bluuebunny/crossref_metadata_2025_split huggingface dataset:
12524 Predictive Factors For Type 2 Diabetes Remission: Insights From A Digital Twin Intervention Program At 18 Months
Authors: Shamanna P , Dharmalingam M , Vadavi A , Keshavamurthy A , Bhonsley S , Thajudeen M , Balasubramanian A , Joshi S R 
Published: October 2024

Abstract
Disclosure: P. Shamanna: None. M. Dharmalingam: None. A. Vadavi: None. A. Keshavamurthy: None. S. Bhonsley: None. M. Thajudeen: None. A. Balasubramanian: None. S.R. Joshi: None.
Background and aims: Digital twin (DT) platform uses Artificial Intelligence (AI) and Internet of Things, to integrate multi-dimensional data for precision nutrition and health recommendations via the mobile app. Remission was defined as A1C levels less than 6.5% without medication for over 3 months. Evidence suggests that remission is more likely in individuals with early type 2 diabetes (T2D) who are not using insulin therapy and who can engage in significant weight loss. We evaluated the predictive value of baseline parameters on T2D remission, including duration of diabetes, HbA1c levels, diabetic medications as drug count, and CGM metrics, with the objective to improvise the patient selection strategies for remission Methods We analyzed T2D patients (n=209) who completed 18 months of digital twin intervention. Potential predictors were examined by logistic regression analyses, with model performance evaluated by accuracy, precision, recall, and Area under the Receiver Operating Characteristic Curve (AUC-ROC) metrics. Results The model achieved an accuracy of 78.57%, precision of 79.41%, recall of 93.10%, and AUC-ROC of 0.745. Significant inverse associations with remission were observed for the duration of diabetes (OR: 0.74), baseline HbA1c (OR: 0.76), and the number of anti-diabetic medications as oral drugs (OR: 0.77), indicating decreased odds of remission with increasing values. Conversely, positive associations were found for Time Below Range 2 at baseline (OR: 1.22) and HOMA2IR at baseline (OR: 1.24), suggesting increased odds of remission with higher values in these metrics. We describe the Receiver Operating Characteristic (ROC) curve for the diabetes remission prediction model, with the area under the curve (AUC) indicating the model's discriminatory ability. The duration of diabetes emerged as the most significant negative predictor, followed by baseline HbA1c and the number of diabetic drugs, while counterintuitive findings like the positive association of baseline HOMA2IR with remission suggest areas for further investigation. Conclusion We identified baseline parameters significantly influencing the likelihood of T2D remission in people undergoing digital twin intervention. The odds ratios indicate the effect sizes of these predictors, highlighting the importance of personalized, data-driven treatment approaches that potentially enhance remission outcomes. Further validation of these findings in larger external cohorts would be useful.
Presentation: 6/1/2024
12600 Predictors Of Diabetes Remission: The Impact Of Early Intervention Through A Digital Twin Platform
Authors: Joshi S R , Dharmalingam M , Vadavi A , Keshavamurthy A , Bhonsley S , Thajudeen M , Balasubramanian A , Panandikar M , Shamanna P 
Published: October 2024

Abstract
Disclosure: S.R. Joshi: None. M. Dharmalingam: None. A. Vadavi: None. A. Keshavamurthy: None. S. Bhonsley: None. M. Thajudeen: None. A. Balasubramanian: None. M. Panandikar: None. P. Shamanna: None.
Introduction and Objective: Digital twin (DT) platform uses Artificial Intelligence (AI) and Internet of Things, to integrate multi-dimensional data for precision nutrition and health recommendations via the mobile app. We aimed to identify the pre-intervention anthropometric and biochemical parameters that predict diabetes remission (HbA1c &lt; 6.5% without medications for over 3 months). Methods: 209 patients with T2D completed 540 days (18 months) of DT intervention. Results: 129 (61.7%) achieved remission of T2DM (R group). At baseline, patients in R group, compared with patients in the Non-remission Group (group NR) (n=80) had shorter duration of diabetes (yrs) (R: 2.9±2.6, 95% CI 2.5 to 3.4) vs. (NR: 4.7±2.2, 95% CI 4.2 to 5.2), p= &lt;0.0001; lower baseline HbA1c % (R: 8.6±1.9, 95% CI 8.3 to 9) vs. (NR: 9.5±1.7, 95% CI 9.1 to 9.9), p=0.0008; lower estimated HbA1c (eA1C) (R: 7.6±2.2, 95% CI 7.2 to 8) vs. (NR: 8.9±2.3, 95% CI 8.4 to 9.4), p= &lt;0.0001; lower glucose management indicator (GMI) % (R: 7.5±1.6, 95% CI 7.2 to 7.8) vs. (NR: 8.4±1.8, 95% CI 7.9 to 8.8), p=0.0006; ; lower Time Above Range level 1 (TAR1 %; target 180-250 mg/dl &lt; 25% time) (R:21.3±17.6, 95% CI 18.2 to 24.4) vs. (NR: 31.2±17.2, 95% CI 27.3 to 35), p&lt;0.0001; lower Time Above Range level 2 (TAR2 %; target &gt;250 mg/dl &lt; 5% time) (R: 15±24.5, 95% CI 10.8 to 19.3) vs. (NR: 24.2±26.3, 95% CI 18.2 to 29.9), p=0.01; higher Time In Range (TIR; target 70-180 mg/dl &gt;70% time) (R: 59.5±31.5, 95% CI 54 to 65) vs. (NR: 43.3±30.9, 95% CI 36.4 to 50.2), p=0.0003; lower fasting plasma glucose (mg/dl) (R: 161±53.4, 95% CI 151.7 to 170.3) vs. (NR: 186.4±69.3, 95% CI 171 to 201.8), p=0.003; higher HOMA2B (%) (R: 56.6±31.7, 95% CI 51.1 to 62.1) Vs (NR: 43.6±27.5, 95% CI 37.4 to 49.6), p=0.002; and comparable fasting insulin (mIU/L) (R: 13.9±10.1, 95% CI 12.2 to 15.7) vs. (NR: 11.8±7.2, 95% CI 10.2 to 13.4), p=0.09 (ns), HOMA2IR (%) (R:1.9±0.93, 95% CI 1.8 to 2.1) vs (NR:1.8±0.84, 95% CI 1.6 to 2), p=0.33 (ns); weight (kg) (R:78.9±14.4, 95% CI 76.2 to 81.6) vs (NR:78.1±12.8, 95% CI 75.3 to 81), p=0.71 (ns). The mean baseline anti-diabetic drug count was lower in R (1.4) Vs NR (2.1). At 540 days the change was as follows: comparable Time Below Range1 - TBR1 %(&lt; 70-54 mg/dl) &lt; 4% (R: 3.5±14.9, 95% CI 0.92 to 6.1) Vs (NR: 1.9±8.3, 95% CI 0.07 to 3.8), p=0.38 (ns); lower HbA1c (R: 5.9±0.35, 95% CI 5.8 to 6) Vs (NR: 7.2±1.1, 95% CI 7 to 7.5), p&lt;0.0001. Conclusion: Shorter diabetes duration, lower baseline HbA1c, eA1C, GMI, and TAR, higher TIR, lower fasting plasma glucose, and higher beta-cell function are key predictors of diabetes remission.
Presentation: 6/3/2024
12397 Predictors Of Hospital Readmission Within Three Months Among Patients Admitted For Diabetic Ketoacidosis (dka)
Authors: Onwudiwe O , Yerashevich L , Onwudiwe C , Baral B , Acharya A , Nguyen H 
Published: October 2024

Abstract
Disclosure: O. Onwudiwe: None. L. Yerashevich: None. C. Onwudiwe: None. B. Baral: None. A. Acharya: None. H. Nguyen: None.
Purpose: Diabetic ketoacidosis (DKA) represents a critical, life-threatening complication of diabetes, with higher rates of re-admission noted among individuals from lower socioeconomic backgrounds, those lacking insurance coverage, and those with suboptimal follow-up care. This study seeks to identify predictors of hospital readmission within three months among patients admitted for DKA in a community hospital setting. Methods: Patient data were extracted from electronic medical records from 2019 to 2021 for individuals admitted due to DKA using ICD codes. DKA diagnosis was based on the presence of hyperglycemia, high anion gap metabolic acidosis, and ketonemia. Demographic information, results of routine biochemical tests, insurance status, follow-up with primary care providers (PCP) or endocrinologists, and clinical progression were retrospectively collected from patients' records. Multivariable logistic regression analyses were conducted to identify predictors of readmission. Results: A total of 222 unique DKA admission visits were analyzed. The mean age (standard deviation) of the patients was 48 (16) years, and 58% of them were male. Among these visits, 39% had type 1 diabetes, 43% had type 2 diabetes, and 18% were newly diagnosed diabetes cases. The majority of patients were overweight, with a mean body mass index (BMI) of 27, and the mean glycated hemoglobin level was 10.8. Common triggers for DKA included insulin non-adherence (52%), infection (37.8%), and alcohol use (8.6%). Logistic regression analysis revealed that lack of follow-up significantly increased the odds of readmission within three months (B = 2.025, p = .003, Exp(B) = 7.576, 95% CI [1.952, 29.401]), as did having type 1 diabetes (B = 1.473, p = .019, Exp(B) = 4.364, 95% CI [1.272, 14.978]). However, the association between insulin adherence and readmission was not statistically significant at the conventional alpha level of 0.05 (B = 1.329, p = .112, Exp(B) = 3.777, 95% CI [0.733, 19.458]). Other demographic (age, gender, employment status, insurance status, medication compliance,) and clinical [insulin adherence, presence of infection, blood glucose level at diagnosis of DKA, and level of glycated hemoglobin (Hba1c)] variables did not significantly predict readmission within 3 months. Conclusion: DKA, being preventable with adequate insulin adherence, is also influenced by factors such as infection and lifestyle choices. The findings highlight the critical role of post-discharge follow-up care in reducing readmission rates among DKA patients. Healthcare providers should prioritize ensuring timely and comprehensive follow-up, particularly for patients with type 1 diabetes, to optimize post-hospitalization management and prevent avoidable readmissions.
Presentation: 6/3/2024
8681 Preoteogenomic Identification Of Novel Translated And Regulatory Open Reading Frames In Human Beta-Cells
Authors: Walters K , Guiterrez R C , Sakhar S , Baldwin A , Nakayasu E S , Russ H , Mukherjee N 
Published: October 2024

Abstract
Disclosure: K. Walters: None. R.C. Guiterrez: None. S. Sakhar: None. A. Baldwin: None. E.S. Nakayasu: None. H. Russ: None. N. Mukherjee: None.
Preoteogenomic Identification of Novel Translated and Regulatory Open Reading Frames in Human Beta-cells The discovery of novel autoreactive T cells that target β cells during type 1 diabetes (T1D) has been challenging due to our limited knowledge in autoreactive β cell antigens. Most of these antigens are derived from canonical open reading frames (ORFs) of protein coding genes, such as preproinsulin and chromogranin A. However, a defective ribosomal product (DRiP) was recently identified from the insulin mRNA (INS-DRiP). This antigen is the result of translation from a novel or unannotated open reading frames (nuORFs). nuORFs have a range of functions from regulating translation to encoding novel small bioactive peptides to producing neoantigens. In this study, we use a transcriptome-wide approach to identify nuORFs in human β cells in an unbiased manner. We performed ribosome profiling (ribo-seq) in stem cell derived β cells (sBCs). Human pluripotent stem cells were differentiated into sBCs expressing a flag-tagged ribosomal protein (RPL22-Flag) driven by the rat insulin promoter. We performed IP-ribo-seq on sBCs enriching for RPL22-Flag containing ribosomes. These data exhibited high-resolution 3-nucleotide periodicity consistent with translating codons and identified sequencing reads consistent with translation of the INS-DRiP. We performed de novo ORF-calling using two software using complementary statistical approaches (RiboCode and ORFQuant). We identified over 12,000 canonical annotated ORFs of which ∼85% were had protein level support from matched proteomics confirming the high specificity of our approach. Of nearly 1000 nuORFs identified in sBCs, over half had protein level support in sBCs and cadaveric human islets. We found that 149 nuORFs were associated with Type-1 Diabetes (T1D) genes, including a novel upstream ORF (uORF) in TYK2, which had the strongest association with T1D and is a promising therapeutic target to halt T1D progression. Using reporter assay, we show that the novel uORF in TYK2 is a translational activator and warrants further investigation. Finally, our data represents a valuable database for the search of novel autoreactive antigens in β cells and accelerate the discovery of novel autoreactive T cells implicated in T1D pathogenesis.
Presentation: 6/2/2024
7513 Presence Of Hispanic/Latino Physicians In Academic Research. Are We There Yet?
Authors: Guillen Lopez Claudia Estefania , Patel Aesha , Rocha Andrea , Arima Chloe , Molkina Angelina , Robles Lydia , Gastelum Alheli Arce 
Published: October 2024

Abstract
Disclosure: C.E. Guillen Lopez: None. A. Patel: None. A. Rocha: None. C. Arima: None. A. Molkina: None. L. Robles: None. A. Arce Gastelum: None.
Hispanic/Latino endocrinologists' presence and active involvement in diabetes research play a pivotal role in shaping the trajectory of healthcare initiatives in the United States. Diabetes, a prevalent and complex health condition, disproportionately affects diverse communities, with Hispanics/Latinos being among the groups facing higher incidence rates. In this context, the significance of Hispanic/Latino endocrinologists cannot be overstated, as their unique perspectives and cultural insights contribute to a more nuanced understanding of the multifaceted factors influencing diabetes prevalence, management, and outcomes in the U.S. By actively involving Hispanic/Latino endocrinologists in diabetes research, we not only enhance the representation of diverse patient populations but also foster a more comprehensive approach to addressing the intricate intersections of genetics, lifestyle, and socio-cultural factors contributing to diabetes disparities in the nation. In the 2021 Physician Specialty Data Report, the Association of American Medical Colleges (AAMC) incorporated physician race and ethnicity information for the first time. Within the 7,354 actively practicing endocrinologists surveyed, only 636 individuals identified as Hispanic/Latino. The majority of these endocrinologists were predominantly dedicated to clinical practice. A descriptive analysis of 1011 abstracts on diabetes and glucose metabolism presented at the Endo Society from 2021 to 2023 revealed that 549 were authored by women and 458 by men. The majority (705 posters, 69.7%) originated from the U.S., and 306 (30.26%) were classified as international posters. Among these, 152 posters (15%) were associated with the Hispanic or Latino authors, but only 91 (9%) were published in the U.S. In conclusion, the engagement of Hispanic/Latino physicians in endocrinology is indispensable for advancing healthcare. Their participation brings diverse perspectives, facilitates a better understanding of health disparities, and promotes innovative research and patient care strategies. By actively involving Hispanic/Latino physicians, we contribute to a more comprehensive understanding of endocrine disorders and work towards a healthcare system that prioritizes inclusivity, cultural sensitivity, and collaboration, ultimately benefiting the well-being of individuals across diverse communities.
Presentation: 6/2/2024
12505 Prevalence Of Mody Diabetes Polymorphism Of Thai Urban Families By Targeted Next Generation Sequencing Of Diabetes Polymorphism
Authors: Niramitmahapanya Sathit 
Published: October 2024

Abstract
Disclosure: S. Niramitmahapanya: None.
Prevalence of MODY diabetes polymorphism of Thai Urban families by targeted next-generation sequencing in diabetes polymorphismObjective: To study the prevalence between single nucleotide polymorphism of urban diabetes (UD) and non-diabetes (noD) in Thai population. Method: Cross-sectional study was collected 240 participant samples; 60 from UD, 60 from RnoD, 60 from non-relative, non-diabetes (noRnoD) and 60 diabetes, non-relatives (noRD). And generated diabetes variant frequency in Thai population by targeted next-generation sequencing. Result; Among group of UD and RnoD found that age, fasting blood glucose (FBG), HbA1c and LDL level were statistic significant all parameter by p&lt;0.001. Age in UD was 64.15±10.74 vs. 43.43±12.46 in RnoD, FBs in UD was 129.39±44.91 vs. 99.74±39.75 in RnoD, A1c in UD was 8.26±4.76 vs. 6.17±1.35 in RnoD and LDL level in UD was 98.28±38.52 vs. 129.35±39.75 in RnoD.In subgroup analysis of diabetes variant, we designed Ion AmpliSeq On-Demand Panels (25 genes related diabetes) for targeted sequencing. We didn’t found statistic significant between UD and RnoD group by p-value =0.998 (23 genes; ABCC8, FGA, SELE, PAX4, HNF1A, BLK, LOC10028732, NEUROD1, KCNJ11, MMP2, APPL1, LPL, CAT, CEL, HNF1A, HNF1B, ICAM1, INSR, SOD, GCK, INS and UCP3). We identified 12 mutations of MODY in UD, the most polymorphism was HNF1a and ABCC8 that found 16.4%, PAX4 found 13.1%, APPL1 found 11.5%, KCNJ11 and NEUROD1 found 8.2%, BLK 6.6% and other less polymorphism that found &lt;5% (HNF1B, HNF4a, CEL, GCK, INS). Conclusion; From the study, we analyzed genetic data from 12 genes that involved pathogenesis for diabetes polymorphism between UD and noD groups. We focus on diabetes variant frequency. We found that 5 pathogenic polymorphism such as HNF1a, GCK, CEL, INS and APPL1. Further study needs to evaluate correlation diabetes polymorphism and their treatment protocols. Keywords; Thai urban diabetes, first degree relatives and MODY diabetes polymorphism
Presentation: 6/1/2024
8132 Prolonged Refractory Hypoglycemia For Seven Days After Discontinuation Of Neutral Protamine Hagedorn (NPH) Insulin And Injectable Semaglutide
Authors: Musleh Anisa , Rauf Mohammad Talha , Afroze Eman , Al-Bacha Souad 
Published: October 2024

Abstract
Disclosure: A. Musleh: None. M.T. Rauf: None. E. Afroze: None. S. Al-Bacha: None.
A 75-year-old male with Type 2 Diabetes was brought to the emergency department (ED) by emergency medical services (EMS) due to altered mentation. The patient’s wife found him unresponsive with seizure-like activity. EMS was called to the scene and obtained a capillary blood glucose reading of 31 mg/dL. Despite initial treatment with 50% dextrose the patient’s capillary blood glucose came down to 21 mg/dL in the ED and was confirmed by venous glucose. Workup including Computed Tomography (CT) imaging was inconsistent with a cerebrovascular accident. Given refractory hypoglycemia and delirium, the patient was started on a dextrose 10% infusion at 150 milliliters per hour. He was admitted to the intensive care unit for closer monitoring. His wife states that the patient had a few episodes of mild hypoglycemia overnight for the past several weeks, which improved after eating. His home medications included NPH insulin 46 units twice daily, empagliflozin 25 mg once daily, and injectable semaglutide 2 mg once weekly. The last dose of NPH insulin was the night before the presentation and the last dose of semaglutide was 5 days prior to admission. Serum creatinine levels were stable at 1.3-1.5 mg/dL throughout the hospitalization, which was below his baseline creatinine of 1.7 mg/dL. Laboratory results were as follows: hemoglobin A1c 5.9%, c-peptide level was 0.3 ng/mL (normal range 0.8-3.9 ng/mL) with a glucose of 68 mg/dL (normal range 70-100 mg/dL), insulin 203.8 mcIU/mL (normal range less than 24 mcIU/mL), proinsulin 3.2 pmol/L (normal range less than or equal to 8 pmol/L), beta-hydroxybutyrate 0.06 mmol/L (normal range 0.02-0.27), cortisol 66.6 mcg/dL (normal range 6.7-22.6 mcg/dL), insulin-like growth factor 1 123 ng/mL (normal range 53-222), and hypoglycemic agent panel was negative. On ICU Day 2, his mentation improved, he was allowed to eat but continued to require dextrose infusion to prevent hypoglycemia. Repeat fasting insulin levels even four days from prior showed an incremental decrease to 59.4 mcIU/mL with a glucose of 77 mg/dL. It took 7 days before the patient was able to maintain glucose above 70 mg/dL off of dextrose infusion. After which he had hyperglycemia requiring gradual reintroduction of his diabetes medicines other than insulin. It is rare to see such prolonged refractory hypoglycemia from an exogenous source of insulin as exhibited in this case. Notably, the patient was on semaglutide and had stable chronic kidney disease without acute kidney injury. Although multiple mechanisms explain the prolonged insulin duration of action in kidney disease, the effects of semaglutide on insulin action are unknown.
Presentation: 6/3/2024
9343 Protection Against Type 1 Diabetes Development In Mice With 4E-BP2 Deletion
Authors: Pita Grisanti V , Pecanha F , Louzada R , Blandino M , Jaramillo C , Arenas N , Bayer A , Bernal-Mizrachi E 
Published: October 2024

Abstract
Disclosure: V. Pita Grisanti: None. F. Pecanha: None. R. Louzada: None. M. Blandino: None. C. Jaramillo: None. N. Arenas: None. A. Bayer: None. E. Bernal-Mizrachi: None.
Type 1 diabetes is an autoimmune disease characterized by β-cell destruction promoted by autoreactive T cells that acquire an effector inflammatory phenotype. 4E-BP1/2 proteins are translational repressors and downstream targets of mTORC1, a key regulator of metabolism. mTORC1 signaling disruption is implicated in human diseases including diabetes. Activation of 4E-BP2/eIF4E pathway by 4E-BP2 deletion promotes translation initiation, which induces β-cell expansion and proliferation and is crucial for the regulation of adaptive immunity. However, the involvement of 4E-BP2 in type 1 diabetes development has not been explored. Therefore, this study aimed to determine the role of 4E-BP2/eIF4E signaling in type 1 diabetes prevention by regulation of β-cell survival and immune modulation. To investigate the role of 4E-BP2/eIF4E axis in diabetes pathogenesis, we used the non-obese diabetic (NOD) mouse model as a type 1 diabetes model, and generated mice with global deletion of 4E-BP2 in the NOD background (4E-BP2KONOD). We assessed type 1 diabetes development, glucose homeostasis, pancreas morphometry and immune responses in male and female 4E-BP2KONOD and control NOD mice. We found that 4E-BP2KONOD exhibited reduced diabetes incidence in male but not female mice. Reduction in diabetes incidence in 4E-BP2KONOD male mice was associated with comparable degree of insulitis and β-cell proliferation, and with preserved β-cell mass compared to the control NOD mice. Glucose-stimulated insulin secretion of the islets, assessed in vitro by static incubation, was significantly higher in the 4E-BP2KONOD compared to the NOD control. Autoimmune responses were also evaluated by assessment of insulitis and characterization of T cell compartments, which showed a decrease in splenic CD8+ cytotoxic T cells and an increase in pancreatic regulatory T cell (Treg) infiltration mainly by increased Treg survival in 4E-BP2KONOD mice compared to control NOD. Finally, adoptive transfer studies demonstrated that lymphocytes derived from male 4E-BP2KONOD mice were less diabetogenic than those derived from control NOD mice. In conclusion, this study showed that activation of 4E-BP2/eIF4E axis in 4E-BP2KONOD male mice protects against type 1 diabetes development by dampening autoimmune responses and preserving β-cell mass. Targeting 4E-BP2 may provide a potential treatment for type 1 diabetes.
Presentation: 6/1/2024