bluuebunny/crossref_metadata_2025_split huggingface dataset:
502-P: Significant Inverse Association between Self-Reported Fast Walking and Incident Severe Diabetic Microvascular Complications Including Retinopathy and Initiation of Dialysis
Authors: YAMAMOTO MASAHIKO , FUJIHARA KAZUYA , HASEBE HIRUMA , YAGUCHI YUTA , ISHIGURO HAJIME , MATSUBAYASHI YASUHIRO , YAMADA TAKAHO , KODAMA SATORU , SONE HIROHITO 
Published: June 2024

Background & Objective: Whether fast walking is inversely associated with the incidence of severe diabetic retinopathy (DR) and/or diabetic macular edema (DME) or initiation of dialysis remains unknown. We aimed to explore the association between self-reported fast walking and the incidence of these outcomes.
Methods: Japanese with type 2 diabetes were enrolled. Severe DR and DME were defined as vision-threatening treatment-required diabetic eye diseases (TRDED). TRDED and initiation of dialysis were identified according to claims using ICD-10 codes and medical procedures. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of TRDED and initiation of dialysis were calculated by Cox proportional hazards models using a nationwide database.
Results: Of 11,594 persons, 298 developed TRDED (4.9/1000 person-years) during the study period (mean 5.2y) and 82 of 14,695 participants required initiation of dialysis (1.0/1000 person-years, mean 5.4y). Multivariate Cox analysis demonstrated that self-reported fast walking was inversely associated with both TRDED and initiation of dialysis after adjustment for covariates. HRs for incident TRDED and initiation of dialysis in persons reporting fast walking was 0.67 (95%CI, 0.52-0.86) and 0.54 (0.33-0.88), respectively, compared with those reporting slow-to-average walking. This inverse association was unchanged after additional adjustment for physical activity (HR0.67 [0.52, 0.87] for TRDED and 0.59[0.35, 0.98] for initiation of dialysis).
Conclusions: This information can be a valuable aid to prevent severe microvascular complications because maintaining walking speed is an inexpensive and almost universally applicable tool, although further interventional studies are required to prove this hypothesis derived from the current observational study.

Disclosure
M. Yamamoto: None. K. Fujihara: None. H. Hasebe: None. Y. Yaguchi: None. H. Ishiguro: None. Y. Matsubayashi: None. T. Yamada: None. S. Kodama: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.

Funding
The Japan Society for the Promotion of Science (JSPS) KAKENHI Grant (JP21K11569 and JP22K1621)
503-P: The Effect of Ten-Year Multifactorial Intervention on Risk Factors for Diabetic Retinopathy in Patients with Type 2 Diabetes in the Beijing Community
Authors: LIAN ZHANG XUE , YUAN YUAN SHEN 
Published: June 2024

Objective: To investigate factors affecting diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) after 10-year interventions in the Beijing community.
Methods: 1,759 patients with T2DM in the Beijing community from August 2008 to July 2009 were enrolled. All patients received 10-year intervention and underwent regular fundus examination during the follow-up. The patients were divided into three groups. Patients without DR during the follow-up were named as the NDR group; Progression from normal fundus to DR during the follow-up was named as the PD-DR group; and those with a diagnosis of DR at both baseline and at the end of follow-up were named as the DR group.
Results: At baseline, comparison of age, the duration of diabetes mellitus, educational attainment, economic level, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose and HbAlc levels among the 3 groups showed significant differences (P&lt;0.05). At the end of follow-up, when compared with the NDR group, the levels of FPG and HbAlc, proportion of all-cause death, cardiovascular events(CVD) were higher in the PD-DR group and DR group (P&lt;0.05), History of diabetic nephropathy, FPG, HbAlc and total cholesterol were independent risk factors for DR at baseline, and the risk factors of DR changed to FPG and HbAlc at the end of follow-up.
Conclusion: After 10-year of strict control of blood glucose, blood pressure and lipid profiles in T2DM in the community, the risk factors for the development of DR changed. Long-term multi-factorial intervention could effectively reduce the risk factors for DR.

Disclosure
X. Zhang: None. S. Yuan: None.

Funding
Capital Medical Development Foundation of China (2007-1035), Beijing Municipal Science &Technology Commission (Z151100004015021)
51-PUB: Assessment the Effect of Therapeutic Education on Nutritional Habits among Pregnant Women with Gestational Diabetes
Authors: SALZBERG SUSANA , GROUP EDUGEST 
Published: June 2024

Background: Maternal obesity elevates the risk of gestational diabetes (GD) andimpacts perinatal outcomes, stemming from excessive caloric intake and unhealthynutrient habits.
Objective: To evaluate the effect of therapeutic education on food intake, and itsadequacy to nutritional recommendations in pregnant women with GD.
Methods: GD women who participated in the EDUGEST study were consider to theanalysis. Educational intervention: workshops in-site and on-line, with material speciallydeveloped for the project, reinforced with an individual interview with thenutritionist.Nutriquid-GEST were completed before and after the intervention. A pre-post intervention analysis was carried out, where food intake indicators and theproportion of adequacy to Institute of Medicine recommendations were verified. Theresults are presented as mean ± standard deviation or proportions. Student's tests andchi-squared test were used for comparisons considering significant p&lt;0.05.
Results: Nutritional records of 497 women with GD were analyzed (31.1 ± 6.4 years atthe beginning of pregnancy, BMI 31.8 ± 7 kg/m2, and 28 ± 5 weeks gestational age atthe time of recruitment. PRE intervention: energy intake was 3,633 ± 2,350 Kcal/day, and only 10.9% of the sample recorded consumption as recommended. POSTintervention, a decrease in energy intake was observed (2,0913 ± 881.9 Kcal/day vs.3,633.2 ± 2,350.4 Kcal/day; p=0.000), and a decrease in macro and micronutrientconsumption; without change in the number of servings of fruits and vegetables.Therewas an increase in the percentage of women with an adequate range of energyconsumption (25.4% vs. 10.9%; p=0.000), Carbohydrates (14.5% vs. 8.9%; p=0.006), Lipids (14.5% vs. 9.9%; p=0.026) and Proteins (19.9% vs. 12.3%; p=0.026).
Conclusion: The educational intervention significantly improved the eating behavior ofpregnant women with GD, adopting healthy eating habits throughout pregnancy.

Disclosure
S. Salzberg: Research Support; Eli Lilly and Company.

Funding
World Diabetes Foundation (WDF 19-1724)
517-P: Postprandial Circulating Endocannabinoidome Mediators—Impact of Host's Metabolic Health and Dietary Fatty Acid Profile
Authors: ROCHELEAU TRISTAN , AMZIL LOUBNA , MAYER THOMAS , LEBLANC NADINE , FLAMAND NICOLAS , RAYMOND FRÉDÉRIC , DI MARZO VINCENZO , VEILLEUX ALAIN 
Published: June 2024

Introduction & Objective: Food digestion and the activity of the gut microbiota enable the production of several nutrient-derived bioactive metabolites. Notably, lipids can be metabolized into endocannabinoidome (eCBome) mediators, a large family of endocannabinoid and their congeners such as N-acyl-ethanolamines (NAEs) and 2-monoacyl-glycerols (2-MAGs) involved in numerous aspects of energy homeostasis. Our objective is to decipher the short-term and postprandial kinetics of dietary fatty acid incorporation into circulating eCBome mediators in individuals living with visceral obesity and type 2 diabetes (T2D).
Methods: The METAc trial consists of a fixed sequence of standardized meals divided in three periods: a) a 3-day run-in control diet, b) a 2-day UFA-rich diet, and c) a 2-day SFA-rich diet. Fasting and postprandial (45-480 min) circulating levels of NAEs and 2-MAGs were measured by LC-MS/MS and analyzed using longitudinal mixed linear models.
Results: Men and postmenopausal women aged 45 to 65 (n=51) were recruited into the following groups: lean, visceral obesity and T2D. Circulating levels of 2-MAGs derived from oleic acid and omega‑3 PUFAs were increased following the 2-day UFA-rich diet (+25 to 120%). Interestingly, circulating levels of all 2-MAGs were rapidly increased along with digestion (+40 to 220%). In contrast, circulating levels of NAEs were decreased throughout the postprandial periods (−40 to 80%). The magnitude of the postprandial response of most NAE and 2-MAG congeners was influenced by the fatty acid profile of the previous meal. In addition, the eCBome profile was impacted by the obesity and T2D status of the host.
Conclusion: This study supports the hypothesis that dietary lipids are rapidly metabolized and incorporated into circulating 2-MAGs. Dietary lipid intake, obesity and diabetes status as well as gut microbiota activity emerge as crucial regulators of the fasting and postprandial circulating eCBome tone.

Disclosure
T. Rocheleau: None. L. Amzil: None. T. Mayer: None. N. Leblanc: None. N. Flamand: None. F. Raymond: None. V. Di Marzo: None. A. Veilleux: None.
55-OR: Diabetes Distress among Persons Living with Latent Autoimmune Diabetes of Adults in the Canadian Cohort BETTER—A Cross-Sectional Study
Authors: NEHME MAYA , ISSA MOHAMAD , BRAZEAU ANNE-SOPHIE , LEROUX CATHERINE , HAAG SARAH , ROY-FLEMING AMÉLIE , TALEB NADINE 
Published: June 2024

Introduction: Latent autoimmune diabetes of adults (LADA) is known for a slowly progressive autoimmune destruction of beta-cells compared to type 1 diabetes while sharing clinical features with type 2 diabetes. Diabetes distress has not been assessed specifically in persons living with LADA (PwLADA) to address potential gaps in their care.
Objective: Assess diabetes distress experienced by PwLADA and compare it to persons living with type 1 diabetes (PwT1D).
Methods: Cross-sectional analysis of Diabetes Distress Scale DDS-17 filled online in the Canadian BETTER registry; Data was analyzed for 2877 participants; 266 (9%) LADA and 2611 (91%) T1D. A total distress score was calculated then items were organized and scored under four categories: emotional burden, physician distress, regimen distress and interpersonal distress. Scores were classified as low, moderate or high distress, mean item score ≥ 3 as “high distress”; chi-square was used for comparison with T1D.
Results: PwLADA vs PwT1D were 50 ± 13 y.o. vs 40 ± 16 y.o (p&lt;0.001); 67% vs. 64% females (p 0.4); diabetes duration 10 ± 9 vs. 22 ± 15 years (p&lt;0.001). Over half PwLADA experienced high (21%) or moderate (35%) distress according to the total distress score. Peak scores (high & moderate) were detected for emotional burden (51% & 31%); followed by interpersonal distress (19% & 27%), regimen distress (20% & 26%) and physician distress (17% &13%). Scores for all categories were comparable to those reported by PwT1D. We explored factors that could modulate distress level among PwLADA including hypoglycemia, use of technology and HbA1c. Significant differences were detected for higher regimen distress among those with severe hypoglycemia in past year (56% vs 18%, p=0.02) and those with A1c &gt;75 mmol/mol (53% vs 11%, p&lt;0.001).
Conclusion: Diabetes distress is highly prevalent among PwLADA, especially the emotional burden similar to PwT1D. Further research is warranted to design adequate interventions.

Disclosure
M. Nehme: None. M. Issa: None. A. Brazeau: Other Relationship; Dexcom, Inc. Research Support; Canadian Institutes of Health Research, Juvenile Diabetes Research Foundation (JDRF), Diabète québec, Fonds de recherche du Québec en Santé. C. Leroux: None. S. Haag: Other Relationship; Omnipod. A. Roy-Fleming: None. N. Taleb: Other Relationship; Dexcom, Inc. Consultant; Viatris Inc. Other Relationship; Novo Nordisk.

Funding
Funding form the CED-CHUM centre d'Expertise en DiabFte at the Centre de recherche de l'UniversitT de MontrTal
55-PUB: Prevalence and Patterns of Multimorbidity among Elderly Aged 65 and above in the Hainan Island
Authors: ZHU XUELI , GENG YIFAN , YI NING 
Published: June 2024

Introduction: Studying multimorbidities in the elderly is vital for improving their health outcomes and quality of life. This study aims to determine the prevalence and patterns of multimorbidity among elderly aged 65 and above living in the Hainan Island.
Methods: This is a cross-sectional study included a total of 1,025,831 participants based on a survey of chronic diseases in the elderly aged 65 and above. Nine chronic disease variables (Hypertension, Diabetes, CHD, Cerebral apoplexy, COPD, Chronic kidney disease, Tumor, Immune defect and Sever disability) were included in the study. Chi-square test and trend chi-square test were used to assess the differences in the prevalence of morbidity and multimorbidity by genders and age. Gephi was used for visualizing the network patterns of associative multimorbidities. Condensation cluster analysis was performed on the multimorbidity network matrix using UCINET.
Results: At least one chronic diseases and two chronic diseases coexisted in 71.28% and 30.54% participants. There is a greater prevalence in women than in men (53.8% vs 46.2%, P &lt; 0.001). The most common combinations of two multimorbidities were hypertension & diabetes (7.78%), hypertension & stroke (2.21%), and hypertension & server disability (2.18%). Condensation cluster analysis revealed that the combined model of multimorbidity could be divided into 3 clusters (Hypertension + Diabetes, CHD + Cerebral apoplexy + COPD + Immune defect + Tumor + Sever disability and Chronic kidney disease ).
Conclusion: Our findings suggest that an integrated strategy of prevention, treatment and management should be developed to target different disease clusters.
Keywords: Multimorbidity; Elderly; Network analysis; Condensed subgroup

Disclosure
X. Zhu: None. Y. Geng: None. N. Yi: None.

Funding
Advanced Talents of Hainan (820RC649)
591-P: Basic Knowledge about Diabetes Mellitus among Nurses in University Hospital of Split
Authors: MAJSTOROVIC HELENA , VLADISLAVIC SILVIJA , MARENDIC MARIO , MILICEVIC MILARDOVIC TANJA , KOKIC MALES VISNJA 
Published: June 2024

Objective: The research of basic knowledge about DM was carried out in order to determine the quality of care for patients with diabetes.
Respondents and Methods: The research was conducted among 194 nurses/technicians of the University Hospital of Split. A survey questionnaire (Table 1) was used as a research instrument, which consisted of general data and factors affecting DM, and examination of basic knowledge about DM. The questionnaire consisted 9 questions and lasted 20 minutes, with the presence of the examiner, without any literature or mobile phones.
Results: To the question about the most common cause of death of patients with diabetes, the respondents answered with only 47.94% correct answers. A higher level of knowledge was shown in questions related to HbA1c (87.63%) and the reference value of HbA1c (68.56%). The lowest level of knowledge was observed in terms of the knowledge about the use of insulin (23.71%) and oral hypoglycaemics (35.05%). A higher percentage (55.67%) gave the correct answer to the question about the application of insulin. A statistical analysis of only the correct answers within individual clinics was also processed.
Conclusion: There is an insufficient level of basic knowledge about the use of insulin therapy, the characteristics of oral antidiabetic drugs and patient education about proper nutrition among nurses.

Disclosure
H. Majstorovic: None. S. Vladislavic: None. M. Marendic: None. T. Milicevic Milardovic: Consultant; Abbott. Advisory Panel; AstraZeneca, Boehringer-Ingelheim. Consultant; Novo Nordisk. V. Kokic Males: None.
597-P: Wearable Device Use and Physical Activity among Individuals with Diabetes—The 2022 Health Information National Trends Survey
Authors: LEE MINJUNG , NAM SOOHYUN 
Published: June 2024

Introduction & Objective: Wearable devices have demonstrated potential in encouraging physical activity (PA) in the general population. This study is to investigate sociodemographic factors linked to the use of wearable devices and assess the influence of the wearable device use on PA among adults with diabetes.
Methods: Data were extracted from the Health Information National Trend Survey 6, covering from March to November 2022. The study included 1,020 adults with diabetes (the survey did not specify the diabetes types). PA levels were self-reported, and logistic regression was employed to examine factors associated with the use of wearable devices and the achievement of a weekly 150-minute moderate-intensity PA (MPA).
Results: About 57% were female, with a mean age of 62.9 years (SD=13.4) (Non-Hispanic White, 47.7 %; Non-Hispanic Black, 22.3%; Hispanic 21.4%). About 25% reported using wearable devices, and 27% engaged in ≥ 150 minutes of MPA per week. Hispanic respondents exhibited significantly higher wearable device use than Non-Hispanic White respondents (OR 1.73, 95% CI, 1.12-2.67). Individuals with an annual household income ≥ $75,000 (OR 4.23, 95% CI, 2.34-7.63) were 4.23 times more likely to use wearable devices; however, household income levels were not significantly associated with MPA. Females (OR 0.60, 95% CI, 0.43-0.82) and individuals with a body mass index ≥ 30kg/m2 (OR 0.54, 95% CI, 0.40-0.74) were less likely to achieve 150 minutes of MPA per week. Importantly, those utilizing wearable devices were 1.72 times more likely to report ≥ 150 minutes of MPA per week (OR 1.72, 95% CI, 1.21-2.43).
Conclusion: The use of wearable devices may have potential to enhance PA among individuals with diabetes. Future efforts promoting PA should take into account the socioeconomic factors linked to wearable adoption. Also, strategies that ensure the equitable adoption of wearable devices should be explored and discussed for individuals with diabetes.

Disclosure
M. Lee: None. S. Nam: None.

Funding
This study is supported by NIH/NIDDK (5R01DK132069).
604-P: Different Exercise Exposures May Protect against Developmental Programming of MASLD in Male Mice?
Authors: CANTIO EVAN , REGINELLI ELEANORE , HINRICHS HOLLY M. , YOUNG MONICA , THOMPSON MICHAEL 
Published: June 2024

Introduction: Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is a chronic liver disease that affects up to a fourth of the adults in the US. Maternal obesogenic diet exposure (MODE) programs worse MASLD in offspring. The beneficial effects of exercise on metabolic disease are well defined. We hypothesized that offspring exercise would mitigate the developmental programming effects of MODE.
Methods: To determine the effect of offspring exercise, male offspring from dams fed chow or High Fat Fructose and Cholesterol (HFFC) diet underwent voluntary exercise. The three exercise conditions include voluntary exercise on a wheel for 3 weeks before (pre exercise) feeding a MASLD-inducing diet, exercise from 3 weeks before and during MASLD-diet feeding (continuous exercise) and sedentary conditions. Body weight and liver weights were measured. Histologic analysis and qPCR was performed to assess disease severity.
Results: Exercise before and during HFFC feeding decreased body weight and liver weight to body weight ratio. Preliminary results show a reduction in steatosis and inflammation in offspring with continued exercise during HFFC feeding. Both pre-exercise alone and continued exercise during HFFC feeding show a trend toward attenuating the increase in fibrosis observed in MODE offspring.
Conclusion: Preliminary data support that exercise may attenuate developmentally programmed worsening of MASLD by MODE. Continual exercise appears to have a greater benefit than pre-exercise alone.

Disclosure
E. Cantio: None. E. Reginelli: None. H.M. Hinrichs: None. M. Young: None. M. Thompson: None.

Funding
National Institute of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health (1R25DK113652)
625-P: Association between Vitamin D Status and Thyroid Function in Individuals with Type 2 Diabetes Mellitus
Authors: WANG XINGCHUN , HUANG YUEYE , QU SHEN 
Published: June 2024

Background: More studies have revealed role of vitamin D(VD) in chronic diseases. Our study aimed to investigate its association with thyroid function in Type 2 Diabetes Mellitus(T2DM).
Methods: 730 patients with T2DM were enrolled. Thyroid and VD levels were measured. Patients were divided into lower VD and higher VD groups according to the median. Thyroid function was compared between groups and their association was investigated.
Results: BMI, TCH, TG and FFA were significantly higher in higher VD group than lower VD group (all P&lt;0.05). FT3 was significantly higher while TT4 and TSH were significantly higher in higher VD group than lower VD group (4.45±0.93 vs. 4.95±1.52 pmol/l, P&lt;0.001; 104.84±21.17 vs. 99.99±23.64 nmol/l, P=0.008; 2.88±7.03 vs. 2.06±1.72 mU/l, P=0.046). VD was significantly negatively associated with BMI, HGB, LDL-C and FFA (r=-0.093, P=0.016; r=-0.082, P=0.036; r= -0.099, P=0.011; r= -0.125; P=0.001). VD were significantly positively FT3 and FT4 and negatively associated with TSH (r=0.248, P&lt;0.001; r=0.086, P=0.025; r=-0.080, P=0.033). Adjusted for height, BMI, HGB, TCH, TG, FFA and LDL, FT3 and FT4 were still significantly positive while TSH was still significantly negatively associated with VD (r=0.227, P&lt;0.001; r=0.089, P=0.030; r=-0.081, P=0.049). Liner Regression analysis also showed that VD was significantly associated with FT3 and negatively with TSH (β=4.144, P&lt;0.001; β= -0.412, P=0.020). Logistic regression analysis showed that VD was a protective factor for SCH (OR: 0.987, 95%CI:0.974-0.999, P=0.035) and even adjusted for BMI, FBG, FINS, TCH and HDL (OR: 0.986, 95%CI:0.974-0.999, P=0.041). T2DM patients with SCH had lower VD levels than those without SCH(46.45±4.76 vs. 45.40±5.84nmol/l, P=0.029).
In conclusion, there was a negative relationship between VD and thyroid function in patients with T2DM. T2DM patients with SCH had lower VD levels.

Disclosure
X. Wang: None. Y. Huang: None. S. Qu: None.