bluuebunny/crossref_metadata_2025_split huggingface dataset:
1223-P: Assessing the Impact of the "Management of Maternal (MOMs) Diabetes Program" in South Carolina
Authors: FU DONGXU , LEYVA MISTI J. , SCHELLINGER MEGAN M. , CAMPBELL BERRY A. , CART COURTNEY U. , FINNERAN MATTHEW , BRITT JESSICA , LILAVIVAT USAH , SMITH MAKALA K. , MANSON MAEGAN E. , HUNT KELLY J. , LYONS TIMOTHY , DIABETES PROGRAM OF SC MOMS 
Published: June 2024

Introduction & Objective: In South Carolina, risks of pregnancy associated with maternal diabetes are worsened by disparities. Expert team-based care that is equitable, feasible, meets real-life needs, and improves communication is essential. Objective: to improve pregnancy outcomes through a ‘Management of Maternal (MOMs) Diabetes Program’ implemented at three centers across SC, intended to provide a ‘one stop shop’ and utilize new technologies.
Methods: We compared outcomes for 948 MOMs patients (13% Type 1, 31% Type 2, and 56% gestational diabetes A2: 2020-2023) with 680 ‘standard care’ comparator patients (‘COMP’, from chart abstractions, Medical University of South Carolina perinatal database: 2017-2019). Maternal age and ‘diabetes type’ distributions were similar between groups, but COMP had a higher proportion of Black patients (52.1% vs. 24.8%) and fewer categorized as Hispanic or ‘other’. Two Proportion Z-Tests (two-tailed) were used for statistical analyses, with/without adjustment for race.
Results: Maternal and infant outcomes in MOMs vs. COMP are shown for all patients and for Black and White patients (Table 1).
Conclusions: Despite COVID-19, the MOMs program reduced C-sections, pre-term birth and neonatal hypoglycemia, and improved APGAR scores. Emphasizing the challenge of racial disparities, benefits were greater for White than Black patients.

Disclosure
D. Fu: None. M.J. Leyva: None. M.M. Schellinger: None. B.A. Campbell: None. C.U. Cart: None. M. Finneran: None. J. Britt: None. U. Lilavivat: None. M.K. Smith: None. M.E. Manson: None. K.J. Hunt: None. T. Lyons: None.

Funding
BlueCross BlueShield of South Carolina Foundation (2020-09,2020-08); Duke Endowment (6877-SP)
1233-P: Early Intervention in Pregnant Women with Preconception History of Glucose Intolerance
Authors: FARROKHI FARNOOSH , WILCOX JOSEPH , PARISE CAROL 
Published: June 2024

Introduction: Diabetes in pregnancy is associated with greater risks. Previous studies focused on early screening of women with variety of risks for gestational diabetes mellitus (GDM), this study focused on women with preconception history of prediabetes or GDM.
Methods: A retrospective query of the electronic health record was conducted to identify deliveries of women with preconception prediabetes or GDM 1/1/2018 - 10/30/2022 at 4 large centers of Sutter Health in Northern California. Patients with history of diabetes were excluded. Primary aim was to assess characteristics of deliveries underwent early (≤20 weeks) vs standard of care intervention (&gt;20 w) for GDM. Secondary aim was to compare pregnancy outcomes between the groups. Early intervention was defined as any of the following that was done ≤20 weeks: glucose tolerance test, prescriptions related to diabetes, referrals for diabetes management.
Results: Total of 1,954 birth deliveries included, 622 (32%) underwent early, 1,332 (68%) had standard intervention. Women in early group were older (35.8±4.1 vs 35.25±4.4, p=0.01), heavier (preconception BMI 29.3±6.5 vs 26.6±5.9, p&lt;0.001), had higher preconception HbA1c (5.5±0.3 vs 5.3±0.3, p &lt;0.001), and higher first trimester HbA1c (5.6±0.5 vs 5.2±0.2, p &lt;0.001). There were no statistically significant differences (p&gt;0.05) between the early and standard for eclampsia, small for gestation (SGA), macrosomia, neonatal hypoglycemia, shoulder dystocia, preterm delivery, NICU admissions, neonatal respiratory distress syndrome. C-section was higher (p=0.002) in early group. Those started on medication early had higher rate of SGA (p=0.003) and neonatal hypoglycemia (p=0.01).
Conclusion: This study showed majority of women with preconception glucose intolerance undergo standard screening for GDM during pregnancy. Although no differences found in most of the maternal fetal outcomes between the groups, women started on medication early had higher SGA and neonatal hypoglycemia.

Disclosure
F. Farrokhi: None. J. Wilcox: None. C. Parise: None.
1265-P: Relationship between Oral Frailty and Sarcopenia in Older Japanese with Type 2 Diabetes
Authors: TAKAHASHI YOSHIHIRO , KUBOTA SODAI , SAKAI MAYU , KATO TAKEHIRO , TAKAO KEN , MIZUNO MASAMI , HIROTA TAKUO , HORIKAWA YUKIO , YABE DAISUKE 
Published: June 2024

Introduction: Oral frailty (OF) is a condition in which oral functions are impaired. We investigated the prevalence of OF in older Japanese type 2 diabetes (T2D) and the relationship with sarcopenia.
Methods: This cross-sectional study was conducted between February and November 2023 and comprised T2D aged ≥65 years who were admitted to our hospital. At admission, we evaluated glycemic control (HbA1c), sarcopenia (skeletal muscle mass index [SMI], grip strength), and OF prevalence. Oral functions were evaluated using the checklist of the Japanese Association for Dental Science; those with three or more of seven items were diagnosed as OF.
Results: Thirty-five individuals were examined: age 75.2±5.4 years, 24 male/11 female, SMI 7.0±1.5 kg/m2, grip strength 22.1±7.6 kg, HbA1c 8.5±2.5%. Of them, 17 (48.6%) were diagnosed with sarcopenia and 30 (85.7%) with OF. When the criteria of sarcopenia and OF were delineated by gender, saliva volume (r=0.610, p=0.003) and masticatory function (r=0.566, p=0.007) were found to be positively associated with grip strength in men. In multi-regression analysis (explanatory variables: age, SMI, saliva volume, and masticatory function), saliva volume was showed a significant association (β=0.481, p=0.033) in men.
Conclusion: There is a close relationship between OF and sarcopenia in older Japanese T2D, underscoring the importance of medical-dental collaboration in diabetes care.

Disclosure
Y. Takahashi: None. S. Kubota: None. M. Sakai: None. T. Kato: None. K. Takao: None. M. Mizuno: None. T. Hirota: None. Y. Horikawa: None. D. Yabe: Advisory Panel; Novo Nordisk. Speaker's Bureau; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Boehringer-Ingelheim. Research Support; Boehringer-Ingelheim. Advisory Panel; Eli Lilly and Company. Speaker's Bureau; Eli Lilly and Company. Research Support; Eli Lilly and Company. Advisory Panel; Sanofi. Speaker's Bureau; Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Kyowa Kirin Co., Ltd. Research Support; Terumo Corporation, Taiho Pharmaceutical Co. Ltd.
1270-P: Evolution of Stroke Incidence over 34 Years Follow-up among People with Newly Diagnosed Diabetes and Impaired Glucose Tolerance in the Da Qing Diabetes and Diabetes Prevention Study 1986–2020
Authors: AN QIER , WANG JINPING , FENG XINXING , QIAN XIN , HE SIYAO , YIN XIANG , WANG XUAN , AN YALI , ZHOU SHUHAN , LI HUI , ZHAI XIUWEI , CHEN XIAOPING , LI GUANGWEI , CHEN YANYAN 
Published: June 2024

Background: Stroke is a leading cause of death among Chinese people; however, the incidence and risk attributable to stroke among adults with diabetes and pre-diabetes have not been quantified. We aimed to discover the evolution in stroke incidence among adults with diabetes and impaired glucose tolerance over a 34-year follow-up period.
Methods: We conducted an observational study among 1632 participants, including 598 individuals with newly diagnosed diabetes (NDD), 540 with impaired glucose tolerance (IGT), and 494 with normal glucose tolerance (NGT), who were initially identified in 1986 and followed up to 34 years. We compared incidence and hazard ratios for stroke across these groups and estimated the difference of median delay time of stroke onset from parametric Weibull distribution models.
Results: Over 34-year follow-up, the cumulative incidence of stroke in NDD group, IGT non-intervention group, IGT intervention group and NGT group was 65.4%, 62.8%, 49.8% and 38.2%, respectively. After adjustment for covariances, the 34 years risk of stroke was significantly higher for those in NDD, hazard ratios (HR) 1.81; 95% CI 1.47-2.72, IGT non-intervention (HR 1.63; 95% CI 1.22-2.18) and IGT intervention groups (HR 1.39; 95% CI 1.11-1.73) compared with those in NGT group. Compared with NDD, a median delay time in onset of stroke was 16.82 years (95% CI 6.50-15.57) in NGT group and 7.84 years (95% CI 4.19-11.48) in IGT intervention. Of note, the subgroup analysis in women revealed that the risk of stroke in IGT intervention group was significantly lower than those in NDD group (HR 0.64, 95% CI 0.47-0.88), and it was comparable to that in NGT controls (HR 0.99,95% CI 0.69-1.40).
Conclusions: More than half of the Chinese adults with newly diagnosed type 2 diabetes and IGT experienced a stroke over 34 years. Lifestyle interventions in women with IGT may favor the risk reduction of stroke.

Disclosure
Q. An: None. J. Wang: None. X. Feng: None. X. Qian: None. S. He: None. X. Yin: None. X. Wang: None. Y. An: None. S. Zhou: None. H. Li: None. X. Zhai: None. X. Chen: None. G. Li: None. Y. Chen: None.

Funding
Centers for Disease Control and Prevention/World Health Organization(U58/CCU424123-01-02); Chinese Academy of Medical Sciences(2020-I2M-2-006)
1271-P: Health Care Utilization and Cost with Empagliflozin vs. GLP-1RA in Patients with Type 2 Diabetes
Authors: HTOO PHYO T. , TESFAYE HELEN , WEXLER DEBORAH J. , GLYNN ROBERT , SCHMEDT NIKLAS , KOENEMAN LISETTE , PAIK JULIE M. , PATORNO ELISABETTA 
Published: June 2024

Introduction & Objective: Despite the established cardiovascular benefits of empagliflozin (EMPA) and glucagon-like peptide-1 receptor agonists (GLP-1RA), questions remain on their impact on healthcare resource utilization (HCRU) and costs.
Methods: Using US Medicare fee-for-service (FFS) and Optum commercial claims (2014-19), we identified 1:1 propensity score (PS)-matched patients aged &gt;18 years with type 2 diabetes (T2D) initiating EMPA or GLP-1RA. We estimated rate ratios (RR) and rate differences (RD) for HCRU per 1,000 person-years, and costs per member per year (PMPY) differences, overall and in patients with baseline cardiovascular disease (CVD).
Results: In 112,942 PS-matched FFS patients, EMPA was associated with similar no. of hospitalizations [RR 0.99 (0.93,1.04); RD -52 (-134, 36)], inpatient days [RR (95% CI) 0.97 (0.91, 1.02); RD -4 (-18, 10)], and no. of emergency room visits [RR 0.98 (0.94,1.01); RD -13 (-32, 6)], vs GLP-1RA. (Table). Estimates were similar in patients with CVD. Relative to GLP-1RA, EMPA was associated with lower total costs ($) [PMPY -1116 (-1359, -871)] and pharmacy costs [PMPY -800 (-934, -664)], with similar inpatient costs [PMPY 4 (-134,148)]. Findings were similar in patients with CVD. Findings from a commercial population were similar.
Conclusion: For adults with T2D, initiating EMPA versus GLP-1RA resulted in similar HCRU with lower total and pharmacy costs.

Disclosure
P.T. Htoo: None. H. Tesfaye: None. D.J. Wexler: Other Relationship; Novo Nordisk. R. Glynn: Research Support; Amarin Corporation, Kowa Pharmaceuticals America, Inc., Novartis AG, Pfizer Inc. N. Schmedt: Employee; Boehringer-Ingelheim, Bayer Inc. L. Koeneman: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. J.M. Paik: None. E. Patorno: Research Support; Boehringer-Ingelheim, Food and Drug Administration (FDA), National Institutes of Health, Patient-Centered Outcomes Research Institute.

Funding
Brigham and Women's Hospital from Boehringer Ingelheim (116283)
1277-P: Medication Adherence Associated with Better Cardiometabolic Control among American Indians with Type 2 Diabetes
Authors: SCARTON LISA , NELSON TARAH N. , YAO YINGWEI , LEGASPI ANATOLIA , DEVAUGHAN CIRCLES ASHLEY , TURNER T. GOINS R. , SEGAL RICHARD , DONAHOO WILLIAM T. , WILKIE DIANA J. 
Published: June 2024

Introduction: Increased medication adherence is expected to be associated with better health outcomes, but the extent to which medication adherence contributes to disparities in cardio-metabolic control (CMC) among American Indians is unknown. Our study purpose was to examine relationships between medication adherence and CMC in American Indians with type 2 diabetes (T2D) who live on Tribal lands with medication at no cost to them.
Methods: From Tribal electronic health record data, we obtained a cross-sectional cohort of 2,938 adults with T2D who were on all three classes of medication (anti-hypertensive, oral glucose- and lipid-lowering) in 2018. Using logistic regression models, we examined the associations between CMC and medication adherence, measured by the proportion of days covered (PDC, range 0-1).
Results: The sample mean ±SD age was 59.6±11.5 years; the majority were male (52%), married (52%), and lived in a rural setting (87%). Medication adherence for patients with a PDC of at least 80% was similar across all drug classes ranging from 63%-68% with an overall PDC of 64%. The mean for each CMC indicator was 135.6±13.2(systolic blood pressure, [SBP]), 7.8±1.6 (HbA1c), and 90.1±31.9(LDL). Higher overall PDC was associated with lower SBP (β=-12.5, p&lt;.001), lower HbA1c levels (β=-1.8, p&lt;.001), and lower LDL levels (β=-45.6; p&lt;.001).
Conclusions: Our sample had higher medication adherence rates, using PDC at an 80% or higher threshold, compared to the typically estimated 40%-50% rates found in settings where medications were not provided at no cost to patients. Even with higher medication adherence rates the sample had above target CMC indicators for SBP (&gt;130) and HbA1c (&gt;7.0).

Disclosure
L. Scarton: None. T.N. Nelson: None. Y. Yao: None. A. Legaspi: None. A. DeVaughan Circles: None. R.T. Goins: None. R. Segal: None. W.T. Donahoo: None. D.J. Wilkie: None.
1279-P: Cumulative Exposure to High Triglyceride–to–HDL Cholesterol Ratio and Risk of Type 2 Diabetes in Young Adults
Authors: LEE MIN-KYUNG , HAN KYUNGDO , HEO JUNG , KIM BYUNGPYO 
Published: June 2024

Introduction & Objective: As the prevalence of type 2 diabetes in young adults is increasing, predicting and preventing it has become a significant challenge. We aimed to evaluate whether the persistence of high triglyceride-to-HDL cholesterol (TG/HDL-C) ratio, which is a marker for insulin resistance, is associated with type 2 diabetes in young adults, considering the variability in TG/HDL-C levels over time.
Methods: This study used data from South Korea National Health Insurance Service between 2009 and 2012. A total of 1,840,251 young adults without type 2 diabetes aged 20-39 years who had undergone four consecutive annual health checkups were included. Participants were classified into five groups based on the exposure score of high TG/HDL-C ratio over a four-year period: 0, 1, 2, 3, and 4. A TG/HDL-C ratio of ≥2.8 in male and ≥1.7 in female was defined as high TG/HDL-C ratio. The risk for developing type 2 diabetes according to different exposure scores was evaluated using multivariable Cox proportional hazards regression model.
Results: During a follow-up period of 6.53 years, 40,286 (2.2%) participants developed type 2 diabetes. The cumulative incidence of type 2 diabetes significantly increased with higher TG/HDL-C ratio exposure scores (log-rank test, P &lt; 0.001). The multivariable-adjusted hazard ratios for type 2 diabetes were 1.557 (95% CI, 1.463, 1.657), 2.046 (95% CI, 1.929, 2.171), 2.857 (95% CI, 2.707, 3.016), and 4.8 (95% CI, 4.563, 5.048) for groups with scores 1-4, respectively, compared with those with a score of 0.
Conclusion: In this large-scale prospective cohort study of young adults, cumulative exposure to high TG/HDL-C ratio was an independent risk factor for type 2 diabetes in young adults.

Disclosure
M. Lee: None. K. Han: None. J. Heo: None. B. Kim: None.

Funding
the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2022R1F1A061069).
1292-P: Loss of Multiple Islet Autoantibody Status during Progression to Type 1 Diabetes
Authors: SIMMONS KIMBER M. , DONG FRAN , WAUGH KATHLEEN , YU LIPING , REWERS MARIAN 
Published: June 2024

Introduction & Objective: Type 1 diabetes (T1D) can be diagnosed before clinical symptoms with the presence of multiple islet autoantibodies (IA) and normoglycemia - stage 1 or IA and dysglycemia - stage 2. Early-stage diagnosis allows for treatment with FDA approved teplizumab or agents being tested in clinical trials. Both options require the presence of two or more IA for eligibility; however, some individuals lose IA prior to clinical diagnosis. We explored the frequency and predictors of regression from multiple to single or negative IA status in youth who progressed to clinical T1D.
Methods: Youth with at least two IA evaluation visits prior to clinical T1D onset were included. They participated in Diabetes Autoimmunity Study in the Young (DAISY) cohort (n=90, median 14 visits/person) or Autoimmunity Screening for Kids (ASK) screening study (n=61, median 4 visits/person).
Results: Of those who progressed to clinical T1D, 92% in DAISY and 84% in ASK were multiple IA+ at least once. However, many multiple IA youth, 39% (32/83) in DAISY and 10% (5/51) in ASK, regressed to single or negative IA status prior to clinical diagnosis. The mean time from multiple to single or negative IA status was 4.0 (2.3-143.3) months. IA regression was more common in males (p=0.025), controlling for the effect of study (ASK vs DAISY). Among youth seen while in stage 2, 30% (32/106) had single or negative IA status. 54% (17/32) of progressors with single or negative IA status in stage 2 T1D had previously been multiple IA+.
Conclusions: IA levels fluctuate over time. With cross-sectional screening for T1D, many patients testing positive for a single IA may have had multiple IA historically. Current eligibility criteria for teplizumab treatment or participation in clinical trials appear too restrictive and may exclude youth who will progress to clinical T1D despite absence of multiple IA.

Disclosure
K.M. Simmons: Advisory Panel; Provention Bio, Inc. Consultant; Provention Bio, Inc. Research Support; Provention Bio, Inc., Novartis AG. Consultant; Medtronic. F. Dong: None. K. Waugh: None. L. Yu: None. M. Rewers: Advisory Panel; Sanofi. Other Relationship; Sanofi. Consultant; Janssen Pharmaceuticals, Inc. Research Support; Juvenile Diabetes Research Foundation (JDRF). Consultant; Provention Bio, Inc. Research Support; Hemsley Charitable Trust, National Institute of Diabetes and Digestive and Kidney Diseases.

Funding
National Institutes of Health (DK32493); JDRF International (3-SRA-2018-564- M-N); The Leona M. and Harry B. Helmsley Charitable Trust
1293-P: Real-World Status of Autoantibody Screening and Teplizumab Administration Readiness among Centers Participating in the T1D Exchange Quality Improvement Collaborative (T1DX-QI)
Authors: DEMETERCO-BERGGREN CARLA , JACOBSEN LAURA M. , GUTTMANN-BAUMAN INES , OSPELT EMMA L. , SMEGO ALLISON , HANNON TAMARA S. , ALEPPO GRAZIA , CHOUDHARY ABHA , WONG JENISE C. , EBEKOZIEN OSAGIE , COLLABORATIVE T1DX-QI 
Published: June 2024

Background: The interest in type 1 diabetes (T1D) screening has been ignited since the U.S. FDA approval of teplizumab (November 2022) for the delay of T1D onset among those at risk. We aimed to identify the real-world status of autoantibody screening and teplizumab administration readiness among T1DX-QI centers.
Methods: A survey was administered from July to September 2023 to 55 centers participating in the T1DX-QI. Descriptive analysis was completed.
Results: Fifty of 55 centers (91%) completed the survey; 68% were pediatric and 32% were adult centers. The majority of centers (68%) had not made any substantive changes to T1D screening practices. Of the centers that had adjusted their screening practices, most developed more specific guidelines and workflows to screen first-degree relatives of people with T1D. Pediatric centers were more prepared to administer teplizumab, with the majority developing and implementing a protocol, in comparison to adult centers (Figure 1a). There is no standard screening laboratory among adult and pediatric centers (Figure 1b).
Conclusions: It is necessary to explore the barriers to implementing T1D screening and teplizumab administration in the real-world setting as the majority of centers are still in the early stages of bringing this to clinical care.

Disclosure
C. Demeterco-Berggren: None. L.M. Jacobsen: Advisory Panel; Insulet Corporation. I. Guttmann-Bauman: None. E.L. Ospelt: None. A. Smego: None. T.S. Hannon: Advisory Panel; Eli Lilly and Company. G. Aleppo: Consultant; Dexcom, Inc., Insulet Corporation. Research Support; Insulet Corporation. Consultant; Medscape. Research Support; MannKind Corporation, Tandem Diabetes Care, Inc., WellDoc, Fractyl Health, Inc. Consultant; Eli Lilly and Company, Bayer Inc. Research Support; Emmes. A. Choudhary: None. J.C. Wong: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc., Abbott. O. Ebekozien: Advisory Panel; Sanofi, Medtronic. Research Support; Vertex Pharmaceuticals Incorporated. Speaker's Bureau; Vertex Pharmaceuticals Incorporated. Research Support; Medtronic, Lilly Diabetes, Abbott, Dexcom, Inc.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust and JDRF International
1296-P: Thermal Imaging—A Simple, Rapid Device to Replace Nerve Conduction Testing for Diabetic Peripheral Neuropathy
Authors: BHATIA SOORAJ , SOLIZ PETER , SAINT-LOT SHERAZ , WIGDAHL JEFFREY , DURAN-VALDEZ ELIZABETH , SCHADE DAVID S. 
Published: June 2024

Introduction & Objective: Early detection of diabetic peripheral neuropathy (DPN) in patients with diabetes mellitus can prevent amputations. However, diagnosing DPN with nerve conduction studies (NCS) is costly and requires highly trained specialists. We present a novel thermal imaging device to detect DPN via foot temperature recovery after cold provocation, which may provide enhanced DPN screening by lowering costs, facilitating nonspecialist testing, and conserving time and resources.
Methods: NCS and thermal imaging recovery data were collected from 176 patients. Plantar feet were exposed to a 2°C cooling pad for 2 min. Recovery temperature was recorded for a point on the 1st metatarsal on the right foot with a thermal video camera for 90 s. Subjects were grouped into 21 controls, 110 diabetic subjects with negative NCS testing, and 45 diabetic subjects with positive NCS testing.
Results: The figure shows the mean temperature warming following cooling with 95% confidence intervals for the 3 groups. Each curve is statistically different from the others.
Conclusion: Thermal imaging is a useful test to diagnose early DPN. It may also detect small fiber diabetic neuropathy before NCS show positive. Because NCS tests are expensive and only available in advanced clinical facilities, thermal imaging will provide greater access to DPN screening and early intervention for many diabetic patients.

Disclosure
S. Bhatia: None. P. Soliz: None. S. Saint-Lot: None. J. Wigdahl: None. E. Duran-Valdez: None. D.S. Schade: None.

Funding
National Institutes of Health (R44DK104578)