bluuebunny/crossref_metadata_2025_split huggingface dataset:
1110-P: Endocrinologists' Perceptions and Implementation of Hemoglobin A1c Targets for Adults with Type 1 Diabetes
Authors: KAUSHAL SANCHIT , HALPERIN ILANA , HAWKER GILLIAN A. , WEISMAN ALANNA 
Published: June 2024

Introduction & Objective: ​​Most adults with T1D do not meet the HbA1c target of ≤7.0%. Endocrinologists’ perceptions may influence target attainment among patients, but have not been previously evaluated. We evaluated endocrinologists’ acceptability of the HbA1c target of ≤7.0%.
Methods: An online REDCap survey was sent to all 309 adult endocrinologists in Ontario. Acceptability of the HbA1c target of ≤7.0% was assessed using the Theoretical Framework of Acceptability (TFA), which evaluates interventions according to seven domains: affective attitude (feelings), burden (required effort), perceived effectiveness (likelihood of achieving purpose), ethicality (fit with personal values), intervention coherence (understanding), opportunity costs (potential negative effects), and self-efficacy (confidence). Agreement with statements representing each domain was rated by 5-point Likert scale. Acceptability was considered high if the proportion agreeing or strongly agreeing (A/SA) was &gt;70% (or proportion disagreeing or strongly disagreeing was &lt;30% for opportunity costs domain).
Results: 120 eligible endocrinologists (39%) completed the survey [69 (58%) female, 95 (82%) urban practice, and 53 (46%) aged 30-40 years]. TFA domains with high acceptability were intervention coherence (91% A/SA), ethicality (87% A/SA) and affective attitude (75% A/SA). Domains with low acceptability were self-efficacy (46% A/SA), perceived effectiveness (67% A/SA), burden (35.8% A/SA) and opportunity costs (33% disagree/strongly disagree). Responses suggest a disconnect whereby endocrinologists highly value the HbA1c target of ≤7.0% but perceive challenges in implementation.
Conclusion: Endocrinologists’ endorsement of the HbA1c target despite acknowledged barriers to implementation could negatively influence the physician-patient relationship. The potential benefits and risks of alternative patient-centered HbA1c targets requires further exploration.

Disclosure
S. Kaushal: None. I. Halperin: Advisory Panel; Dexcom, Inc. Speaker's Bureau; Dexcom, Inc., Novo Nordisk, Sanofi. Advisory Panel; Sanofi, Abbott. Speaker's Bureau; Tandem Diabetes Care, Inc. G.A. Hawker: None. A. Weisman: None.

Funding
Banting & Best Diabetes Centre Sunlife Financial New Investigator Award
1114-P: Management Outcomes by Provider Type in People with Diabetes Receiving Care at a Federally Qualified Health Center
Authors: SAN DIEGO EMILY ROSE N. , VINCENT LAUREN , ORENDAIN NATALIA , SPIERLING BAGSIC SAMANTHA R. , GORDON CHRIS , PHILIS-TSIMIKAS ATHENA 
Published: June 2024

Introduction: Federally Qualified Health Centers (FQHCs) provide crucial health services to medically underserved populations. While primary care has been shown to improve outcomes in people with diabetes, comprehensive care from a multidisciplinary team of endocrinologists and other diabetes care specialists can optimize management outcomes.
Objectives: Examine differences in management outcomes by provider type using data from an FQHC offering a recently established Diabetes Specialty Care service to people with diabetes in San Diego, CA.
Methods: t-tests and linear regressions models.
Results: Of N = 35,092 adults with diabetes seen between 2017-2022, 7% were seen by an endocrinologist. Compared to patients only seen by a primary care provider (PCP), patients receiving diabetes care from an endocrinologist had higher A1C (M=8.9% vs. M=7.8%; p &lt; 0.001) and lower systolic blood pressure (M=108 mmHg vs. M=114 mmHg; p &lt; 0.001), and higher prescription rates of metformin (55% vs 52%, p &lt; 0.01), insulin (25% vs 22%, p &lt; 0.01), sulfonylureas and meglitinides (24% vs 22%, p = .005), and continuous glucose monitors (CGM) (54% vs 10%, p &lt; .0001). After controlling for age, sex, race, education, and provider type, patients seen by an endocrinologist had 17% increased odds of metformin (p = .0005) and insulin (p = .0009) prescriptions, 14% increased odds of sulfonylurea and meglitinide prescriptions (p = .010), and 1699% increased odds of CGM (p = &lt;.0001) compared to patients seen by a PCP. While not significant (p’s &gt; .05), there were more patients seen by an endocrinologist who were prescribed SGLT2i (9% vs 8%), GLP-1 RA (11% vs 10%), and DPP-4i (15% vs 13%).
Conclusion: Higher prescription rates of diabetes medications and technology were observed in patients seen by an endocrinologist at an FQHC. These findings emphasize the importance of integrating endocrinologists and other diabetes specialty care services into FQHCs, where many vulnerable people with diabetes receive care.

Disclosure
E.N. San Diego: None. L. Vincent: None. N. Orendain: None. S.R. Spierling Bagsic: None. C. Gordon: None. A. Philis-Tsimikas: Advisory Panel; Dexcom, Inc., Lilly Diabetes, Novo Nordisk, Sanofi, Medtronic, Bayer Inc.

Funding
National Institutes of Health (K12 TR004410)National Institutes of Health (KL2 TR001112)
1119-P: Patient Directives to Improve Care for Gestational Diabetes Informed by Lived Experience—A Systematic Review of Qualitative Studies
Authors: JULIANNE FENG YUYANG , DENG ZHIDI , YEUNG ROSEANNE O. , NAGPAL TANIYA 
Published: June 2024

Introduction & Objective: Gestational diabetes (GDM) can negatively impact the long-term metabolic health of patients and their infants, and mixed experiences with GDM care have been reported. The objective of this study was to identify themes and directives for improving quality of prenatal care from patients with lived experiences of GDM or their partners.
Methods: This study is a systematic review of qualitative studies and was registered on PROSPERO (CRD42023394014). A comprehensive search strategy was developed to identify qualitative studies including pregnant or postpartum patients with GDM, or their partners. A thematic synthesis approach, following meta-aggregation was applied to identify patient-directives for GDM care. The Critical Appraisal Skills Programme qualitative checklist was used to assess quality and risk of bias.
Results: Our search strategy was executed in six databases and a total of 80 studies were included. Patient-reported directives for improving care included: education on GDM and its management, personalized or tailored care, patient-centered care, digital or online adjuncts to care, and peer support. Additional directives for care arising from interpretation of patient-reported barriers and enablers of GDM management included providing support from healthcare professionals and facilitating support from partners and family, and acknowledging the stigma around GDM and patients’ motivations and concerns.
Conclusion: Many patient and environmental factors affect the experience of GDM. Our systematic review findings identify several patient-reported directives for care, and our interpretation of additional directions through barriers and enablers experienced by patients. These findings provide rich direction for improving antenatal GDM care from the patient perspective.

Disclosure
Y. Feng: None. Z. Deng: None. R.O. Yeung: Research Support; Abbott. Advisory Panel; Dexcom, Inc. T. Nagpal: None.
1121-P: Nurse-Led Diabetes Screening Protocol
Authors: LI CARRIE 
Published: June 2024

Introduction and Objective: Approximately 8.7 million Americans live with undiagnosed diabetes, with one in five of them being unaware they have Type 2 diabetes, and an additional 97.6 million American adults have prediabetes, with disproportionate impacts on minority communities. Screening for prediabetes is essential for early identification and intervention in this population. The study objective was to determine if implementing a standardized diabetes risk screening protocol in an urban New York primary care facility increases screening and early intervention for Type 2 diabetes.
Methods: A quantitative descriptive design was implemented using a pre-and post-design and the Plan, Do, Study, Act Model. Participants were new adult clinic patients aged 35 to 70, exclusion criteria were: comprising pregnancy, screening declination, having Type 2 diabetes, cognitive impairment, or materials not available in the preferred language. The American Diabetes Association (ADA)/Centers for Disease Control and Prevention (CDC) Prediabetes Risk Test (PRT) was used for screening diabetes risk (independent variable). Dependent variables included nurse-led diabetes prevention education, nutritionist referrals, and ordering hemoglobin A1c (HbA1c). A three-month retrospective chart review included individuals identified using the ADA/CDC PRT for comparison. Data were analyzed using descriptive statistics and Pearson correlation.
Results: There were 31 eligible participants; the ADA/CDC Risk Test correctly identified 74% (n =31) with HbA1c levels indicating prediabetes or diabetes. Pearson correlation analysis showed moderate positive associations between the ADA/CDC PRT score and HbA1c levels (0.359, p&lt;0.05), age (0.623, p&lt;0.05), and BMI (0.350, p&lt;0.05). Performance improved in patient diabetes prevention education, nutritionist referrals, and HbA1c screening.
Conclusion: Study results highlight the importance of improving screening strategies and early identification in diabetes prevention and management.

Disclosure
C. Li: None.
1136-P: Post–Metabolic Bariatric Surgery Protein Profiles—Navigating the Proteomic Landscape of Glycemic Regulation
Authors: JI CHOI YE , NGUYEN NHUNG , NARONGKIATIKHUN PHOOM , NASH KELLY , TOMMERDAHL KALIE L. , INGE THOMAS , RYDER JUSTIN R. , BJORNSTAD PETTER , PYLE LAURA 
Published: June 2024

This study aims to investigate the effects of metabolic bariatric surgery (MBS) on plasma proteins linked to loss of glycemic control, insulin resistance and impaired insulin secretion in youth with type 2 diabetes (T2D).We measured 7604 Aptamers in 326 plasma samples from youth with obesity, both with and without T2D, in Teen-LABS cohort, examining pre- and post-MBS changes. This analysis focused on proteins previously identified in the TODAY cohort as predictors of glycemic control loss, defined by sustained HbA1c ≥8% or insulin dependence, in youth with T2D. A mixed model evaluated proteomic changes post-MBS, maintaining a 5% false discovery rate with reported q-values. In Teen-LABS, several proteins associated with a higher glycemic control loss risk in TODAY showed notable post-surgical downregulation. Key proteins such as Fructose-bisphosphate aldolase B, Liver carboxylesterase 1, Semaphorin-6A, Interleukin-18 receptor 1, Neurofascin, and Plexin-D1 were among those most affected (Figure). These proteins participate in metabolic and immunomodulatory pathways, potentially influencing glucose homeostasis. The study identified specific proteomic changes following MBS that potentially impact metabolic and immune function relevant to glycemic regulation. Recognizing these proteins as biomarkers could tailor post-MBS care, achieving long-term glycemic control.

Disclosure
Y. Choi: None. N. Nguyen: None. P. Narongkiatikhun: None. K. Nash: None. K.L. Tommerdahl: None. T. Inge: Consultant; Medtronic, Eli Lilly and Company, Brainstorm Therapeutics. Stock/Shareholder; Standard Bariatrics. Consultant; Teleflex. J.R. Ryder: None. P. Bjornstad: Consultant; AstraZeneca, Boehringer-Ingelheim. Advisory Panel; Lilly Diabetes, Novo Nordisk, Bayer Inc., Horizon Therapeutics plc. L. Pyle: None.

Funding
American Diabetes Association (7-23-ICTSTDY-08); NIH/NIDDK (U01 DK61242)
1138-P: Continuous Glucose Monitor (CGM)–Based Glycemic Variability Is Associated with Beta-Cell Function in Youth at Risk for Type 2 Diabetes
Authors: HARRISON CALEB , RODRIGUEZ GONZALEZ ADRIANA , HEWITT BRIANNA , ARSLANIAN SILVA A. , ELLEN VAJRAVELU MARY 
Published: June 2024

Introduction & Objective: Screening for type 2 diabetes (T2D) is recommended for youth with risk factors, but current tests do not assess β-cell function, a predictor of disease progression. We evaluated whether CGM-based glycemic variability (GV) is associated with β-cell function in youth at risk for T2D.
Methods: Prospective observational study of pubertal youth ages 8-18y not on glucose-altering medications, with overweight/obesity (BMI ≥ 85th percentile) and at least one ADA-defined T2D risk factor or HbA1c 5.7-6.4%, fasting glucose (FG) ≥100 mg/dL, or 2-hour plasma glucose (2hG) on oral glucose tolerance test (OGTT) ≥140 mg/dL. Participants completed a 75g 2-hour OGTT, with every-30-minute glucose (G), insulin (I), and c-peptide (C). Blinded Dexcom G6 CGM was placed after OGTT and worn for 10 days. GV measures were calculated using the R package iglu, including coefficient of variation (CV), standard deviation (SD), mean amplitude of glycemic excursions (MAGE), and mean of daily difference (MODD). β-cell function was calculated using 2 versions of the OGTT-based oral disposition index (oDI): 1) I-oDI = 1/IF x ΔI30/ΔG30 and 2) C-oDI = 1/CF x ΔC30/ΔG30; Δ30 is the difference from 0 to 30 minutes. Log-transformation was performed for skewed distributions. Linear regression was used to evaluate the association between oDI outcomes and GV measures, adjusted for BMI Z-score.
Results: Of 39 youth enrolled, 33 (55% F; 30% Black, 58% White, 12% multiracial; mean ± SD 14.9±1.8y; BMI 36.8±6.6 kg/m2; HbA1c 5.6±3.2%; FG 84.8±8.2 mg/dL; 2hG 116.2±28.9 mg/dL) had evaluable CGM data. MAGE and MODD were inversely associated with I-oDI (p=0.04, p=0.02) and C-oDI (p=0.009, p=0.016). CV (p=0.047) and SD (p=0.03) were inversely associated with C-oDI but not associated with I-oDI.
Conclusion: Based on its demonstrated association with β-cell function, CGM-based GV offers a novel approach to evaluating T2D risk in youth with overweight/obesity and other risk factors.

Disclosure
C. Harrison: None. A. Rodriguez Gonzalez: None. B. Hewitt: None. S.A. Arslanian: Consultant; AstraZeneca, Eli Lilly and Company, Nestlé Health Science, Avoro Capital Advisor LLC. Research Support; Eli Lilly and Company, Novo Nordisk. Advisory Panel; Novo Nordisk. M. Vajravelu: None.

Funding
Endocrine Fellows Foundation; Tanner Scholar Advancing Equity Award
1139-P: Discovery of a Potent, Orally Efficacious Small Molecule Agonist of Glucagon-Like Peptide-1 (GLP-1) Receptor
Authors: BEARSS DAVID J. , LIN CHENYU , MEDLEY KYLE , VANKAYALAPATI HARIPRASAD 
Published: June 2024

Introduction: Given its physiological roles, GLP-1 agonists are considered a class of drugs used in the treatment of type 2 diabetes and obesity. These agents mimic 7-36 amide Semaglutide, increase insulin release, decrease glucagon secretion, and a slowing of gastric emptying but are injectables, week half-life, and cold chain storage limit their utility. Several small molecule agonists of the GLP-1 receptor have been investigated as potential alternatives to peptide-based GLP-1 agonists like Danuglipron, and Orforglipron. Here we present the discovery of the MLX-7005 series exhibited on target-specific GLP-1 agonist activity in its binding and cellular studies.
Methods: Tag-Lite GLP-1 receptor binding assay. Ca2+ mobilization in Min6-c4 cells. cAMP in PSC-HEK293 Cell Line Expressing GLP-1R. cAMP β-Cell Line 1.2B4. The cAMP Gs dynamic and a LANCE Ultra cAMP kit. GLP-1 agonist in db/db and DIO models of T2D and obesity.
Results: Small molecule GLP-1 agonists we discovered are orally available, stable, lower manufacturing costs than peptide-based drugs. We disclose MLX-7005 and its analogs, exhibiting potent activity in vitro MIN6 Ca2+ assay dose-dependently with an EC50 of 241 nM and reference Danuglipron, GLP-1 peptide are 219 nM and 70 nM. MLX-7005 additional in vitro and in vivo pharmacology profile results consistent with its on-target potency. MLX-7005 has a high binding affinity to human GLP-1R. MLX-7005 strongly activated the GLP-1R cAMP pathway without inducing measurable β-arrestin recruitment signaling. The insulin secretion effect of MLX-7005 was evaluated in a functional human pancreatic beta cell line, in which MLX-7005 showed dose-dependent induction of insulin secretion.
Conclusion: In conclusion, MLX-7005 is a highly potent, orally available, GLP-1 agonist. pre-clinical in vivo DIO, db/db rodent models studies are underway along with safety, and tolerability to further evaluation as a potential therapy for T2DM and obesity will be presented.

Disclosure
D.J. Bearss: Employee; BioLexis Therapeutics, Halia Therapeutics. C. Lin: None. K. Medley: None. H. Vankayalapati: Board Member; Biolexis Therapeutics, Inc. Stock/Shareholder; Arrien Pharmaceuticals. Board Member; Oncolexis Therapeutics, Inc.

Funding
Biolexis Therapeutics, Inc.
1143-P: Early Aged Mice Stay Metabolically Stable with High-Fat Diet
Authors: BAHMAN FATEMAH , KOCHUMON SHIHAB P. , ALRASHED FATEMA , ABUKHALAF NERMEEN A. , THOMAS REEBY S. , ALMULLA FAHD , AHMAD RASHEED 
Published: June 2024

The relationship between obesity, aging, and the risk of metabolic diseases is a crucial area of study. This research focuses on understanding how aging influences the body's response to high-fat diet (HFD) consumption and its subsequent impact on metabolic health. Our hypothesis posits that aging significantly affects how the body adapts to HFD intake, potentially improving metabolic outcomes. To explore this, we conducted a study using mice of varying ages (4, 6, 8, and 10 weeks old, with 6-8 mice per age group). Over a period of 16 weeks, these mice were fed either a standard chow diet or an HFD. Our findings indicate that older mice (aged) demonstrate a more rapid weight gain in response to HFD compared to younger (early-aged) mice. Interestingly, younger mice appeared to be protected against HFD-induced obesity. Additionally, adipose tissues from younger mice showed fewer inflammatory markers. We also investigated the characteristics of non-alcoholic fatty liver disease (NAFLD), including fatty deposition, lesions, atypical yellowish coloration, and enlargement. These were notably absent in younger mice consuming HFD. Further analysis involved staining liver sections with hematoxylin and eosin (H&E) and Oil Red O to assess lipid accumulation. Results revealed a higher presence of lipid vacuoles in the livers of older mice compared to their younger counterparts on an HFD. Consistent with increased adiposity, fat accumulation in the liver, and inflammation, older mice exhibited impaired glucose tolerance and reduced insulin sensitivity compared to younger mice fed the same diet.
In conclusion, our study unveils a significant link between the body's adaptations during early aging and its metabolic responses to HFD. These findings suggest potential avenues for preventing obesity and its associated complications, particularly those exacerbated by overnutrition. This research contributes valuable insights to the field, highlighting the importance of age as a factor in dietary and metabolic health.

Disclosure
F. Bahman: None. S.P. Kochumon: None. F. Alrashed: None. N.A. Abukhalaf: None. R.S. Thomas: None. F. Almulla: None. R. Ahmad: None.

Funding
Kuwait Foundation for the Advancement of Sciences (KFAS)
1148-P: Trajectories of Abnormalities in Metabolic Parameters in Japanese Adolescents and Young Adults
Authors: IKEDA IZUMI , FUJIHARA KAZUYA , SHIOZAKI HARUKA , MORIKAWA SAKIKO Y. , HORIKAWA CHIKA , TAKEDA YASUNAGA , ISHIGURO HAJIME , YAMADA TAKAHO , KODAMA SATORU , OGAWA YOHEI , SONE HIROHITO 
Published: June 2024

Childhood obesity mostly transitions into adulthood and leads to non-communicable diseases such as type 2 diabetes and metabolic syndrome. We aimed to examine individual-level transitions in metabolic parameters during adolescence and young adulthood. We analyzed metabolic parameters in 523 participants (311 males) who underwent health examinations at the ages of 14 y (8th grade) and 20 y. Weight status was assessed by the International Obesity Task Force at 14 y and by BMI (thinness: &lt;18.5; normal: 18.5-24.9; obesity: ≥25.0) at 20 y. HbA1c ≥5.7% was defined as high. Clustered metabolic risk score (CMR) was calculated by summing the sex-age specific Z-scores of each metabolic factor (mean arterial pressure, non-HDLC, and HbA1c) with ≥1 SD defined as high. Among participants who were obese at 14 y, 56% of males and 29% of females remained obese at 20 y. In both sexes, 30-50% had high HbA1c and 30-50% had high CMR as tracked from adolescence to adulthood (table). Furthermore, the high CMR of obese females increased markedly from about 20% at 14 y to 50% at 20 y. In addition, 60% of females who were obese at both 14 y and 20 y had high HbA1c at 20 y. Results suggested the importance of lifestyle interventions from childhood, as about half of the high metabolic parameters observed in adolescents were tracked into adulthood, and obesity complications, which were rarely shown at 14 y, appeared in many at age 20 y.

Disclosure
I. Ikeda: None. K. Fujihara: None. H. Shiozaki: None. S.Y. Morikawa: None. C. Horikawa: None. Y. Takeda: None. H. Ishiguro: None. T. Yamada: None. S. Kodama: None. Y. Ogawa: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.
1154-P: Diabetes-Specific Distress Persists over Time in Adolescents with Type 2 Diabetes—A Longitudinal Study
Authors: LUU YASMIN , SHAH MARK , OXLAD MELISSA , CURRAN JACQUELINE A. , SPAJIC DANA , PENA ALEXIA S. 
Published: June 2024

Introduction: Diabetes-specific distress (DD) is the least evaluated psychological comorbidity among adolescents with type 2 diabetes (T2D). We aimed to assess longitudinally DD levels in adolescents with T2D.
Methods: Adolescents with T2D completed the Diabetes Distress Scale (DDS), World Health Organisation-5 Wellbeing Index (WHO-5), and Patient Health Questionnaire-2 (PHQ-2) at baseline, 3 and 6 months to measure DD levels, general emotional wellbeing, and depressive symptoms, respectively. A linear regression model was used to estimate differences in means and 95% confidence intervals with Generalised Estimating Equations.
Results: Thirty-seven adolescents with T2D participated (24 females, 34 from non-Indigenous background, mean+SD age 15.9±2.2 years, mean diabetes duration of 2.2±1.6 years, median [IQR] HbA1c 6.7[5.9-8.9]%. Adolescents with T2D have persistent DD (highest levels in the emotional burden and regimen-related domains), high depressive symptoms and deterioration of emotional wellbeing over six months (See Table 1).
Conclusion: DD and depressive symptoms persisted over time, whilst emotional wellbeing deteriorated, approaching suboptimal levels in adolescents with T2D. Regular screening and management of DD (especially emotional burden and regimen-related distress) and emotional wellbeing should occur during follow-up of adolescents with T2D.

Disclosure
Y. Luu: None. M. Shah: None. M. Oxlad: Research Support; Ferring Pharmaceuticals Australia. J.A. Curran: Other Relationship; Novo Nordisk, Eli Lilly and Company. D. Spajic: None. A.S. Pena: None.