bluuebunny/crossref_metadata_2025_split huggingface dataset:
1359-P: Diabetes Control and Complications in North India—Three-Year Results of LANDMARC Trial
Authors: MITHAL AMBRISH , KUMAR WANGNOO SUBHASH , ZARGAR ABDUL H. , CHAWLA RAJEEV , GUPTA MUKULESH , MITTAL VINOD , KHANDELWAL DEEPAK , JULKA SANDEEP , JINDAL SUSHIL , LODHA SAILESH , BANZAL SUBODH S. , MENON SHALINI K. , GADEKAR ARVIND , CHODANKAR DEEPA 
Published: June 2024

Glycemic control, therapy trends, and diabetes complications were evaluated in LANDMARC, a prospective observational 3-year study (CTRI/2017/05/008452), having participants with T2D on ≥2 antihyperglycemic medications. This subgroup analysis of 114 sites in North India (Delhi, Jaipur, Lucknow) included 1686 participants (mean [SD] baseline [BL] age: 51.7 [8.8] years, T2D duration: 8.7 [5.5] years and A1C: 8.1% [1.6]). At BL, most were insulin-naïve (n=1332; 79.0%), relying mainly on OADs (n=1324; 78.5%). At 3 years, 1028 (70.1%) participants were on OADs only, while 414 (28.2%) were on insulin + OADs. Biguanides was the most prescribed drug class (BL: 1558 [92.4%] and 3-years: 1313 [89.5%]). Basal insulin usage increased from BL (n=199; 11.8%) to 3 years (n=284; 19.4%). At 3 years, there was a decrease in the mean (SD) A1C by 0.8 (1.7) %, FPG by 17.0 (51.4) mg/dL, and PPG by 19.1 (79.0) mg/dL; and an increase in proportion of those with A1C&lt;7% (BL: 257 [21.2%]; 3 years: 363 [38.6%]). Peripheral vascular disease and neuropathy were most common macrovascular and microvascular complications, respectively (Table). Hypertension and dyslipidemia were the most common CV risk factors reported at 3 years. The highest burden of hypertension was noted in North India. This pivotal understanding of regional trends in glycemia, therapy, and complications may help strategize future diabetes management practices in India.

Disclosure
A. Mithal: Other Relationship; Sanofi. S. Wangnoo: None. A.H. Zargar: None. R. Chawla: None. M. Gupta: None. V. Mittal: None. D. Khandelwal: None. S. Julka: Other Relationship; Sanofi, Eli Lilly and Company, Novo Nordisk, USV Private Limited. S. Jindal: None. S. Lodha: None. S.S. Banzal: None. S.K. Menon: Employee; Sanofi. A. Gadekar: None. D. Chodankar: Employee; Sanofi.

Funding
Sanofi
1364-P: Racial and Ethnic Disparities in COVID-19 Outcomes among Dialysis Patients with Diabetes
Authors: CONWAY REBECCA B. , QUANDELACY TALIA , HU MING , WANG YUEDONG , KOTANKO PETER 
Published: June 2024

Hemodialysis patients w/ COVID-19 have fatality rates higher than the general population. Racial minorities in the U.S. bear a disproportionate burden of diabetes and dialysis and were the hardest hit by COVID-19. Whether the impacts of COVID-19 and its outcomes on those receiving dialysis vary by race are unknown. To determine racial differences in COVID-19 infection, hospitalization, and mortality in dialysis patients w/ diabetes, we followed 114,881 in-center hemodialysis patients w/diabetes (AIAN; Asian; Black/African American: AA; Hispanic; Native Hawaiian/Other Pacific Islander: NH; Non-Hispanic White: NHW) from January 2020 to March 2022 for risk of COVID-19 infection, hospitalization, and mortality. ORs and 95% CIs were calculated, adjusting for demographic characteristics, vaccination status, vintage, and lab data. During follow-up, the cumulative incidence of COVID-19 was 26%; 34% of the population was hospitalized and 12% died. Infection rates were highest in AIAN and lowest in Asian patients: AIAN: 30%; Hispanic: 26%; NH: 22.4%; AA: 21.5; NHW: 19.8; Asian: 15.3. Risk of infection was higher in Hispanic (OR=1.36, 1.22-1.52), but lower in Asian (OR=0.69, 95% CI=0.53-0.89) patients compared to NHWs. Though Asian patients had lower infection risks, they had marginally higher hospitalization risk (OR=1.45, 95% CI=0.94-2.26; p=0.09) compared to NHW. NH were at a marginally 45% lower risk of hospitalization (OR=0.55, 95% CI =0.28-1.01; p=0.07). AA (OR=0.66, 95% CI=0.53-0.83) and Hispanic infected patients (OR=0.64, 95% CI=0.48-0.84) were at lower risk of mortality compared to NHW. Despite lower COVID-19 infection risk, US Asian dialysis patients w/ diabetes are at increased hospitalization risk when infected, whereas AIAN patients though at increased infection risk are at lower risk of hospitalization. AA and Hispanic patients are at lower risk of death. Understanding reasons for these differences may provide clues to increasing survival for dialysis patients w/ diabetes.

Disclosure
R.B. Conway: None. T. Quandelacy: None. M. Hu: None. Y. Wang: None. P. Kotanko: Other Relationship; Fresenius Medical Care.
1366-P: Cardiovascular Complications (Myocardial Infarction, Stroke, and End-Stage Renal Disease) and Mortality in Youth-Onset Type 1 and Type 2 Diabetes Based on National Health Insurance Service (NHIS) Data
Authors: KIM SUNGEUN , HAN KYUNGDO , CHO WON-KYOUNG 
Published: June 2024

Background: In South Korea, little is known regarding the mortality and the occurrence of related cardiovascular complications in youth-onset diabetes.
Methods: Based on Korean National Health Insurance Service-National Sample Cohort database from 2006 to 2020, data of patients with type 1 (T1DM) and type 2 diabetes (T2DM) who were aged ≤30 were collected. Mortality and incidence of cardiovascular complications (myocardial infarction [MI], stroke and end-stage renal disease [ESRD]) in T1DM and T2DM were compared to the general population of the cohort.
Results: The total population was 513,633. Patients with T1DM and T2DM were 413 and 1,250, respectively. After adjusting for sex, age and income, the odds ratios (ORs) of MI were 8.71 (95% confidence interval [CI], 3.25-23.31) for T1DM and 7.81 (95% CI, 4.38-13.94) for T2DM. The ORs of stroke were 5.95 (95% CI, 2.23-15.91) for T1DM and 4.72 (95% CI, 2.59-8.60) for T2DM. The ORs of ESRD were 144.05 (95% CI, 89.00-233.15) for T1DM and 28.20 (95% CI, 15.69-50.66) for T2DM. The mortality risks in patients with T1DM (5.16; 95% CI, 2.77-9.61) and T2DM (5.18; 95% CI, 3.65-7.36 for T2DM) were significantly higher than the control group. The morality risk for T2DM aged &lt; 20 (14.00; 95% CI, 5.82-33.69) was predominantly higher than other subgroups in T1DM and T2DM.
Conclusion: In South Korea, patients with youth-onset diabetes had a high risk of cardiovascular complications, particularly more pronounced in patients with T1DM for ESRD. Both types of diabetes were associated with notably increased mortality risk compare to the general population.

Disclosure
S. Kim: None. K. Han: None. W. Cho: None.

Funding
Catholic Medical Center Research Foundation
1368-P: Early-Life Adversity, Indicated by Difference between Observed and Genetically Predicted Height, and Risks of Diabetes and 48 Related Diseases
Authors: ZHANG YANBO , LI YANG , XUE XIAONAN , WANG TAO , MOON JEE-YOUNG , ISASI CARMEN R. , ROHAN THOMAS , QI QIBIN 
Published: June 2024

Introduction & Objective: Early-life adversity contributes significantly to global disease burden but lacks objective measures. Given height is determined by genetic and early environmental factors, we aimed to assess early-life conditions by the difference between observed and genetically predicted height (i.e., residual height) and to examine its associations with risks of diabetes and related diseases.
Methods: Among 407366 UK Biobank participants, we calculated genetically predicted height by fitting age- and sex-specific linear regression models regressing observed height on a polygenic score of 9863 height-related SNPs (Fig A). Outcomes were obtained via disease registry (median follow-up=12.5 years).
Results: Residual height was correlated with favorable early-life indicators (Fig B). Shorter residual height (comparing &lt;-2 SD to ≥2 SD away from the mean) was associated with higher risks of diabetes (HR 1.19, 95% CI 1.00-1.41), CVD (1.26, 1.10-1.45), psychiatric/neurological, digestive, musculoskeletal, and other diseases (HR range 1.13-1.25), and mortality (1.38, 1.23-1.55). Among 49 individual diseases, shorter residual height was associated with higher risks for 27 diseases (Fig C).
Conclusion: Shorter residual height, a potential early-life adversity indicator, was associated with higher risks of diabetes and related diseases.

Disclosure
Y. Zhang: None. Y. Li: None. X. Xue: None. T. Wang: None. J. Moon: None. C.R. Isasi: None. T. Rohan: None. Q. Qi: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK119268, R01DK120870, and R01DK126698), National Heart, Lung, and Blood Institute (R01HL060712), and National Institute on Aging (1RF1AG077639).
1390-P: Access to Telehealth and Changes in Diabetes Care Patterns during the Pandemic
Authors: OVIEDO SOFIA A. , GANDER JENNIFER C. , MCDONALD BENNETT , ALI MOHAMMED K. , HARDING JESSICA L. 
Published: June 2024

Objective: To investigate the impact of the COVID-19 pandemic on telehealth utilization and adherence to annual diabetes care guidelines and risk factor management among people with diabetes.
Research Design and Methods: We included all adults (≥18 years) with prevalent diabetes as of January 1, 2018, who were continuously enrolled at Kaiser Permanente Georgia (KPGA) through December 31, 2021 (n=22,854). We defined pre (2018-2019) and during COVID-19 (2020-2021) periods. Logistic generalized estimating equations (GEE) were used to assess the within-subject change in screening adherence (blood pressure (BP), HbA1c, cholesterol, creatinine, urine-albumin-creatinine ratio, eye and foot exam) pre and during COVID-19 among telehealth users (i.e., at least one telehealth visits per period) and non-telehealth users. Linear GEE similarly compared mean lab measurements pre vs. during COVID-19, stratified by telehealth use.
Results: The proportion of telehealth users increased from 38.7% to 91.5% pre vs. during COVID-19. During the pandemic, adherence to all annual screenings declined but the decline was significantly less in telehealth (range: 1.6% for foot exams to 12.4% for BP) vs. non telehealth users (range: 1.9% for foot exams to 40.7% for BP). Average HbA1c, BP, creatinine, and UACR worsened during (vs. pre) COVID-19, while LDL cholesterol improved, and this effect was greater in non-telehealth users.
Conclusion: The proportion of people with diabetes meeting guideline recommended screenings decreased during the pandemic, coinciding with worsening glucose, kidney, and (some) cardiovascular risk profiles, and was more severe for non-telehealth users. Follow-up is needed to assess the long-term implications and the role of telehealth use in addressing these care gaps.

Disclosure
S.A. Oviedo: None. J.C. Gander: None. B. McDonald: None. M.K. Ali: Advisory Panel; Eli Lilly and Company. J.L. Harding: None.

Funding
Supported by a Georgia Center for Diabetes Translation Research Pilot Award; National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (P30DK111024)
1391-P: Prevalence of Barriers to Preventive Care among U.S. Adults of Multiple Races Eligible for Type 2 Diabetes Screening
Authors: KOYAMA ALAIN , ONUFRAK STEPHEN J. , XU FANG , BULLARD KAI M. , SAELEE RYAN , MIYAMOTO YOSHIHISA , PAPALII MICHELLE , PAVKOV MEDA E. 
Published: June 2024

Introduction: While much research exists on racial and ethnic disparities in access to preventive care, less is known in persons of multiple races. We described prevalence of barriers to preventive care in US adults, by subgroups of multiple races.
Methods: Using the Behavioral Risk Factor Surveillance System (2013-2022), we conducted a pooled cross-sectional study of 3,301,491 US adults (≥18 years) eligible for type 2 diabetes screening. Among adults reporting a single race or ethnicity and subgroups of multiple races, we estimated the prevalence of: being uninsured, not having a primary care doctor, healthcare cost concerns in the past 12 months, and no physical exam in the past 12 months.
Results: Prevalence of preventive care barriers were heterogenous among all groups. For most subgroups of multiple races, prevalence was within that of the component single race groups. Healthcare cost concerns were more prevalent in adults self-identified as both American Indian/Alaska Native and White than those who reported either racial group alone, while adults self-identified as both Asian and Pacific Islander showed the opposite pattern.
Conclusions: Heterogeneity in the prevalence of barriers to preventive care among subgroups of multiple races highlights the possible need to properly identify these subgroups and for culturally sensitive approaches for type 2 diabetes prevention.

Disclosure
A. Koyama: None. S.J. Onufrak: None. F. Xu: None. K.M. Bullard: None. R. Saelee: None. Y. Miyamoto: None. M. Papalii: None. M.E. Pavkov: None.
141-OR: Cardioprotective Effect of Empagliflozin and Modification of Sirtuins and Their Noncoding RNAs Regulators in Patients with Myocardial Infarction
Authors: NOWAK ANNA , WICIK ZOFIA , EYILETEN CEREN , AHMADOVA SARA , SILLER-MATULA JOLANTA , VON LEWINSKI DIRK , SOURIJ HARALD , POSTULA MAREK 
Published: June 2024

Introduction: Studies have demonstrated direct cardio-protective effect of SGLT2 inhibitors, but the mechanism of action is unclear. We hypothesize that cardioprotective effects of SGLT2 inhibitors are due to increased expressions of Sirtuins and their regulator-miRNAs.
Method: We conducted in silico prediction analysis using a computational approach. We identified/ranked the most promising ncRNAs associated with sirtuin pathways and SGLT2. We identified top miRNAs by preparing a gene list of all SIRT genes, 1st and 2nd level SGLT2 interactors, and genes involved in inflammation, fibrosis, oxidative stress, hypoxia-ischemia, MI and HF based on DisGeNet database. We validated our findings through qRT-PCR using selected plasma samples (empagliflozin/placebo=24/24; baseline, 26-weeks after treatment) collected from the double-blinded EMMY clinical trial (NCT03087773).
Results: Our in silico analysis identified six miRNAs; miR-34a-5p, miR-27a-3p, miR-302a-3p, miR-146a-5p, miR-182-5p and miR-124-3p, which target the highest number of SIRT1-7 genes, SGLT2 and first-level SGLT2 interactors. qRT-PCR analysis showed that after 26 weeks of treatment, patients taking empagliflozin had significantly higher expression of miR-214 (p=0,015), miR-34a (p&lt;0,001), miR-146a (p&lt;0,001), miR-182-5p (p&lt;0,001) and SIRT2 (p=0,005) compared to baseline. We also found that patients taking empagliflozin had significantly higher expression of SIRT6 (p=0,036), and significantly lower expression of miR-214 (p=0,007) and miR-302a-3p (p=0,042) compared to placebo.
Conclusion: Our in silico analysis for the first time predicted the interaction network between ncRNAs and HF-related genes in the context of the SGLT2-sirtuin axis. We showed based on our prediction, empagliflozin, an SGLT2 inhibitor, can demonstrate cardioprotective effects via SIRT2 and SIRT6 and their ncRNA regulators axis.

Disclosure
A. Nowak: None. Z. Wicik: None. C. Eyileten: None. S. Ahmadova: None. J. Siller-Matula: None. D. von Lewinski: Speaker's Bureau; AstraZeneca. Research Support; Novo Nordisk. H. Sourij: Advisory Panel; Amarin Corporation. Speaker's Bureau; Amgen Inc., Amarin Corporation, Bayer Inc. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Boehringer-Ingelheim. Research Support; Boehringer-Ingelheim. Advisory Panel; Eli Lilly and Company. Research Support; Eli Lilly and Company. Speaker's Bureau; Eli Lilly and Company. Advisory Panel; Novartis AG. Speaker's Bureau; Novartis AG. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Speaker's Bureau; Novo Nordisk. Research Support; Sanofi. Speaker's Bureau; Sanofi. Consultant; K:Businesscom. M. Postula: None.

Funding
Polish National Scientific Centre (2022/45/N/NZ7/02461); Polish Medical Research Agency (2019/ABM/01/00037)
1413-P: Youth-Onset Diabetes—Who Is Missed by EHR-Based Surveillance
Authors: BELLATORRE ANNA , BURGETT SHAWNA , ANDERSON THERESA , CONWAY REBECCA B. , SHIFERAW BETHELHEM A. , DABELEA DANA , CRUME TESSA L. 
Published: June 2024

Background: Efficient population-level surveillance of youth-onset diabetes is essential for public health planning. Early surveillance approaches predated the use of electronic health records (EHR) and required manual chart reviews of all potential cases. Approaches utilizing EHR data present the potential for significant gains in cost efficiency, but the degree of precision remains unclear.
Objective: Identify characteristics of diabetes patients &lt;20 years in Colorado who were missed or misclassified by an EHR algorithm compared with patients identified by a traditional approach including manual chart review.
Methods: We compared incident diabetes patients diagnosed in 2014-2018 in Colorado by SEARCH for Diabetes in Youth and ascertained using manual chart review to determine diabetes status, type, and date of diagnosis to those identified by date of first diabetes diagnosis per EHR data extracts. Both approaches used similar and multiple case sources (networks of providers and hospitals) designed to cover all of Colorado.
Results: SEARCH ascertained 2206 patients with incident diabetes in 2014-2018. The EHR-based algorithm correctly identified incident diabetes status for 81% with 8.7% not identified as a diabetes case, and 10.3% assigned the wrong incident year. Patients missed or misclassified by the algorithm were more likely to have type 2 diabetes (36.1% incorrect or missing) or other diabetes types (36.4% incorrect or missing), to identify as Hispanic of any race (24.0% incorrect or missing) or other race (45.5% incorrect or missing) or were first identified by SEARCH at sources that did not use EHRs (75.8% incorrect or missing).
Conclusion: Algorithmic misclassification from EHR system data using date of first diagnosis may be more profound for minority race/ethnic groups and those without type 1 diabetes. Improved understanding of who is missed or misclassified by such approaches may assist with bias correction efforts to provide valid, generalizable estimates of the diagnosed diabetes population.

Disclosure
A. Bellatorre: None. S. Burgett: None. T. Anderson: None. R.B. Conway: None. B.A. Shiferaw: None. D. Dabelea: None. T.L. Crume: None.

Funding
Centers for Disease Control and Prevention and National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (U18DP006139)
1416-P: Unveiling the Risk Factor Landscape for Global Type 2 Diabetes Burden in Adults—An Attribution Analysis from 1990 to 2050
Authors: HUANG YUE , WANG JINGXUAN , ZHONG VICTOR W. 
Published: June 2024

Introduction & Objective: The lack of assessing risk factor contributions to the rising burden of type 2 diabetes (T2D) across various subpopulations hinders targeted interventions. We conducted a subgroup-focused analysis to evaluate the contributions of different risk factors to the T2D burden.
Methods: Utilizing the Global Burden of Disease study (GBD) 2019, we analyzed the disability-adjusted life-years (DALYs) for T2D due to 15 risk factors in adults (aged 25+ years) globally and by sex, age, Socio-demographic Index (SDI) and GBD region, from 1990 to 2019. Additionally, we assessed future trends of these risk factors through 2050.
Results: High BMI emerged as the top one risk factor in all subpopulations, accounting for over 60% of T2D-related DALYs in 2019, and the DALYs rates due to high BMI were projected to double by 2050. In 2019, males were more affected by smoking and diet high in red meat, while females by secondhand smoke and household air pollution. The related DALYs burden due to specific risk factors escalated with age, except for high BMI and smoking which peaked in the 60-74 age group. Notable regional disparities were observed, with diet high in processed meat ranking second in high SDI regions, instead of household air pollution in low SDI regions (Figure 1).
Conclusion: Targeted actions are required to address the varying risk factors for the T2D burden across subpopulations.

Disclosure
Y. Huang: None. J. Wang: None. V.W. Zhong: None.

Funding
National Natural Science Foundation of China (82373551)
1419-P: The Effect of Remnant Cholesterol on Pathophysiology of Metabolic Dysfunction–Associated Steatotic Liver
Authors: MIYAKE TERUKI , FURUKAWA SHINYA , MATSUURA BUNZO , YOSHIDA OSAMU , KANAMOTO AYUMI , MIYAZAKI MASUMI , SHIOMI AKIHITO , NAKAGUCHI HIRONOBU , HIROOKA MASASHI , ABE MASANORI , HIASA YOICHI 
Published: June 2024

Insulin resistance is associated with the inactivation of lipoprotein lipase and elevated levels of remnant lipoproteins, including remnant cholesterol (Rem-C). On the other hand, insulin resistance is the risk factor for progression of MASLD, and might induces cirrhosis, hepatocellular caricinoma, and liver-related death. Additionally, DM, high Rem-C level, and MASLD are risk factors for cardiovascular disease (CVD), and these three pathologies may be closely related. However, the correlation between REM-C levels and the pathophysiology of MASLD remains unclear. The present study aimed to elucidate the relationship between serum REM-C levels and the histological finding of MAFLD. We assessed 222 patients (94 men and 128 women; age 20-80 years) who were diagnosed with NAFLD by liver biopsy with available medical history, physical examination, and biochemical measurement data. Serum ester-type cholesterol and free cholesterol contents in the remnant lipoproteins were measured using an enzymatic method. The relationship between serum Rem-C levels and histological findings was analyzed. Serum Rem-C levels were significantly higher in patients with NAFLD activity score (NAS) 5-8,&gt;66% steatosis grade, lobular inflammation with ≥ 5 foci, and many cells/prominent ballooning cells than in patients with NAS 1-4, &lt; 33% steatosis grade, lobular inflammation with &lt; 2 foci, and few ballooning cells. While univariate analysis revealed no significant association between Rem-C levels and advanced fibrosis, a significant association between Rem-C levels and NAS was evident. The relationship remained significant in multivariate analysis adjusted for confounders.
In conclusion, high serum Rem-C levels were associated with high NAS but not with fibrosis stage. Controlling serum Rem-C level may help alleviate NAFLD.

Disclosure
T. Miyake: None. S. Furukawa: Speaker's Bureau; Lilly Diabetes, Novo Nordisk, Mitsubishi Tanabe Pharma Corporation. B. Matsuura: None. O. Yoshida: None. A. Kanamoto: None. M. Miyazaki: None. A. Shiomi: None. H. Nakaguchi: None. M. Hirooka: None. M. Abe: None. Y. Hiasa: None.