bluuebunny/crossref_metadata_2025_split huggingface dataset:
1107-P: Reporting on the Full Clinical Implementation of the Digital Danish National PROMS Tool—Optimising Routine Diabetes Outpatient Care and Connecting Each Person with Diabetes Directly with the National IT-Infrastructure
Authors: EJSKJAER NIELS 
Published: June 2024

Reporting on behalf of the VBHC-PRO-DIA Research Team.
Background: Our dedicated research team developed a national Danish digital Patient-Reported Outcome (PRO) diabetes tool to enable and advance multi-sectorial person-centered diabetes care. Now fully implemented at all 4 hospitals in our region and nationally in Denmark. 2018-2021 funded by the Danish Regions, North Denmark Region and Danish Health Data Authority.
Aim: To individualize routine diabetes care in daily practice by involving specific PwD perspectives, wishes and needs enabling targeted action plans.
Methods: Persons with diabetes (PwD) and healthcare professionals (HCP) were involved in all phases. A systematic participatory multi-stakeholder research design process with systematic involvement of +600 PwD and +40 HCP using interviews, workshops, clinical & qualitative research: 1) A minimal patient-important diabetes outcome domain set (VBHC structure). 2) A unified PRO diabetes “logic model” to use PRO to drive health value. 3) A national psychometric PRO Questionnaire & Decision-Algorithm built on nine detected domains (i.e.: treatment burden, selfcare ability, self-reported health). 4) A seamless one-click IT-tool for use of outcome data in routine diabetes care coupling the PwD and national infrastructure. 5) Datadriven implementation execution.
Results: This tool is highly accepted and shows benefits related to an active engagement of PWD focusing on person-centred individual diabetes care and adds value to the delivery of quality person-centered care.
Conclusion: We report on the full clinical national implementation of a digital scalable diabetes PROMS tool, connecting the person with diabetes, the healthcare provider and the national IT-infrastructure. Secures an individualized consultation and identifies uncovered needs and deploys action plans accordingly.

Disclosure
N. Ejskjaer: None.

Funding
Danish Regions - The North Denmark Region - Danish Health Data Authority
1108-P: Building Capacity for Diabetes Care via Endocrinology Telementoring
Authors: O'BRIEN KATELYN , SANFRATELLO NATALIE , DUNTON CATHERINE , GIULIANI ANTHONY , BRECHTELSBAUER ERIKA , STEENKAMP DEVIN W. 
Published: June 2024

Introduction: An urban academic medical center initiated a project to enhance diabetes care by addressing limited in person endocrinology (endo) access. The objective was to assess the impact of a telementoring (TM) program, utilizing endo to support clinical pharmacists (CPs) managing diabetes in internal medicine (IM).
Methods: Jan-June 23, 3-6 CPs and 1 endo met virtually weekly for 1 hour to review cases that would have been otherwise referred for in person endo consult. Pre-and 3-month post A1c and BMI were collected. Endo recommendations and implementation barriers were documented in the EMR.
Results: Over 21 sessions, 41 cases were discussed. Mean baseline A1c was 9.2% and BMI was 30.3. Post-A1c or BMI was not available for 5 pts (lost to follow-up/deceased.) Mean post intervention A1c was 8.2% and BMI was 29.9. CPs universally found value in sessions and reported increased confidence in practicing diabetes care. 62 interventions were documented - most common related to med initiation or adjustment. The most common reasons for lack of implementation include pt deceased, missed follow-up, changes in insurance coverage, and frequent hospitalizations. Less than 10% of pts were subsequently referred to endo for management.
Conclusion: Building IM capacity through virtual TM support of CP driven diabetes care is feasible and results in improved 3-month glycemic outcomes and may help address limited endo access in a value based care model.

Disclosure
K. O'Brien: Advisory Panel; Bayer Inc. N. Sanfratello: None. C. Dunton: None. A. Giuliani: None. E. Brechtelsbauer: None. D.W. Steenkamp: Consultant; Abbott. Research Support; Novo Nordisk A/S, MannKind Corporation, Tandem Diabetes Care, Inc.

Funding
This activity is supported by an educational grant from Lilly (A-31212).
114-OR: Proteome-Wide Analysis of USP2 Substrates Revealed Its Role in Thermogenesis via Stabilization of EBF2
Authors: XU YUEJIE , PAN JIEMIN , HU CHENG 
Published: June 2024

Increasing the thermogenic capacity of adipose tissue to enhance organismal energy expenditure is considered a promising therapeutic strategy to combat obesity. Here, we report that ubiquitin-specific protease 2 (USP2), a member of the deubiquitinating enzyme family, plays regulatory roles in obesity progression. Expression of USP2 is down-regulated in the white adipose tissue of obese individuals and high-fat diet (HFD)-induced or genetically obese mice. When challenged with HFD, adipose-specific USP2 overexpression mice exhibited increased energy expenditure and thermogenic capacity, protecting mice against diet-induced obesity and the development of diabetes. In contrast, mice knocked down of USP2 expression or administered the USP2-specific inhibitor ML364 showed adverse trends regarding adipose accumulation and glucose metabolic disorders. Mechanistically, we demonstrate that, USP2 stimulate adipose thermogenesis by interacting with and deubiquitinating the transcription factor early B cell factor-2 (EBF2), which promotes thermogenic gene transcription through increasing the expression and activity of ERRα and PGC1α. Overall, our findings reveal for the first time an indispensable role of USP2 in thermogenesis and systemic homeostasis through EBF2 stabilization.

Disclosure
Y. Xu: None. J. Pan: None. C. Hu: None.
1140-P: Impact of Empagliflozin on Hyperfiltration in Youth with Type 2 Diabetes—Post Hoc Analysis of the DINAMO and DINAMO MONO Trials
Authors: BJORNSTAD PETTER , DANNE THOMAS , TAMBORLANE WILLIAM V. , KLINGENSMITH GEORGEANNA J. , SCHUELER ELKE , TARTAKOVSKY IGOR , MARQUARD JAN , ZEITLER PHILIP , WILLI STEVEN M. , LAFFEL LORI M. 
Published: June 2024

Introduction & Objective: Hyperfiltration, common in youth with T2D, may increase risk for early diabetic kidney disease (DKD). The DINAMO trial showed empagliflozin (empa) vs placebo (pbo) provided durable, clinically relevant improvements in glycemic control in youth aged 10-17 years with T2D. This post hoc analysis examined changes in eGFR with empa vs pbo in the DINAMO & DINAMO MONO trials (the latter were drug naïve or not on active therapy).
Methods: We estimated eGFR using the Zappitelli combined creatinine and cystatin C equation, with hyperfiltration defined as 2 SDs above the mean for healthy youth per NHANES (&gt;126.8 mL/min per 1.73 m2). After randomization, 116 participants received once daily empa 10 or 25 mg or pbo. We compared eGFRresponses to therapy from baseline to Week 26 stratified by hyper- and normofiltration (eGFR&gt;126.8 and ≤126.8 mL/min per 1.73 m2, respectively), with empa dosing groups pooled.
Results: At baseline, there were 55 youth (47%) with hyperfiltration; both subgroups were of similar age and pubertal status. In the hyperfiltration subgroup at Week 26, mean eGFR had decreased substantially with empa vs pbo (Figure). In the normofiltration subgroup, mean eGFR changes between groups were similar.
Conclusion: Treatment with empa was associated with attenuated hyperfiltration in youth with T2D. The potential long-term effects of such changes on DKD risk are unclear.

Disclosure
P. Bjornstad: Consultant; AstraZeneca, Boehringer-Ingelheim. Advisory Panel; Lilly Diabetes, Novo Nordisk, Bayer Inc., Horizon Therapeutics plc. T. Danne: Speaker's Bureau; Abbott. Research Support; AstraZeneca. Consultant; Bayer Inc. Research Support; Boehringer-Ingelheim. Advisory Panel; Dexcom, Inc. Research Support; Lilly Diabetes. Advisory Panel; Roche Diabetes Care, Medtronic. Research Support; Novo Nordisk. Advisory Panel; Sanofi. W.V. Tamborlane: Consultant; AstraZeneca, Boehringer-Ingelheim, Novo Nordisk, Medtronic. G.J. Klingensmith: None. E. Schueler: None. I. Tartakovsky: Employee; Boehringer-Ingelheim. J. Marquard: Employee; Boehringer-Ingelheim. P. Zeitler: Consultant; Boehringer-Ingelheim. Research Support; Eli Lilly and Company. Consultant; Eli Lilly and Company. Research Support; Janssen Pharmaceuticals, Inc. S.M. Willi: Advisory Panel; MannKind Corporation. Other Relationship; Medtronic. Advisory Panel; Boehringer-Ingelheim. Other Relationship; National Institute of Diabetes and Digestive and Kidney Diseases. L.M. Laffel: Consultant; Dexcom, Inc. Advisory Panel; Medscape, Medtronic, Vertex Pharmaceuticals Incorporated. Consultant; Novo Nordisk. Advisory Panel; Lilly Diabetes, Provention Bio, Inc., Sanofi-Aventis U.S., Janssen Pharmaceuticals, Inc., MannKind Corporation.

Funding
Boehringer Ingelheim and Eli Lilly and Company Diabetes Alliance
1142-P: Fat Distribution in Youth-Onset Type 2 Diabetes
Authors: DOBBS TYLER , SHAH AMY S. , DUDLEY JONATHAN , TROUT ANDREW T. , JENKINS TODD M. , XANTHAKOS STAVRA , BROWNE LORNA , BAILEY ALEXANDER , BAUMGARTNER AMY , HINES ASHTON , RIEGLER ALLEN , RUSK SHENA , SCHAAF LISA R. , WITT KAITLYN , INGE THOMAS , HELMRATH MICHAEL , KELSEY MEGAN M. , NADEAU KRISTEN J. 
Published: June 2024

Adult studies show that females generally have higher total body fat than males, with higher subcutaneous adipose tissue (SAT), yet less visceral adipose tissue (VAT), an independent risk factor for cardiovascular disease. Less is known about fat distribution in youth-onset type 2 diabetes (Y-T2D) and severe obesity (SO), specifically SAT, VAT, or the VAT/SAT ratio. Here we examine fat-specific depots by sex in participants with SO and Y-T2D enrolled in ST2OMP, a study comparing metabolic bariatric surgery (MBS) to medical treatment for Y-T2D. Abdominal MRI was performed at enrollment and volumetric analysis of SAT, VAT, and the VAT/SAT ratio was calculated. Total body fat was estimated by bioelectric impedance. Linear regression examined differences in fat distribution adjusting for specific covariates (Table). Participants (n=60) at baseline had a mean age of 16.5 yrs and BMI of 42.6 kg/m2. Females had significantly higher %body fat (51.2%) vs. males (42.1%), p &lt;0.05. Females also exhibited lower VAT and VAT/SAT ratio compared to males, with no significant race/ethnicity differences in VAT, SAT, or VAT/SAT ratio. Youth prescribed a GLP-1 receptor agonist (RA) had lower VAT (p &lt;0.05) and trended towards lower VAT/SAT (p = 0.07). Female youth with T2D and SO showed higher %body fat, similar SAT, but less VAT vs. males. GLP-1RA use was associated with lower VAT. Future outcomes from the ST2OMP study will examine if differences in fat distribution occur after MBS.

Disclosure
T. Dobbs: None. A.S. Shah: None. J. Dudley: None. A.T. Trout: Research Support; Siemens Healthcare Diagnostics, GE Healthcare, Perspectum Ltd. Consultant; GE Healthcare. T.M. Jenkins: None. S. Xanthakos: None. L. Browne: None. A. Bailey: None. A. Baumgartner: None. A. Hines: None. A. Riegler: None. S. Rusk: None. L.R. Schaaf: None. K. Witt: None. T. Inge: Consultant; Medtronic, Eli Lilly and Company, Brainstorm Therapeutics. Stock/Shareholder; Standard Bariatrics. Consultant; Teleflex. M. Helmrath: None. M.M. Kelsey: Other Relationship; Rhythm Pharmaceuticals, Inc., Lilly Diabetes. K.J. Nadeau: None.

Funding
National Institutes of Health (R01DK119450)
1144-P: Maternal Exercise Alters the Human Milk Metabolome—Associations with Infant Thermogenesis
Authors: ISGANAITIS ELVIRA M. , LU CHANG , DREYFUSS JONATHAN , KYERE-DAVIES GERTRUDE , SHORT KEVIN R. , FIELDS DAVID A. , RUDOLPH MICHAEL 
Published: June 2024

Breastfeeding reduces childhood obesity risk, though the mechanisms remain unclear. We recently reported that maternal exercise significantly increases breastmilk levels of lipids and metabolites involved in brown adipocyte thermogenesis. It is unclear whether differences in these milk constituents may play a functional role in infant adipose tissue metabolism. Thus, we tested whether consumption of human milk after an acute bout of maternal exercise alters infant thermogenesis, a surrogate for brown adipose tissue function.
Exclusively breastfeeding mothers (n=31, 1-mo postpartum) completed a supervised exercise session (45 minutes, heart-rate reserve 65-75%) and, on a separate day, a control period of rest, each followed by an infant feeding session 1h afterwards. We analyzed human milk (metabolomics, lipidomics) before and after exercise. We compared infant anterior neck surface temperature (infrared thermography, IRT) following feeding of either “exercise milk” or “control milk”. We analyzed resting metabolic rate (RMR) and body composition (DXA) in all infants; a subset (n=10) also underwent fat-fraction MRI to assess sub-clavicular beige fat depot volume.
Infant temperature trended higher (+0.245°C, P=0.1) after consumption of “exercise milk” vs. “control milk”; higher delta temperature was associated with higher infant trunk fat free mass (P&lt;0.05). Of 213 metabolites detected in breastmilk; 37 were nominally changed (P&lt;0.05) and 3 significantly changed (FDR&lt;0.05) by exercise. For 16 metabolites, the change in abundance with maternal exercise correlated with change in infant temperature after "exercise-" vs. "control-milk" consumption. Top-ranking positively correlated metabolites included signaling lipids, lactate, guanine, and spermine (P&lt;0.05).
Our findings indicate that exercise-induced changes in human milk are associated with activation of infant metabolism via thermogenesis.

Disclosure
E.M. Isganaitis: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc., Insulet Corporation, MannKind Corporation. C. Lu: None. J. Dreyfuss: None. G. Kyere-Davies: None. K.R. Short: None. D.A. Fields: None. M. Rudolph: None.

Funding
Harold Hamm Pilot and Feasibility Grant; NIDDK P30 Pilot and Feasibility Grant
1147-P: Monogenic Obesity and Type 2 Diabetes Linked to Pathogenic DYRK1B Variants—A Comprehensive Study
Authors: JHA SUDHIR C. , KARN JYOTI P.L. , BHARTI BISHWA B. , KUMAR NAWEEN 
Published: June 2024

Introduction: Dual-specificity tyrosine phosphorylation-regulated kinase 1B is implicated in metabolic processes, and its variants have been hypothesized to contribute significantly to obesity and T2D development. This study focuses on understanding the role of pathogenic, total loss-of-function variants in the DYRK1B gene in monogenic obesity and its association with Type 2 Diabetes (T2D).
Methods: A cohort of 240 individuals diagnosed with monogenic obesity and T2D was examined. Genetic sequencing was used to identify loss-of-function variants in the DYRK1B gene. Participants' metabolic profiles, including glucose and insulin levels, were monitored. Statistical analysis included logistic regression to determine the association between DYRK1B variants and disease phenotypes, and Kaplan-Meier curves were used to assess the onset of T2D in relation to obesity.
Results: Pathogenic DYRK1B variants were identified in 60% of the participants. Those with these variants presented earlier onset and higher severity of obesity and T2D compared to those without. The statistical analysis showed a significant correlation (p &lt; 0.05) between the presence of these variants and early-onset obesity and T2D.
Conclusion: The study establishes a strong link between pathogenic, total loss-of-function variants in the DYRK1B gene and the development of monogenic obesity associated with T2D. These findings highlight the importance of genetic screening in individuals with early-onset obesity and T2D for targeted interventions. This research opens avenues for personalized treatment strategies and better management of these conditions based on genetic profiling.

Disclosure
S.C. Jha: None. J.P.L. Karn: None. B.B. Bharti: None. N. Kumar: None.
1156-P: Depression in Adolescents with Type 2 Diabetes (T2D) Attending a Multidisciplinary Tertiary Care (MTC) Clinic
Authors: TALACHUTLA SAHITYA G. , GAWEY HEIDI , GUTIERREZ-COLINA ANA , PERZOW SARAH E.D. , KELSEY MEGAN M. , SHOMAKER LAUREN B. 
Published: June 2024

T2D incidence has risen ~5% per year in adolescents over the past decade. Comorbidities are common, requiring MTC that addresses medication management and lifestyle change. Clinical guidelines recommend depression monitoring, but depression in relation to health indices (e.g., HbA1c, lipids) in adolescents with T2D attending MTC is not well characterized. We aimed to evaluate depression and in-clinic psychology contact (PC) as it relates to health indices in youth with T2D presenting to MTC. Retrospective chart review of youths 12-18y with T2D was conducted for MTC visits at a pediatric hospital from 2016-21. Depression was assessed with the 20-item Center for Epidemiologic Studies-Depression Scale (CES-D). PCs were determined by charted encounters. Health indices were extracted from initial clinic visit. Fisher’s exact/Kruskal Wallis tests assessed associations of depression with PC and patient health indices. N=126 adolescents (M age±SD 15±2y) with T2D (onset age 13±3y). Majority (73%) were screened for depression in the first 2 MTC visits. Of those, 48% reported at least mildly elevated symptoms (CES-D&gt;=16); 27% had moderately elevated symptoms (CES-D&gt;=20). 93% (n=117) of all patients saw a clinic psychologist in the first 2 MTC visits; PC was more likely for youths with CES-D&gt;=16 (X2=6.97, p&lt;.01). Youths with CES-D&gt;=20 had higher total cholesterol (212±45 vs 176±47mg/dL, p&lt;.01) and LDL (131±43 vs 90±34 mg/dL, p&lt;.01) than those with no-to-mild symptoms. HbA1c (9±3%) and triglycerides (253±191 mg/dL) were elevated in all patients, regardless of depression. Overall, depression screening with prompt PC is feasible in MTC for adolescents with T2D. Nearly half of youth screened had elevated depression, and youth with moderate symptoms demonstrated elevated LDL and cholesterol levels. Future work is needed to delineate the progression of depression with comorbidities, and to evaluate if early psychology contact increases likelihood of positive health outcomes.

Disclosure
S.G. Talachutla: None. H. Gawey: None. A. Gutierrez-Colina: None. S.E.D. Perzow: None. M.M. Kelsey: Other Relationship; Rhythm Pharmaceuticals, Inc., Lilly Diabetes. L.B. Shomaker: None.
1158-P: Racial Disparities in Youth with Diabetes and the COVID-19 Pandemic
Authors: MUZUMDAR UMA L. , MARCH CHRISTINE , MKPARU NKEIRUKA , LIBMAN INGRID 
Published: June 2024

Racial disparities in youth with diabetes have been described with higher hemoglobin A1c (HbA1c) and lower technology use in minoritized groups. Limited data are available on the effect of the pandemic.
We assessed disparities at onset and 1 year follow-up in White and Black youth diagnosed with type 1 (T1D) and type 2 (T2D) diabetes in 2019, prior to the pandemic and 2020, 1st year of the pandemic. Of 465 subjects (49% male, 85% White), 83% were diagnosed with T1D and 17% with T2D.

At 1 year follow-up, T1D Black youth had higher HbA1c than Whites (8.9±2.5 vs 7.4±1.4, p=0.004 (onset in 2019) and 8.3±2.6 vs 7.6±1.6, p=0.1 (onset in 2020)). T2D Black youth had higher HbA1c than Whites; 9.1±2.4 vs 6.4±1.4, p=0.11 and 9.1±2.9 vs 7.7±1.5, p=0.06 for those diagnosed in 2019 and 2020 respectively, not significant likely due to small numbers. Use of continuous glucose monitors was lower in Blacks vs Whites (33.3 vs 81.9%, p=&lt;0.001) with onset in 2019, improved in those with onset in 2020 (66 vs 77%, p=0.03).
In summary, there was a doubling in the number of youths diagnosed with T2D in 2020 compared to 2019 with Blacks presenting with higher HbA1c, more often in DKA. Higher HbA1c was seen in Blacks at follow-up irrespective of DM type or year of onset. Further research should focus on evaluating interventions before and after clinical onset of diabetes.

Disclosure
U.L. Muzumdar: None. C. March: None. N. Mkparu: None. I. Libman: None.
1161-P: Are There Sex-Differences in Response to Metabolic/Bariatric Surgery among Adolescents with Severe Obesity?
Authors: JANG SUBIN , DAHLGREN JOVANNA , JENKINS TODD M. , INGE THOMAS , RYDER JUSTIN R. 
Published: June 2024

Bariatric surgery is safe and effective for adolescents, but sex-differences are difficult to examine owing to female predominance in individual studies. We pooled data from four high-quality studies to examine sex-differences among adolescent bariatric surgery. Data from three prospective observational studies and one randomized trial in the United States (Teen-LABS, FABS5+) and Sweden (AMOS, AMOS2), were harmonized. Descriptive statistics explored changes in standard body mass index (BMI) categories over time. We evaluated sex differences in % change in BMI using linear mixed effects models. 389 participants (278 females; 111 males; aged 16.9±1.5 years; 76.6% Non-Hispanic White) were used for analysis. Baseline BMI was 50.5 kg/m2 for females and 53.8 kg/m2 for males with 79.7% having gastric bypass, 16.7% sleeve gastrectomy, and 3.6% gastric banding. Severe obesity was ubiquitous among participants pre-operatively (M: 100%, F: 99.6%). At 24 months, 40%, 35%, 15%, and 6% of males, 29%, 36%, 21%, and 10% of females were in severe obesity, obesity, overweight, and normal weight categories, respectively. Mean BMI change for females and males, respectively was -22.5% and -25.5% at 6 months, -31.59% and -34.15% at 12 months, and -29.68% and -32.73% at 24 months. A greater BMI reduction was observed among males at 6 months (-2.99%, 95%CI: -5.16, -0.81%, p=0.01), 12 months (-2.56%, 95%CI: -4.52, -0.60, p=0.01), and 24 months (-3.05%, 95%CI: -6.09, -0.01, p=0.05). After adjusting for age, race/ethnicity, and types of procedure, a greater BMI reduction among males at 6 months (-1.95%, 95%CI: -3.77, -0.12, p=0.04), 12 months (-2.10%, 95%CI: -3.89, -0.31, p=0.02), and 24 months (-2.45%, 95%CI: -5.34, 0.43, p=0.10) was still observed. While weight loss following bariatric surgery is significant among both sexes up to 2 years, males consistently exhibit somewhat greater BMI reduction. The clinical relevance and mechanisms driving sex-differences warrant further exploration.

Disclosure
S. Jang: None. J. Dahlgren: None. T.M. Jenkins: None. T. Inge: Consultant; Medtronic, Eli Lilly and Company, Brainstorm Therapeutics. Stock/Shareholder; Standard Bariatrics. Consultant; Teleflex. J.R. Ryder: None.

Funding
Funding for Teen-LABS was provided by the National Institutes of Health (NIH) (U01DK072493 / UM1 DK072493 to T.H.I.) (UM1 DK095710 to C.X., T.M.J.) and the National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH (8UL1TR000077). Support also came from National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH, (UL1TR000114).