institutes of Health
756-P: Changes in Gut Microbiota in Response to a Plant-Based Diet Are Related to Changes in Weight, Body Composition, and Insulin Sensitivity: A 16-Week Randomized Clinical Trial
Authors: KAHLEOVA HANA , TURA ANDREA , BARNARD NEAL 
Published: June 2019

Background: This study tested the effect of a 16-week plant-based diet on gut microbiota composition, body weight, body composition, and insulin resistance in overweight adults with no history of diabetes.
Methods: Participants (n=148) were randomized to follow a low-fat vegan diet (n=73) or to make no diet changes (n=75) for 16 weeks. At baseline and 16 weeks, gut microbiota composition was assessed, using uBiome kits. Dual energy X-ray absorptiometry was used to measure body composition. PREDIM index was used to assess insulin sensitivity. Repeated measure ANOVA was used for statistical analysis.
Results: Body weight was reduced significantly in the vegan group (treatment effect -5.8 kg [95% CI, -6.9 to -4.7 kg]; p&lt;0.001), particularly due to a reduction in fat mass (treatment effect -3.9 kg [95% CI, -4.6 to -3.1 kg]; p&lt;0.001) and in visceral fat (treatment effect -172 cm3 [95% CI, -308 to -37 kg]; p=0.01). PREDIM increased significantly (p&lt;0.001) in the vegan group (treatment effect +0.88 [95% CI, +0.5 to +1.2]; p&lt;0.001). The relative abundance of Faecalibacterium prausnitzii increased in the vegan group (treatment effect +4.8% [95% CI, +1.97 to +7.58%]; p=0.001). Relative changes in Faecalibacterium prausnitzii correlated negatively with changes in body weight (r=-0.26; p=0.008), fat mass (r=-0.26; p=0.008), and visceral fat (r=-0.25; p=0.01). The relative abundance of Bacteoides fragilis increased in the vegan group (treatment effect +19.5% [95% CI, +14.7 to +24.3%]; p&lt;0.001). Relative changes in Bacteroides Fragilis correlated negatively with changes in body weight (r=-0.48; p&lt;0.001), fat mass (r=-0.48; p&lt;0.001), visceral fat (r=-0.24; p=0.02), and positively with changes in PREDIM (r=0.36; p=0.0004).
Conclusions: A 16-week low-fat vegan dietary intervention induced changes in gut microbiota that were related to changes in weight, body composition and insulin sensitivity in overweight adults.

Disclosure
H. Kahleova: None. A. Tura: None. N. Barnard: None.

Funding
Physicians Committee for Responsible Medicine
764-P: Low Dietary Energy Density (DED) Diet Is Associated with Favorable Dietary Pattern in Japanese Patients with Type 2 Diabetes (T2DM)
Authors: TAKEDA YASUNAGA , FUJIHARA KAZUYA , HATTA MARIKO , MORIKAWA SAKIKO Y. , HORIKAWA CHIKA , ISHII DAI , NEDACHI RINA , MAEGAWA HIROSHI , SONE HIROHITO ,   JDDM STUDY GROUP
Published: June 2019

Dietary energy density (DED) is receiving increased attention reflecting recent reports of inverse associations with health outcomes. Although high DED meals are reportedly associated with low diet quality in the general population, such evidence in patients with diabetes is sparse, which led us clarify this issue in Japanese patients with T2DM. Analyzed were 1,615 outpatients with T2DM (men 62.2%) who attended 24 clinics specializing in diabetes care nationwide. Dietary habits were obtained using a food frequency questionnaire (FFQg) based on 18 food groups. DED (kcal/g) was calculated by dividing EI (kcal) from foods (excluding beverages) by weights of these foods (g). Mean DED (±SD) was 1.53±0.23 (kcal/g). Typical dietary patterns comprised of some significant food groups were extracted by principal component analysis. Pearson's correlation analysis was used to evaluate the associations between identified food patterns and DED. We could extract and validate three dietary patterns, which we labeled as “Healthy,” “Western,” and “Animal foods and confectionery.” Two patterns were significantly correlated with DED (Healthy: r=-0.48, Animal foods and confectionery: r=-0.69). A multivariate linear regression model was used to determine food groups that were independently related to DED. DED was positively associated with confectioneries (standardized β=0.19, P&lt;0.001), bread (0.10, P&lt;0.001), and fat and oil (0.09, P&lt;0.001). On the contrary, DED was negatively associated with brightly colored vegetables (-0.25, P&lt;0.001), fruits (-0.31, P&lt;0.001), and light-colored vegetables (-0.43, P&lt;0.001).
In conclusion, lower DED, which is related to higher intakes of vegetables and fruits was associated with a healthy diet pattern in T2DM patients. DED is a useful indicator of diet quality and could be utilized in nutritional education for people with T2DM.

Disclosure
Y. Takeda: None. K. Fujihara: None. M. Hatta: None. S.Y. Morikawa: None. C. Horikawa: None. D. Ishii: None. R. Nedachi: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.