bluuebunny/crossref_metadata_2025_split huggingface dataset:
64-OR: Continuous Glucose Monitoring among Pregnant Individuals with Glucose Intolerance
Authors: GORDON RACHEL D. , GRASCH JENNIFER , NANDAM NEEHARIKA , WU JIQIANG , SCHNEIDER PATRICK , GABBE STEVEN G. , LANDON MARK B. , COSTANTINE MAGED , VENKATESH KARTIK , BUSCHUR ELIZABETH 
Published: June 2024

Introduction & Objective: Glucose intolerance is common in pregnancy but incompletely characterized. We used continuous glucose monitor (CGM)-derived metrics to assess dysglycemia amongst pregnant individuals with a varying levels of glucose intolerance.
Methods: In this prospective observational study, pregnant individuals between 24-32 weeks gestation with no history of pregestational diabetes wore blinded CGM for up to 10 days. Participants were separated into four cohorts: normal 1-hour glucose challenge test (GCT), abnormal GCT and normal 3-hour oral glucose tolerance test (OGTT), abnormal GCT and 1 abnormal value on OGTT, and GDM by Carpenter-Coustan criteria. We calculated summary statistics and tested between-group differences with one-way ANOVA pair-wise comparisons with the prespecified primary outcome of time in range (TIR) within the pregnancy-specific goal of 63-140 mg/dL. We used one-way ANOVA and post-hoc tests for secondary outcomes of average glucose, time hyperglycemic, and coefficient of variation.
Results: Among 71 pregnant individuals at a mean gestational age of 29 weeks, the mean CGM use was 7.6 days. The mean time in range for the normal GCT cohort was 96.6% (95% CI 94.9-97.8%), for failed GCT/normal OGTT was 92.0% (95% CI 89.6-96%), for failed GCT/1 abnormal OGTT value was 91.8% (95% CI 83.7-95.7%), and for GDM was 92.6% (95% CI 83.9-97.9%). Normal GCT TIR was significantly different from failed GCT and 1 abnormal OGTT (p=0.04) and GDM (p= 0.04); no other pairwise comparisons of TIR were significantly different. There were no significant between-group differences for average glucose (p= 0.31), time hyperglycemic (p= 0.17), and coefficient of variation (p= 0.10).
Conclusion: Pregnant individuals with 1 abnormal OGTT value had similar TIR as those with a diagnosis of GDM. Further research is needed to determine if these individuals have clinically significant dysglycemia associated with adverse pregnancy outcomes that requires monitoring and intervention.

Disclosure
R.D. Gordon: None. J. Grasch: None. N. Nandam: Other Relationship; American Journal of Managed Care. J. Wu: None. P. Schneider: None. S.G. Gabbe: None. M.B. Landon: None. M. Costantine: None. K. Venkatesh: None. E. Buschur: Research Support; Dexcom, Inc.
647-P: Outcomes Associated with the Medicare Diabetes Prevention Program
Authors: GAO DE , ELY ELIZABETH , LANDAU ERIN O. 
Published: June 2024

Introduction & Objective: The National Diabetes Prevention Program lifestyle change program (LCP) is an evidence-based behavior change intervention to prevent or delay type 2 diabetes among adults at high risk for type 2 diabetes. In 2018, the Centers for Medicare & Medicaid Services (CMS) began approving Centers for Disease Control and Prevention (CDC)-recognized organizations to deliver the Medicare Diabetes Prevention Program (MDPP) to eligible Medicare enrollees with prediabetes.
Methods: This study compares outcomes for adults aged 65+ enrolled in the LCP in approved MDPP suppliers to those of adults aged 65+ enrolled in non-suppliers. The analysis used data submitted to CDC by organizations delivering the LCP from 23,579 participants who had the opportunity to complete the program on or before 08/31/2023 (n=2,324 MDPP; n=21,255 non-MDPP).
Results: Among MDPP participants, 62.0% met the 5% programmatic weight loss goal, compared to 55.0% of non-MDPP participants (p&lt;.001). Among female MDPP participants, 60.6% (n=1,034) met the goal, compared to 54.3% (n=8,680) of non-MDPP female participants (p&lt;.001). Among male MDPP participants, 66.4% (n=395) met the goal, compared to 57.1% (n=2,944) of non-MDPP male participants (p&lt;.001). Overall, mean weight loss among MDPP participants was 7.0% (SD=5.7) and 6.3% (SD=6.0) for non-MDPP participants. Across all race and ethnicity groups, at least 50% of MDPP participants met the 5% weight loss goal, ranging from 50.0% to 66.7%. MDPP participants attended a mean of 19 (SD=7.7) of the minimum required 22 sessions, while non-MDPP participants attended a mean of 17 (SD=10.7).
Conclusion: While Medicare-age adults enrolled in the LCP are meeting programmatic weight loss goals, those enrolled in the MDPP are doing so at a higher rate. MDPP participants are also attending more sessions on average than non-MDPP participants. Scaling the MDPP so that more Medicare beneficiaries have access to the LCP may help in lowering the risk of developing type 2 diabetes among this population.

Disclosure
D. Gao: None. E. Ely: None. E.O. Landau: None.
65-OR: Continuous Glucose Monitoring Metrics and Suboptimal Pregnancy Outcomes in Women with Gestational Diabetes—Secondary Analysis of the DiGest Trial
Authors: KUSINSKI LAURA C. , JONES DANIELLE , ATTA NOORIA , TURNER ELIZABETH , OUDE GRIEP LINDA M. , RENNIE KIRSTEN L. , DE LUCIA ROLFE EMANUELLA , MURPHY HELEN R. , TAYLOR ROY , MEEK CLAIRE L. 
Published: June 2024

Background: Continuous glucose monitoring (CGM) is increasingly used in gestational diabetes but the optimal metrics and targets in this population are undefined. We assessed if CGM metrics were associated with pregnancy outcomes in gestational diabetes.
Methods: 432 women with gestational diabetes (BMI &gt;25 kg/m2) received a dietary intervention (DiGest trial; ISRCTN; 37866), with masked CGM (Dexcom G6) at 29 (n=332) and 36wks (n=225) respectively. We used logistic regression, adjusted for trial arm, to assess the associations between standardized CGM metrics and pregnancy outcomes, including preeclampsia, preterm delivery, large-for-gestational-age (LGA), admission to the neonatal intensive care unit (NICU) and neonatal hypoglycemia. Time in range (TIR) was defined using 63-120 mg/dl.
Results: At 29wks, mean glucose, TIR and time-above-range (TAR) were significantly associated with multiple outcomes, including pre-eclampsia, LGA, NICU admission and neonatal hypoglycemia (table 1). TIR and TAR recalculated using range 63-140mg/dl (3.5-7.8 mmol/l) performed similarly. Glucose SD at 29 and 36wks was significantly associated with LGA. Time-below-range at 36wks was associated with neonatal hypoglycemia (table 1).
Conclusions: CGM metrics are strong predictors of multiple relevant pregnancy outcomes in gestational diabetes.

Disclosure
L.C. Kusinski: None. D. Jones: None. N. Atta: None. E. Turner: None. L.M. Oude Griep: None. K.L. Rennie: None. E. De Lucia Rolfe: None. H.R. Murphy: Advisory Panel; Medtronic. Research Support; Abbott, Dexcom, Inc. Speaker's Bureau; Ypsomed AG, Eli Lilly and Company, Dexcom, Inc. R. Taylor: Advisory Panel; Fast800. C.L. Meek: Research Support; Dexcom, Inc.

Funding
Diabetes UK 17/0005712EFSD - NNF NNF19SA058974
651-P: Group Matching Preferences for Emerging Adults with Type 1 Diabetes
Authors: RODRIGUEZ GONZALES BRUNO , ALLEN NANCY A. , IACOB ELI , BLANCHETTE JULIA E. , MARIE MORAITIS ANN , SHAH NAZEEN , LITCHMAN MICHELLE L. 
Published: June 2024

Introduction & Objective: D-COPES (Diabetes - Connecting Online Peers to Enhance Support) is a social support intervention that matches emerging adults (EA) into small groups led by a trained peer connector (PC) who engage virtually over 12 weeks. The purpose of this pilot was to evaluate the process for matching EA to PC.
Methods: Pre-intervention, EA and PC completed a matching survey consisting of diabetes and personal characteristics and priority matching preferences. The research team manually matched EA to PC across three separate cohorts. Cohort 1 matched on characteristics and preferences. Cohort 2 matched on availability, then characteristics and preferences. Cohort 3 matched on availability, EA’s prioritization rating of their preferred PC, then characteristics and preferences. Post-intervention, a subset of EA from each cohort were interviewed about group matching satisfaction.
Results: A total of 83 EA were part of the intervention group. EA were primarily female (59%), non-Hispanic (90.4%), and white (91.6%) and 33.7% identified as a sexual gender minority. The three cohorts had 20, 36, and 27 EA respectively that were matched into 14 groups. EA most frequently endorsed the following matching preferences for demographic and diabetes characteristics: similar age (67.5%), similar life stage (50.6%), gender (24.1%), use of continuous glucose monitoring (65.1%), insulin pump use (49.4%), cooks at home (33.7%), and moderate-high endurance exercise (32.5%). Interviewed EA (n=14) reported matching well to their PC and group. EA preferred similarities in personal characteristics over diabetes characteristics. Only one EA requested a group change, reporting a mismatch with the PC. No differences were found between cohorts with attendance or retention and matching on availability or rating of the PC.
Conclusion: These results suggest prioritizing EA to PC matching on personal characteristics to support successful group matches. Processes to automate matching are needed to support larger studies.

Disclosure
B. Rodriguez Gonzales: None. N.A. Allen: Research Support; Dexcom, Inc. Consultant; Diathrive Health. E. Iacob: None. J.E. Blanchette: Speaker's Bureau; Insulet Corporation. Board Member; Juvenile Diabetes Research Foundation (JDRF). Research Support; American Heart Association, Association of Diabetes Care & Education Specialists, National Institute of Diabetes and Digestive and Kidney Diseases, Leona M. and Harry B. Helmsley Charitable Trust. Advisory Panel; LifeScan Diabetes Institute. Consultant; WellDoc. Advisory Panel; Cardinal Health/Edgepark. A. Moraitis: None. N. Shah: None. M.L. Litchman: Research Support; American Diabetes Association, Association of Diabetes Care & Education Specialists, Dexcom, Inc. Other Relationship; Association of Diabetes Care & Education Specialists. Research Support; National Institutes of Health.

Funding
Franklin S. Ivory and Rachael C. Ivory Foundation
66-OR: Using Continuous Glucose Monitoring to Identify Neonatal Hypoglycemia following Gestational Diabetes—The DiGest Newborn Study
Authors: JONES DANIELLE , THOMSON LYNN , KUSINSKI LAURA C. , BEARDSALL KATHRYN , MEEK CLAIRE L. 
Published: June 2024

Introduction: Offspring exposed to intrauterine hyperglycemia are at risk of neonatal hypoglycemia (NH) and associated neurocognitive dysfunction in later life. As prevalence of gestational diabetes increases, early identification and treatment of NH is crucial to avoid long-term sequelae. We assessed the efficacy of current perinatal guidelines to identify NH using continuous glucose monitoring (CGM) in neonates.
Methods: Pregnant women with gestational diabetes from the DiGest trial (ISRCTN; 37866) were recruited to wear a masked Dexcom G6 CGM device intrapartum. Masked CGM was also sited on the infant thigh within 4 hours of life. NH was defined as glucose &lt;47 mg/dL (2.6 mmol/L), with a target glucose range of 47-180 mg/dL (2.6-10.0 mmol/L).
Results: 13 mother-infant dyads with paired data were included in this analysis. Maternal characteristics were: white (62%), mean (SD) age 32.3 (5.8) years, mean (SD) booking BMI 32.1 (4.8) kg/m2 and Caesarean section delivery (69%) at mean (SD) 38.9 (0.6) weeks gestation. Neonates (69% male, Apgars &gt;9) wore CGM for mean (SD) 3.9 (1.9) days with mean percent time below range (TBR) 2.8 (5.6)%, and a mean (SD) glucose 91.8 (19.8) mg/dL (5.1 (1.1) mmol/L). CGM identified periods of suspected NH which were not detected clinically with standard monitoring and were identified after the first 24 hours of life, outside of typical monitoring periods. CGM was well tolerated by mothers and neonates.
Conclusions: CGM may offer novel opportunities to improve the identification of NH following gestational diabetes.

Disclosure
D. Jones: None. L. Thomson: None. L.C. Kusinski: None. K. Beardsall: None. C.L. Meek: Research Support; Dexcom, Inc.
660-P: Participant Retention in the National Diabetes Prevention Program Lifestyle Change Program
Authors: ELY ELIZABETH , CARSTENSEN BENDIX 
Published: June 2024

Introduction & Objective: Since 2012, the Centers for Disease Control and Prevention (CDC) has recognized organizations, through the Diabetes Prevention Recognition Program, that deliver the National Diabetes Prevention Program lifestyle change program (LCP) and achieve specific metrics. Organizations enroll adults at high risk for type 2 diabetes and submit data to CDC for evaluation.
Methods: Because data have shown that retention is key to achieving outcomes that reduce risk of type 2 diabetes, we used a Cox model to compute hazard ratios (HR) of early dropout and survival curves for being retained in the program using data from 403,392 adults who enrolled 1/1/2012-8/31/2022. The model included sex, race/ethnicity, and age, and time in the program was censored at day 274. The racial/ethnic groups American Indian/Alaska Native, Asian/Asian American, Native Hawaiian/other Pacific Islander, and Multiracial were combined due to small numbers (5.3% of total). Analysis was limited to in-person and online programs.
Results: We saw no difference in dropout rates for men vs. women in in-person programs across racial/ethnic groups; for online programs, the men to women HRs were between 1.08 and 1.17. Among men in in-person programs who reported race/ethnicity, the largest HR was found for those who identified as Hispanic/Latino vs. White (1.46). Regarding men in online programs, this was the only comparison where a racial/ethnic difference was seen (1.04). Dropout rates for women in in-person programs were different between all racial/ethnic groups except those who identified as Other vs. White. The largest HR was for those who identified as Hispanic/Latino vs. White (1.29). Women in online programs who identified as Black/African American or Other had lower rates than White women, both with HRs of 0.98.
Conclusion: As we strive to retain participants in the LCP to maximize reducing risk of type 2 diabetes, our data predicting retention for different populations may allow for more focused coaching.

Disclosure
E. Ely: None. B. Carstensen: Stock/Shareholder; Novo Nordisk.
662-P: Type 1 Diabetes (T1D) Medical Providers' Perceptions of a Video to Bring Awareness to Diabetes Stigmatizing Language
Authors: JOINER KEVIN , AGAPIOU ALEXANDRA , ELJAHMI SARAH A. , PIATT GRETCHEN 
Published: June 2024

Introduction & Objective: Language guidelines state that when medical providers use certain language in encounters with adults with type 1 diabetes (T1D), they contribute to diabetes stigma and other language might be preferred. A team at the University of Michigan created a video in consultation with a leader of the language matters movement, which shows the difference between a clinical encounter when diabetes stigmatizing language is used and the same clinical encounter when preferred language is used. The purpose was to explore the acceptability of this video in a sample of medical providers who care for adults with T1D.
Methods: Nurse practitioners, physicians, and physician assistants were invited to participate using snowball sampling. Participants (n=16; 56% aged 30-39 yrs., 94% female, 56% non-Hispanic White, 56% physicians) viewed the video, and were interviewed via Zoom. The transcriptions were analyzed using a qualitative descriptive approach.
Results: Four themes emerged from the data: (1) the juxtaposition of the diabetes stigmatizing language and the preferred language aligns with values of empathy and respect, (2) the language used by medical providers is central to building and maintaining therapeutic relationships, (3) medical providers play an outsized role in determining the culture of outpatient settings, and (4) systemic issues (e.g., time constraints) exacerbate and provoke the use of diabetes stigmatizing language. The majority indicated that the video brings awareness to diabetes stigmatizing language (87%), that they planned to make a personal practice change after viewing the video (69%), and that raising awareness about diabetes stigmatizing language among medical providers is important (100%).
Conclusion: The results suggest that the video brings awareness to diabetes stigmatizing language among medical providers who provide care for adults with T1D. Future research to pilot the video as part of an intervention is warranted.

Disclosure
K. Joiner: None. A. Agapiou: None. S.A. Eljahmi: None. G. Piatt: None.
676-P: Associations between Individual Characteristics and Diabetes Self-Care among Black and White Women
Authors: BURCH ASHLEY , JACOBS MOLLY M. 
Published: June 2024

Introduction & Objective: Evidence-based guidelines recommend several practices to facilitate diabetes management. This study explored the association between individual characteristics and diabetes care behaviors among Black and White women.
Methods: Cross sectional data from the 2018-2022 Behavioral Risk Factor Surveillance System were pooled yielding a sample of 149,706 women with diabetes. Logistic regression models evaluated the association between individual level characteristics and the likelihood of having an annual healthcare visit, taking a diabetes education course, and checking feet at least once a day.
Results: White women living in an urban area and currently employed were less likely to have an annual healthcare visit within the last year. For Black women, being employed was associated with not having taken a diabetes education course. A daily diabetes-related self-care behavior, checking feet for sores or irritations, was less likely among Black women who were high school graduates and White women with a higher income and those who were employed.
Conclusion: Results suggest that employment may be a barrier to diabetes management among both Black and White women. Offering virtual diabetes education courses and opportunities for annual visits outside of traditional office hours could benefit women with diabetes who are members of the workforce.

Disclosure
A. Burch: None. M.M. Jacobs: None.
685-P: Digital Platform Users Taking GLP-1 and Managing Diabetes Adapt Lifestyle Behavior Change over Twelve Months
Authors: HERSHCOVITZ YIFAT , BREUER ASHER INBAR , MANEJWALA OMAR 
Published: June 2024

Glucagon-like peptide 1 (GLP-1) agonists improve blood glucose (BG) in adults with type 2 diabetes (T2D) along with diet and exercise modifications. Dario, a digital health platform, may assist in supporting these users with needed lifestyle changes. This study followed behavior change in users utilizing a new “medication cabinet” feature for medication logging and were identified as existing GLP-1 users, versus non-GLP-1 users. The purpose of the study was to investigate monthly activities over twelve months of using a digital platform in GLP-1 users versus non-GLP-1 Metformin users. A retrospective data analysis was performed on early users of “medication cabinet” with T2D and prediabetes who measured their Blood glucose (BG) at months 1,3,6,9,12. The GLP-1 group included users who reported taking GLP-1 and non-GLP-1 group reported taking metformin. A piecewise mixed effects model was applied to follow monthly average BG and lifestyle digital activities (logging meal/reference, carbohydrate intake and calories burned). A cohort of 107 users was evaluated: GLP-1 (N=35) and non GLP-1 users (N=72). The groups were statistically equivalent in baseline average BG (150 vs. 152 mg/dL) and monthly average BG measurements (31.3 vs 30.5). GLP-1 users showed significant reduction in BG at months 1-5 (p=0.02) maintained throughout the year. GLP-1 and non-GLP-1 users both demonstrated a statistically significant increase in lifestyle activities during their first three months (p&lt;0.001, p=0.02 respectively) maintained for a year. Moreover, mixed-effects model revealed a statistically significant increase in monthly average weight measurements over the year among GLP-1 users (p&lt;0.001). Lifestyle monitoring components in a metabolic digital disease management solution have the potential to drive behavior change and enhance clinical care among users taking GLP-1 medications. These lifestyle changes may be important in driving outcomes in users taking GLP-1 medications.

Disclosure
Y. Hershcovitz: Employee; DarioHealth Corp. I. Breuer Asher: None. O. Manejwala: Employee; DarioHealth Corp. Stock/Shareholder; DarioHealth Corp.
686-P: Prevalence and Determinants of Diabetes Distress in Type 2 Diabetes Patients in India—A Cross-Sectional Study
Authors: TRIPATHI PRAMOD , KADAM NIDHI S. , SHARMA BABY , KULKARNI POURNIMA , DAS BISWAS MAYURIKA , GANLA MALHAR H. , HIREMATH MAMATA , SABOO BANSHI D. 
Published: June 2024

Background: Research suggests a mutual relationship between type 2 diabetes (T2D) and mental health concerns. It is estimated that one in ten individuals with T2D experience severe distress.
Aim: To examine the prevalence and determinants of diabetes distress in T2D patients in India.
Materials and Methods: This cross-sectional study included patients enrolled in a one-year online diabetes management program conducted at the Freedom from Diabetes Clinic in Pune, India, between June 2023 and November 2023. Data on the medical history, anthropometry, and biochemical parameters were collected. The combined type 2 Diabetes Distress Assessment System (T2-DDAS) was used to assess diabetes distress. Regression analysis was used to identify the predictors of diabetes distress.
Results: This cross-sectional study included 144 patients with T2D (14 pre-diabetes) (49.3% female). The mean age, duration of diabetes, and HbA1c were 50.9±10.8 years, 8.1±7.1 years, and 8.3±1.9%, respectively. The prevalence of diabetes distress (score =&gt; 2) was 62.5%. Of the patients with diabetes distress, 72.2% reported multiple elevated sources, with long-term health (70.1%) and management demands (70.8%) being the top two sources. Regression analysis revealed that a longer duration of diabetes (&gt;5 years), a family history of diabetes, and comorbid hypertension were predictors of diabetes distress.
Conclusion: The study revealed a high prevalence of diabetes distress at 62.5%, with factors like longer diabetes duration, family history, and hypertension as predictors. Targeted interventions addressing psychological well-being in T2D patients, especially those with specific risk factors, are needed to improve health outcomes and manage diabetes-related distress.
Keywords: Diabetes Distress; Type 2 Diabetes; Mental health; India; cross-sectional study

Disclosure
P. Tripathi: None. N.S. Kadam: None. B. Sharma: None. P. Kulkarni: None. M. Das Biswas: None. M.H. Ganla: None. M. Hiremath: None. B.D. Saboo: None.