bluuebunny/crossref_metadata_2025_split huggingface dataset:
1874-LB: PG-102, a Bivalent GLP-1R/GLP-2R Agonist, Protects ß-Cell Mass and Enhances Glycemic Control in Obese db/db Mice, Showing Superiority over Semaglutide, Tirzepatide, and Retatrutide
Authors: WON KIM SAE , YANG SANG-IN , SUNG YOUNGCHUL 
Published: June 2024

PG-102, a first-in-class heterodimeric Fc fusion protein, simultaneously targets GLP-1R and GLP-2R. In this study, we assess the efficacy of PG-102 against established comparators - semaglutide, tirzepatide, and retatrutide - in severely hyperglycemic, obese db/db mice. Based on our dose response findings, we chose 30 nmol/kg as the optimal PG-102 dose for maintaining normoglycemia in subsequent comparative studies. Strikingly, at the same dosage and regimen, PG-102 surpassed all comparators in reducing blood glucose and HbA1c levels. It was also worth noting that PG-102 was uniquely capable of achieving and sustaining normoglycemia at the end of the study. Histopathological and immunohistochemical analysis of pancreatic islets revealed that PG-102 treatment led to the largest islet mass with the highest percentage of insulin-positive β-cell area along with the lowest percentage of glucagon-positive α-cell area among the treatment groups. We also observed reduced macrophage infiltration into pancreatic islets and peri-pancreatic adipose tissue. These results demonstrate that PG-102’s superior glycemic control may be due to a combination of better protection of β-cell and reduction in islet inflammation. Collectively, our study provides the rationale for advancing the clinical investigation of PG-102.

Disclosure
S. Kim: Employee; ProGen. Co., Ltd. S. Yang: Employee; Progen. Y. Sung: Advisory Panel; Progen Co., Ltd.
1882-LB: Efficacy and Safety Outcomes with Once-Weekly Insulin Icodec vs. Once-Daily Insulin Degludec in Type 1 Diabetes According to Glycemic Variability—ONWARDS 6 Post Hoc Analysis
Authors: IRACE CONCETTA , BEGTRUP KAMILLA , FRAGÃO MARQUES MARIANA , WATT SARA K. , KLONOFF DAVID C. 
Published: June 2024

Introduction & Objective: ONWARDS 6 assessed the efficacy and safety of once-weekly insulin icodec (icodec) vs once-daily insulin degludec (degludec) in adults with type 1 diabetes (T1D). This post hoc analysis evaluated the impact of glycemic variability on efficacy and safety outcomes.
Methods: Outcomes were assessed across coefficient of variation (CV) subgroups (≤36% and &gt;36%) based on CGM data from week 0-2.
Results: Estimated change in A1C with icodec vs degludec from baseline to week 26 was similar regardless of CV subgroup. In both arms, a numerically higher proportion of people with CV ≤36% vs CV &gt;36% achieved A1C &lt;7.0% at week 26. Estimated rate ratios (icodec/degludec) of combined clinically significant or severe hypoglycemia and CGM-based clinically significant hypoglycemic episodes were similar regardless of CV subgroup (Table). In both arms, hypoglycemia rates were numerically lower for people with CV ≤36% vs CV &gt;36%. Time below range (&lt;70 mg/dL and &lt;54 mg/dL) during weeks 22-26 in the CV ≤36% subgroup was below recommended targets (&lt;4% and &lt;1%, respectively) and comparable between arms.
Conclusion: Similar to degludec, when used as part of a basal-bolus regimen in T1D, once-weekly icodec may offer a lower risk of hypoglycemia for people with low glycemic variability (CV ≤36%) than for those with high glycemic variability (CV &gt;36%).

Disclosure
C. Irace: Board Member; Abbott, Roche Diabetes Care, Novo Nordisk, Medtronic. K. Begtrup: Employee; Novo Nordisk A/S. M. Fragão Marques: None. S.K. Watt: Employee; Novo Nordisk. D.C. Klonoff: Consultant; Afon Technology Ltd, Better Therapeutics, Inc, Glucotrack, LIfecare, Nevro Corp., Novo Nordisk, Samsung, Thirdwayv Inc.

Funding
Novo Nordisk A/S
1885-LB: Status of Irrational Prescription of Oral Antidiabetic Drugs (OADs) Based on eGFR in Elderly Type 2 Diabetes Patients and the Related Affecting Factors
Authors: LI TINGZHI , SHAO YUAN , LUO WEN , ZHU JINGJING , LIU ZHIGU , XU WEN , ZENG LONGYI 
Published: June 2024

Objective: To explore the current status of irrational prescription of OADs in elderly T2D patients based on eGFR and the related affecting factors.
Methods: Data from 219 patients over 65 years old with established T2D and treated on OADs who admitted to our department in 2023 were retrospectively analyzed. The irrational prescription was defined as the doses of OADs were not reduced or OADs were not discontinued based on eGFR level before admission. The patients were therefore divided into the rational prescription (RP) or irrational prescription (IRP) group. The clinical characteristics were compared between groups, and the related affecting factors for irrational prescription were analyzed with multivariate logistic regression model.
Results: Among these patients [mean age: 72.2 years old; mean duration of diabetes: 11.3 years; mean HbA1c: 7.8%; 46 (21%) with eGFR&lt;60 ml/(min·1.73m2) ], the most frequently used OADs were biguanides (80.4%) and sulfonylureas (43.8%). And 37 (17%) patients were in the IRP group. Compared with the RP group, patients in the IRP group had higher serum creatinine (144.3±45.8 vs. 67.6±20.4 umol/L, P&lt;0.001), lower eGFR [39.3±12.4 vs. 85.0±14.2ml/(min·1.73m2), P &lt;0.001], and treated with more OADs (2.2±0.8 vs. 1.9±0.7, P&lt;0.05). Multivariate logistic regression model showed that the number of OADs (OR: 4.14, P&lt;0.05) and eGFR (OR: 0.802, P&lt;0.001) were the affecting factors for irrational prescription.
Conclusions: The irrational prescription of OADs were common in elderly T2D patients. The number of OADs used and lower eGFR were the risk factors accounting for the irrational prescription in this papulation.

Disclosure
T. Li: None. Y. Shao: None. W. Luo: None. J. Zhu: None. Z. Liu: None. W. Xu: None. L. Zeng: None.
1899-LB: The Predictors and Management of Eating Disorders in Adult Patients with Type 1 Diabetes Mellitus
Authors: SASMAZER BASAK , YILDIZ MEVHIBE I. , KELES SUKRU , OGUZ SEDA H. , SENDUR SULEYMAN N. , ÜNLÜTÜRK UGUR , GÜRLEK ALPER , ERBAS TOMRIS , DAGDELEN SELCUK 
Published: June 2024

Introduction & Objective: Eating disorders are a common issue in T1DM. The use of diabetes technologies in this patient group is controversial. In this study, we investigated the impact of eating disorders on the clinical course of T1DM and how insulin pumps affect treatment goals.
Methods: In a prospective, case-control study, the Diabetes Eating Problem Survey-Revised (DEPS-R) was used as a screening tool for diabetes-specific eating disorders in T1DM. A total score of ≥20 indicates a high risk for eating disorders. All patients were divided into 2 groups based on DEPS-R scores: those at high risk for eating disorders (n:42 cases, F/M: 26/16, age: 26.5 years, disease-duration: 11.5 years, HbA1c: %8.4, rates of minor hypoglycemic events &gt;1 per week: %57.1, history of major hypoglycemic events on treatment: %11.9, hypoglycemia unawareness: %11.9) and those not at high risk (n:75 controls, F/M: 48/27, age: 29 years, disease-duration: 16 years, HbA1c: %7.5, rates of minor hypoglycemic events &gt;1 per week: %60, history of major hypoglycemic events on treatment: %22.7, hypoglycemia unawareness: %13.3). Patients with confirmed or suspected Munchausen Syndrome were excluded. These 2 groups were compared in terms of clinical predictors, complications, and comorbidities. Patients at high risk for eating disorders using insulin pumps were compared with those not using pumps in terms of HbA1c, glycemic variability, and hypoglycemia.
Results: Younger age, shorter disease duration, and higher HbA1c are associated with a higher risk of eating disorders. When cases with DEPS-R scores ≥20 were compared as active pump users (n:13) versus MDI (n:29), pump provides lower HbA1c (%7.8 vs %9.4, p=0.005), lower major hypoglycemic events (%0 vs %17.2, p=0.302), and lower glycemic variability (0.66 vs 0.90, p=0.041).
Conclusion: When Munchausen Syndrome is excluded, we suggest with these data that insulin pump therapy is also safe and efficient for patients with high risk of eating disorders in T1DM.

Disclosure
B. Sasmazer: None. S. Keles: None. U. Ünlütürk: None. A. Gürlek: None. T. Erbas: None. S. Dagdelen: None.
19-PUB: Improved Glycemic Control in People with Type 2 Diabetes (T2D) Initiating or Switching to Insulin Degludec/Insulin Aspart (IDegAsp) in a Real-World Setting in China
Authors: GUO LIXIN , CHEN LIMING , ZHAO FAN , LIU XIAO Y. , DING HONGCHENG , WANG KUN , XING ZHONG , BABU SHANKARAPPA VINAY , CHAUDHARY GAURAV 
Published: June 2024

Introduction & Objective: This study investigated clinical parameters in a real-world population of Chinese individuals with T2D treated with IDegAsp in routine clinical practice.
Methods: This 20-week, prospective, single-arm, open-label, non-interventional study (NCT05221580) included adults with T2D receiving anti-hyperglycemic treatment (oral antidiabetic drugs [OADs] only, basal insulin [±OAD], basal-bolus insulin [±OAD], premixed insulin [±OAD] or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) ± insulin [±OAD]), initiating or switching to IDegAsp. Primary endpoint: change in HbA1c from baseline (BL) to end of study (EOS). Secondary endpoints: change in fasting plasma glucose (FPG) and hypoglycemic episode incidence.
Results: Of 878 adults (57.4% male; mean age 59.6 yrs), patients generally received IDegAsp once (47.2%) or twice (52.2%) daily. Initiating/switching to IDegAsp significantly lowered mean [95% CI] HbA1c (-1.27% [-1.36;-1.19], p&lt;0.0001), with similar decreases in all prior treatment groups (Figure). Mean [95% CI] FPG fell significantly (-1.61 mmol/L [-1.81;-1.41], p&lt;0.0001). Non-severe hypoglycemic episodes in last 20 wks were reduced at EOS vs BL (45 vs 115 patients).
Conclusion: Initiating/switching to IDegAsp improved glycemic control in a real-world population of Chinese adults with T2D.

Disclosure
L. Guo: Consultant; Abbott, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Eli Lilly and Company, Hengrui (USA) Ltd., Dreisamtech, Dongbao, Gan & Lee, Hansoh. L. Chen: None. F. Zhao: None. X.Y. Liu: None. H. Ding: None. K. Wang: None. Z. Xing: None. V. Shankarappa: Employee; Novo Nordisk A/S. G. Chaudhary: None.

Funding
Novo Nordisk
1903-LB: Real-World Bolus Dose Timing and Glycemic Impact Using the Tempo Platform
Authors: JOHNSON JENNAL , XUE JIE , DUKE DAVID L. , DAVIDSON MICHAEL B. , DASSAU EYAL 
Published: June 2024

Background: Optimization of bolus dose timing is associated with better glycemic control and dose timing variability can be associated with negative glycemic impact. Use of the Tempo Platform in multiple daily insulin users allows visualization of bolus behavior. The objective for this analysis is to assess real-world bolus dose timing data and glycemic impact for users on CGM and the Tempo Platform.
Method: We performed a retrospective analysis of 31,140 bolus doses over 7,933 days from 120 MDI users (84 T1D and 36 T2D users) on the Tempo Platform. We analyzed glucose excursions using the GRID method and evaluated bolus timing and glycemia.
Results: There was no difference in bolus timing between T1D and T2D results by pooled mealtime excursions however, separately, breakfast showed the greatest differences by diabetes type. On average, those with T1D delayed boluses 22 minutes post glucose excursion and those with T2D delayed boluses 51 minutes post glucose excursions. The 4 hour glycemic analysis (post glucose excursion initiation and bolus) identified more hyperglycemia &gt;180mg/dL than hypoglycemia (&lt;70 mg/dL) post mealtime bolus dosing in both user groups with delayed boluses.
Conclusions: The Tempo Platform reveals critical insights on insulin utilization for MDI users. Our results indicate bolus dose timing differences by type of diabetes, predominately at breakfast. Late bolus timing can lead to dysglycemia.

Disclosure
J. Johnson: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. J. Xue: Employee; Eli Lilly and Company. D.L. Duke: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. M.B. Davidson: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. E. Dassau: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company.
191-OR: Symposium on the International Consensus Statement and Movement to End Diabetes Stigma
Authors: DE GROOT MARY , JOINER KEVIN , GARZA MATTHEW , GUZMAN SUSAN 
Published: June 2024

Diabetes stigma is recognized as a highly prevalent experience for people living with diabetes across the lifespan. Diabetes stigma has been demonstrated to negatively impact health and quality of life for people living with diabetes. With the appreciation that many health practitioners have varying resources with which to implement suggestions to combat diabetes stigma, this symposium focuses on identifying strategies that practitioners and health care systems can put the recommendations of the International Consensus Statement for Ending Diabetes Stigma into practice within the context of their own training, practice patterns and access to resources. The session topics will also help practitioners and researchers to identify areas of need to better understand successful implementation of the recommendations of the End Diabetes Stigma campaign to improve diabetes health and quality of life outcomes. The proposed symposium will consist of the following sections:
I. International Consensus Statement for Ending Diabetes Stigma: Background, methodology of the Consensus Statement, and overview of recommendations for health professional and researchers - Dr. Mary de Groot
II. Prevalence and impact of diabetes stigma: Implications for health outcomes - Dr. Susan Guzman
III. Research in diabetes stigma: What's next? - Dr. Kevin Joiner
IV. Integration into care settings: Patient perspective and identifying resources - Matthew Garza, Diabtribe

Disclosure
M. de Groot: None. K. Joiner: None. M. Garza: Other Relationship; Sanofi. S. Guzman: Consultant; Abbott.
1915-LB: Impact of Glycemic Variability on the Relationship between TIR and GMI among Type 2 Diabetes Patients with TIR &gt;70%
Authors: YANG YANLING , LIU ZHIGU , CHEN DANRUI , LIN BEISI , JIANG WEI , YAN JINHUA , ZENG LONGYI , XU WEN 
Published: June 2024

Aim: Previous studies proved that glucose variability (GV) affected the relationship between TIR and glucose management indicator (GMI) in T2D patients with poor glycemic control. This study aimed to explore whether GV indexes affect the relationship between TIR and GMI in T2D patients with TIR &gt; 70%.
Methods: Data were collected from T2D patients who received 6-day CGM between January 2018 and March 2023. TIR, GMI and GV indexes were obtained from CGM system. A linear regression equation was generated with values of TIR and GMI. Patients were then divided into three subgroups according to the tertile of different GV indexes. Predicted TIR in given GMI was calculated via the linear regression equations in different subgroups.
Results: A total of 216 T2D patients (age: 54.3±14.1 years old, median diabetes duration: 89.1 months, HbA1c: 8.1±2.2%, and TIR: 86.1±9.0%) were included. There was a strong negative correlation between TIR and GMI (r=-0.763, P&lt;0.001). The slopes of regression lines fitted to TIR values as a function of GMI differed significantly for individuals with varying degrees of different GV indexes. For a given GMI, the predicted TIR values varied in different tertiles of GV indexes (Table 1).
Conclusions: Even in T2D patients with TIR &gt; 70%, GV indexes mediated the relationship between TIR and GMI. Thus, GV indexes should be taken into consideration when setting an individualized target of TIR.

Disclosure
Y. Yang: None. Z. Liu: None. D. Chen: None. B. Lin: None. W. Jiang: None. J. Yan: None. L. Zeng: None. W. Xu: None.
1916-LB: Prevalence, Characteristic, and Chronic Complications of Patients with the Fast-Glycator Phenotype in Type 1 Diabetes
Authors: DENG CHAO , TAN KE , XU RUOYAO , FAN WENQI , LI XIA 
Published: June 2024

Objective: To investigate the prevalence, characteristic and chronic complications of patients with the fast-glycator phenotype in type 1 diabetes (T1D), as well as the relationship between the fast-glycator phenotype and hemoglobin glycation index (HGI).
Methods: We enrolled individuals with T1D who utilized the continuous glucose monitoring system (CGM) for at least 10 days. Skin advanced glycation end products (AGEs) was measured by a spectroscopy device. Chronic complications were assessed through a standardized screening process. Glucose management indicator to HbA1c ratio &lt; 0.9 was defined as a fast-glycator phenotype.
Results: We included 418 participants of T1D (59.3% female) with a median age of 17 years and a median duration of 28 months. 109 individuals (26.1%) were classified as having the fast-glycator phenotype. The prevalence of the fast-glycator phenotype was higher in patients who were adult-onset (38.6% vs. 14.9%, P&lt;0.001), female (31.5% vs. 18.2%, P=0.003) and having a duration of 10 years or more (48.0% vs. 19.2%, P&lt;0.001) than their counterparts. Fast-glycators had significantly higher HbA1c (8.3% vs. 6.9%, P &lt; 0.001) with similar GMI (6.8% vs. 6.8%, P=0.663) compared with non-fast-glycators. Fast-glycators had notably higher skin AGEs (75.5 vs. 65.2, P &lt; 0.001) and HGI (1.16% vs. 0.17%, P &lt; 0.001), as well as increased prevalence of retinopathy (43.1% vs. 19.7%, P &lt; 0.001), regardless of adjusting for age, duration of diabetes.
Conclusions: Fast-glycator phenotype is more prevalent in adults, females, and patients with longer disease duration in T1D, associated with higher risk of retinopathy, and increased skin AGEs and HGI.

Disclosure
C. Deng: None. R. Xu: None. W. Fan: None. X. Li: None.
1922-LB: CGM Use in People with Type 2 Diabetes Initiating GLP-1 or GIP/GLP-1RA Therapy—Real-World Data
Authors: WANG XIAOHAN , XU YING , NORMAN GREGORY J. , REID JENNIFER L. , SINGH HARSIMRAN , YANG LEI 
Published: June 2024

Introduction & Objective: CGM use has been shown to improve glycemic outcomes in people with diabetes. We investigated CGM use pre- and post-initiation of GLP-1 or GIP/GLP-1 RA (incretin) therapy in a T2D cohort using real world data.
Methods: Retrospective analyses of electronic health records were conducted using Truveta data. People with T2D aged ≥30 years initiating incretin therapy were evaluated from 2018-2022 in 3 cohorts: intensive-insulin treated (IIT), basal-insulin treated (BIT) and non-insulin treated (NIT). CGM use was assessed 12-months pre- and post-incretin therapy initiation.
Results: Overall the cohort (n=299,157) was: 64.9-67.8% White, 52.1-53.8% female, mean (SD) 57.3 (11.7) to 59.5 (12.4) years of age. Over 5 years, individuals initiating incretin therapy approximately doubled in the insulin-treated cohorts (IIT=99%, BIT=85%) with a nearly 250% increase in the NIT cohort. CGM use increased each year pre- and post-incretin therapy initiation, with larger proportions observed in the insulin-treated cohorts vs NIT (Table).
Conclusion: These findings indicate that CGM use in people with T2D has increased substantially over 5 years, with a greater relative proportion of CGM use post- vs pre-incretin therapy initiation, independent of insulin use. Future research will evaluate the potential benefits of CGM use in conjunction with incretin therapy to optimize glycemic outcomes in people with T2D.

Disclosure
X. Wang: Employee; Dexcom, Inc. Y. Xu: Employee; Dexcom, Inc. G.J. Norman: Employee; Dexcom, Inc. J.L. Reid: Employee; Dexcom, Inc. H. Singh: Employee; Dexcom, Inc. L. Yang: Employee; Dexcom, Inc.
1933-LB: Innovative At-Home Kidney Health Testing Program for Diabetics
Authors: SPICER MORGAN J. , MILLER JUSTIN , WESTFIELD GERWIN , NORTHROP LESLEY , GAVIOLA GABRIEL 
Published: June 2024

Introduction & Objective: Chronic kidney disease, or CKD, impacts approximately one in three of these diabetic patients. An estimated 37 million people in the US have CKD and 90% are unaware due to the lack of associated symptomatology. Routine monitoring of CKD-related biomarkers such as eGFR (estimated glomerular filtration rate) and UACR (urine albumin-creatinine ratio) help aid in early diagnosis, and can prevent progression into later stages where hemodialysis or transplants are needed. Advances in home-collected laboratory tests have now made it easier to perform this needed screening.
Methods: A retrospective analysis of eGFR and UACR home-collected, laboratory test results from January 1, 2020 through January 31, 2024 as part of Kidney Health program directed at diabetic individuals at high risk for CKD was conducted.
Results: Of 902,802 results available, 8.44% of eGFR (n = 73,788/873,617) results and 10.94% (n = 3,194/29,185) of UACR results were categorized as abnormal or critical. All patients with critical values received outreach and instructions on how to seek follow-up care.
Conclusions: Critical UACR results were 3.6x more frequent than those for eGFR, highlighting the need for both tests to assess kidney health. Patients who receive abnormal or critical result values received outreach and were directed to follow up with in-person healthcare providers to receive treatment and/or lifestyle interventions to slow progression of CKD. At-home lab testing combined with counseling is effective for closing healthcare gaps in a diabetic population.

Disclosure
M.J. Spicer: Employee; Everly Health. J. Miller: None. G. Westfield: Employee; Everly Health. L. Northrop: None. G. Gaviola: None.
1942-LB: Detecting Unmet Psychosocial Needs in Adult Persons with Diabetes—First Data from Our National Danish Diabetes PROMS Questionnaire DiaProfil
Authors: NIKONTOVIC AMAR , TROELSEN LISE , MELLERGAARD NØRGAARD LISE , EJSKJAER NIELS 
Published: June 2024

Introduction & Objectives: Persons with diabetes (PwD) and our VBS-PRO-DIA research team developed the national Danish Patient-Reported Outcome (PRO) fully digital questionnaire (#DiaProfil). It is now fully implemented in all 4 hospitals in our region (uptake 600.000 inhabitants). DiaProfil identifies unmet psycho-social needs addressing appropriate individual action plans. This study is the first to psychometrically describe the magnitudes of need for selected psycho-social domains in our hospital population in the North Denmark Region.
Methods: All PwD attending the outpatient clinic at Aalborg University Hospitals, completing the DiaProfil questionnaire (9 domains with 91 parameters) were included. The prevalence of each variable was determined using frequencies and percentages, while distributions were examined to clarify variable spread. T-tests were used to examine differences between variables.
Results: 1525 PwD (870 men and 655 women) with an average age of 50.9 years were included. Response rate 72 %. The average WHO-5 score was 63.7 points (national Danish non-diabetes score 68.5 points). We detected impacted sleep quality (40% disturbed sleep), sexual health (18% difficulty with intercourse), blood sugar regulation (39% report inadequate control), diabetes management (30% lacked confidence in their own diabetes management) and diabetes stress or depression (14,6 % in need of professional assistance).
Conclusion: This study describes the prevalence of specific psycho-social need domains in adult PwD enabling individualized action planning. Specific domains in need were poor sleep quality, sexual health challenges, self-management confidence and undetected diabetes stress, all excerting a substantial impact on diabetes management, individual well-being and quality of life.

Disclosure
A. Nikontovic: None. L. Troelsen: None. L. Nørgaard: None. N. Ejskjaer: None.