bluuebunny/crossref_metadata_2025_split huggingface dataset:
617-P: Impact of Culturally Sensitive, Mobile Health Based Nutrition Platform in Metabolic Health of African Americans in Southeast Virginia
Authors: CASELLINI CAROLINA M. , PARSON HENRI , PETTAWAY JORDAN L. , AUSTIN-STEPHENS ANN-MARIE B. , STEPHENS ED , BARTHOLMAE MARILYN M. , INGRAM AMBER M. , SEARS TANEISHA , HAQUE FERAS , EKDAHL LUKE , AYESHA FNU , SIRAJ ELIAS S. 
Published: June 2024

Mobile health (mHealth) lifestyle interventions for obesity have gained popularity. However, acceptance and efficacy of these in minority populations is less known. The aim of this study was to assess efficacy of a 12-week culturally sensitive mHealth dietary intervention on weight in African Americans (AA) Randomized 12-week pilot study of 43 overweight or obese AA. Subjects were randomized to mHealth intervention (INT) or Standard of Care (SOC). INT included virtual session with dietitian, customized meal plans based on personal preferences, and educational videos. SOC included CDC-guidelines on weight loss. Mixed Methods Repeated Measures analysis was used Baseline characteristics were similar between the groups (age 60 years, weight 204 lbs, 84% females, 67% hypertension, 56% dyslipidemia and 25% diabetes). Mean weight loss was 4.4 lbs for INT & 3.2 lbs for SOC. Weight significantly improved in both groups over time (p=0.0002) but there was no significant difference between the groups. 74% of INT and 68% of SOC lost weight (Figure 1) This study shows potential benefit of tailoring mHealth interventions in a minority population. Results should be interpreted within the context of small sample size and short duration. Qualitative feedback from participants led to improvements in INT and a larger and longer 48-weeks study is underway to better assess the efficacy of INT

Disclosure
C.M. Casellini: None. H. Parson: None. J.L. Pettaway: None. A.B. Austin-Stephens: None. E. Stephens: None. M.M. Bartholmae: None. A.M. Ingram: None. T. Sears: None. F. Haque: None. L. Ekdahl: None. F. Ayesha: None. E.S. Siraj: Consultant; Novo Nordisk. Research Support; Novo Nordisk. Consultant; Boehringer-Ingelheim, Eli Lilly and Company.

Funding
Hampton Roads Biomedical Research Consortium (HRBRC)
624-P: Cardiometabolic Improvements Increase with Weight Loss among People with Type 2 Diabetes in a Carbohydrate-Restricted Nutrition Therapy
Authors: ADAMS REBECCA N. , ATHINARAYANAN SHAMINIE J. , ROBERTS CAROLINE G.P. , VOLK BRITTANIE M. , ZOLLER ALISON R. , MCKENZIE AMY L. 
Published: June 2024

Background: Recent therapeutic advancements yield cardiovascular benefit with weight loss (WL) significantly greater than the 5% target, but carbohydrate restriction has been associated with improved cardiometabolic markers independent of WL. We explored differences in cardiometabolic outcomes by percent WL in the context of carbohydrate-restricted nutrition therapy (CRNT) delivered via a continuous remote care model at Virta Health.
Method: Percent WL at 1 year was computed among patients with T2D, and they were categorized into 5 WL groups: &lt;5%, 5-9%, 10-14%, 15-19%, & 20+%. We randomly selected 250 patients within each WL group and conducted 8 linear mixed effects models (intent-to-treat analyses) to assess cardiometabolic changes within and between groups (N=1250; 49% female; enrollment mean age=55, BMI=36, HbA1c=7.6%).
Results: All markers improved across WL groups except total cholesterol (TC) and LDL-C. The change in all markers except TC differed by WL group, such that HbA1c, HDL-C, TG, and liver markers improved more with greater WL and LDL-C increased within normal range in the 2 highest WL groups only. TC was unchanged.
Conclusion: Overall, cardiometabolic benefits increased with WL in T2D, but even patients with &lt;5% WL had some clinically significant improvements (e.g., HbA1c -0.7%) in the context of CRNT.

Disclosure
R.N. Adams: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. S.J. Athinarayanan: Employee; Virta Health Corp. C.G.P. Roberts: Other Relationship; Virta Health Corp. B.M. Volk: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. A.R. Zoller: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. A.L. McKenzie: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. Employee; Abbott.
629-P: Serum Creatinine–to–Cystatin C Ratio Is Related to Handgrip Strength as Well as Muscle and Fat Mass in People with Type 2 Diabetes Independently of Glycemic Control and Daily Protein Intake
Authors: MORIYA TATSUMI , SUZUKI AKIHIKO , HITOMI MAMIKO , MATSUBARA MADOKA , MIYATSUKA TAKESHI 
Published: June 2024

Sarcopenia is one of the serious diabetic complications and it is related to poorer glycemic control and other diabetic chronic complications. Therefore, it is necessary to diagnose sarcopenia as early as possible in people living with diabetes. Serum creatinine to cystatin C ratio (Scr/Scys) and difference between eGFRcr and eGFRcys (diff. eGFR) were proposed as markers for sarcopenia in person with diabetes. We aimed to examine whether or not Scr/Scys or diff. eGFR predicted muscle and body fat mass in 50 persons with type 2 diabetes (32 male, 63±11 years old, BMI 26.5±5.0 kg/m2, HbA1c 7.7±1.4 %, eGFRcr 57±21 ml/min/1.73 m2, eGFRcys 61±26 ml/min/1.73 m2). 1) HbA1c was correlated with muscle mass (R=0.31, p=0.033), but not handgrip strength.2) Muscle mass was correlated with handgrip strength (r=0.58, p&lt;0.001), but not with body fat mass.3) Both eGFRcr and eGFRcys themselves were not related to muscle and body fat mass, and handgrip strength.4) Scr/Scys was associated with handgrip strength (r=0.62, p&lt;0.001) and muscle and fat mass (r=0.43, p=0.002; r=-0.38, p=0.007, respectively).5) The diff.eGFR was associated with handgrip strength (r=-0.39, p=0.007), but not with muscle and fat mass.6) Daily protein intake evaluated in 24 hr urine collection was related to muscle mass (r=0.47, p=0.019), whereas protein intake at breakfast was not.7) Multivariate analysis showed that Scr/Scys related to muscle mass (p=0.012) independently of both HbA1c (p=0.954) and daily protein intake (p=0.129).
Conclusions: The Scr/Scys could be a reliable marker to reflect handgrip strength as well as muscle and body fat mass. The muscle mass might be maintained in person with enough daily protein intake. These results suggested beneficial findings to diagnose sarcopenia as early as possible in people with type 2 diabetes.

Disclosure
T. Moriya: None. A. Suzuki: None. M. Hitomi: None. M. Matsubara: None. T. Miyatsuka: None.
641-P: Body Image and Insulin Restriction among Adolescents with Type 1 Diabetes
Authors: SANNEGOWDA RACHNA , CAMPBELL MARYJANE , GURNURKAR SHILPA , PIERCE JESSICA S. , WASSERMAN RACHEL M. 
Published: June 2024

Introduction: Adolescents with type 1 diabetes (T1D) are at increased risk for disordered eating compared to peers without T1D. We examined whether a single item assessing preference for thinness vs. glycemic control was associated with T1D health outcomes (HbA1c and DKA) among adolescents with T1D.
Methods: 224 adolescents (M age=16.9±1.1, 49% female, M HbA1c=8.5%±1.3) were recruited through the T1D Exchange to complete an online survey, including one item from the Diabetes Eating Problems Survey-R, “I would rather be thin than have good control of my diabetes”, which included a 6-point Likert scale (never to always), and one item from the Diabetes-Specific Risk-Taking Inventory, “Taken less insulin than you knew you needed”, which included a 6-point Likert scale (never to daily). Adolescents also reported whether they experienced DKA in the past year. We obtained HbA1c values from the T1D Exchange Registry database.
Results: Greater priority for thinness was correlated with higher HbA1c (r=0.17, p=0.01). Adolescents who experienced DKA in the past year also reported higher priority for thinness over glycemic levels (M=1.80, SD=1.86) than those who had not experienced DKA (M=0.88, SD=1.35; t(164)=2.43, p &lt; 0.05). Adolescents who reported experiencing DKA in the last year did not differ in how frequently they restricted insulin (M=2.33, SD=1.59) compared to adolescents who had not experienced DKA (M=2.37, SD=1.51; t(163)=0.12, p &gt; .05).
Conclusions: Prioritizing thinness over glycemic health may increase risk for higher HbA1c and DKA; and may be more closely associated with DKA events than restricting insulin. This finding aligns with existing evidence that body image concerns are predictive of diabetes outcomes, and recommendations in ADA guidelines to screen for body image concerns. This single item (prioritizing thinness) may be a useful question for such screening. Future research should examine how body image concerns are linked with disordered eating behaviors and T1D outcomes.

Disclosure
R. Sannegowda: None. M. Campbell: None. S. Gurnurkar: None. J.S. Pierce: None. R.M. Wasserman: None.

Funding
Helmsley Charitable Trust, Type 1 Diabetes Exchange Pilot Award
642-P: Reasons behind Fasting Ramadan against Medical Advice for Individuals under 18 Years with Uncontrolled Type 1 Diabetes—A Tertiary Center Experience
Authors: RAHME ZAHRA , MESBAH NAGLAA , TAHA NEHAD , ALROUDHAN DHERAR 
Published: June 2024

Introduction: Although sick and pre-pubertal children are exempted from fasting, many patients with T1D choose to fast.
Objectives: To explore feelings & perceptions towards Fasting Ramadan of children &adolescents with uncontrolled type 1 diabetes (T1D) who insisted on fasting Ramadan against medical advice.
Methods: Before Ramadan, children and adolescents under 18 years with uncontrolled T1D received advice by their healthcare providers to not fast Ramadan to avoid the severity of acute complications. Shortly after the end of the month of Ramadan, the patients who fast against medical advice were invited to attend a focus group to discuss emotions towards fasting Ramadan. Data from the focus group was analyzed using thematic analysis.
Results: Forty-four patients with T1D duration 5.25 ± 4.32 y (age 12.7 ± 3.78 y); HbA1c 7.96% ± 1.34% (before Ramadan) participated in prior Ramadan education. 34% fasted against medical advice; 70.2% intend to fast again in the following years. The 4 main themes emerged from the focus group: 1- Proud to meet a religious obligation of Islam, 2-feeling happy sharing their fasting experience with the community and avoiding social stigma, 3-feeling "normal" as all their peers, 4- readiness to follow strict instructions to control diabetes to be able to fast again.
Conclusion: Although of the current Fasting Ramadan guidelines clearly highlight the risk of fasting Ramadan for T1D, especially in uncontrolled patients, still, many T1D individuals insist on fasting due to social stigma and misconceptions of religious rules, regardless of the risk they may face. Therefore, we need to develop a new protocol and guidelines to closely follow up with those individuals during fasting days. Adding to that the importance of Muslim Clerics' role in clarifying the opinion of religion in fasting Ramadan for people with chronic diseases to help them in improving acceptance and adherence to medical advice regarding fasting.

Disclosure
Z. Rahme: None. N. Mesbah: None. N. Taha: None. D. Alroudhan: None.
652-P: Impact of a Six-Month Digital Health Coaching Program on Individuals with Type 2 Diabetes Mellitus Experiencing Food Insecurity in Rural Areas
Authors: MOORE JASMINE , RUTLAND SARAH , MURPHY JANE , TARASOVICH MERCEDES 
Published: June 2024

Individuals with type 2 diabetes mellitus (T2DM) experiencing food insecurity often have worse health outcomes than those not experiencing food insecurity. These poor outcomes are often exacerbated among individuals who live in rural areas. Current studies have evaluated the impact of digital health coaching (DHC) and food delivery programs as separate interventions. This study was conducted to assess the impact of a combined health coaching and food delivery intervention on individuals with T2DM who live in rural areas. In this retrospective analysis, individuals were referred by a national insurance payor and screened for food insecurity by a social worker, provider, or payor record. Participants were considered to live in a rural area if they lived outside of a US Census Bureau Urbanized Area (an urban area of 50,000 or more people). Patient reported outcome measures were collected at baseline and 6 months after starting the program. Paired t-tests were used to determine significant differences. At 6 months, 1093 participants were enrolled in the DHC and food delivery program. Of those enrolled, 31% lived in a rural area. Rural participants had significant improvements in HbA1c (7.49 to 6.93, P&lt;0.0295), diabetes distress (2.71 to 2.01, P&lt;0.0001), and food insecurity (2.46 to 1.20, P&lt;0.0024). There were also significant improvements in the PROMIS mental health score (43.04 to 46.30, P=0.0024) and PROMIS physical health score (40.07 to 43.61, P=0.0007). While previous studies have focused on the impact of health coaching or food delivery, few assessed the impact of a combined intervention, and most studies had a small percentage of rural participants. Participants who completed the 6-month intervention had significant improvements among food insecurity and diabetes related quality of life metrics. A combined intervention may lead to improved mental and physical health outcomes among rural populations with T2DM and food insecurity.

Disclosure
J. Moore: None. S. Rutland: Employee; Quest Diagnostics. J. Murphy: Employee; Quest Diagnostics. M. Tarasovich: Employee; Quest Diagnostics.
658-P: Diabetes Distress and Hearing Impairment—Differential Racial/Ethnic Associations in Adults with Diabetes
Authors: JACOBS MOLLY M. , ELLIS CHARLES , EVANS ELIZABETH 
Published: June 2024

Introduction: Substantial literature has documented the association between diabetes and hearing impairment, however, the relationship between diabetes distress and hearing impairment is poorly understood.
Methods: The 2021 National Health Interview Survey (NHIS) included diabetes distress, hearing impairment, and demographic/household characteristics. Multilevel, binary dependent variable regressions evaluated these association between diabetes distress and hearing impairment controlling for age, income, residence, marital status, rurality, educational attainment, insurance, and household composition. Interaction terms tested for sex, race, income, and residential differences in these associations. Finally, the association between hearing aid use and distress was tested.
Results: Over 25% of adults with diabetes in the sample reported hearing difficulty and 30% reported diabetes distress. Results indicated that diabetes distress was significantly more likely among female (OR=1.44, CI=1.20, 1.74), low income earning (OR=1.97, CI=1.47, 2.55), Black (OR=1.46, CI=1.12, 1.93) and Hispanic (OR=1.47, CI=1.07, 2.04) individuals with diabetes compared to their counterparts. Diabetic individuals with hearing impairment (OR=1.48, CI=1.18, 1.85) were comparatively more likely to report distress particularly among females (OR=1.31, CI=1.68) and Hispanic (OR=1.63, CI=1.08, 3.15) respondents. However, when diabetics with hearing impairment used a hearing aid, they were nearly 20% less likely (OR=0.83, CI=0.57, 0.99) to report diabetes related distress than those without assistive devices.
Conclusion: Diabetes distress was significantly more likely among individuals with hearing impairment, particularly hearing-impaired female, and Hispanic respondents. Hearing aid usage decreased the likelihood of distress suggesting that potential communication difficulties could potentially explain the observed differences in distress.

Disclosure
M.M. Jacobs: None. C. Ellis: None. E. Evans: None.
67-PUB: Ambulatory Blood Pressure Monitoring among Type 2 Diabetes Mellitus Patients in India—A Prospective Observational Study
Authors: PATNI BIJAY , SAXENA ASHISH K. , KUMAR SINGH NAGENDRA , SINGH AKASHKUMAR N. , VERMA NARSINGH , MAHESHWARI ANUJ 
Published: June 2024

T2DM increases the risk of HTN, with 35-75% of diabetes-related complications linked to HTN. Traditional HTN measurement methods, including single-office BP measurements, may be fallacious and miss out on masked HTN and desynchrony in nocturnal BP. This multicentric, cross-sectional study aimed to assess different BP parameters in Indian patients with T2DM. A total of 229 T2DM patients (mean age [range]: 56.8 [17-88] years and 139 were men) with normal clinical BP (&lt;140/90 mmHg) who visited the investigating doctors for routine clinical management of T2DM over 6 months were included and further referred for ABPM. The 24-hour (h) ABPM device was connected to the patient at the clinic during a routine visit and was collected the following day. The ABPM report was sent to the treating doctor, and the collected data was analyzed using an Excel spreadsheet. HTN defined by either elevated 24-h mean or daytime or nighttime BP was detected in 138 (60.27%) patients who were normotensives during the office visit. The majority of these were either female patients (n=45), and/or who were aged &gt;60 years. Among 229 patients, the observed nocturnal BP patterns exhibited as follows: normal dippers (10-20%) were seen in 66 patients (28.8%), excess dippers (&gt;20%) in 4 patients (1.74%), non-dippers (&lt;10%) in 112 patients (48.9%), static BP (no BP fluctuations) in 4 patients (1.74%), and BP risers at night in 43 patients (18.77%). Only 66 patients (28.8%) had normal dipping circadian BP patterns. HCPs often label patients as normotensive based on a single clinic-based reading, but this can be misleading. A significant number of T2DM patients labeled normotensives may be hypertensives or have nocturnal BP desynchrony, negatively impacting their prognosis. Physicians should therefore check the BP of their T2DM patients in each visit and on suspicion of HTN mediated organ damage; subject the patient to 24-h ABPM study to detect such cases which are missed out by taking office BP.

Disclosure
B. Patni: None. A.K. Saxena: None. N. Singh: None. A.N. Singh: None. N. Verma: None. A. Maheshwari: None.
70-OR: PROTECT Per-Protocol Analysis—Preserving ß-Cell Function in Children and Adolescents with Newly Diagnosed Stage 3 Type 1 Diabetes (T1D)
Authors: HEROLD KEVAN C. , DAYAN COLIN , CHATENOUD LUCIENNE , GITELMAN STEPHEN E. , SUMNIK ZDENEK , SIMMONS KIMBER M. , SZYPOWSKA AGNIESZKA , KNECHT LAURA , NIEMOELLER ELISABETH , TIAN WEI , RAMOS ELEANOR L. 
Published: June 2024

Background & Aims: Teplizumab is an anti-CD3 mAb approved for delaying onset of Stage 3 T1D in people ≥8 years old with Stage 2 T1D. In the PROTECT study intent-to-treat (ITT) population, teplizumab demonstrated significantly greater β‑cell function preservation vs placebo (PBO; least-squares mean difference of C-peptide ln(AUC+1) change from baseline to Week 78 between teplizumab and PBO was 0.13 pmol/mL; p&lt;0.001). In the ITT population, insulin dose was lower with teplizumab vs PBO from Week 12. Here we explore reduction in insulin dose and sustained glycemic control in the per-protocol (PP) population.
Methods: The Phase 3 PROTECT study (NCT03875729) of 8-17-year-olds with Stage 3 T1D, diagnosed ≤6 weeks, randomized participants 2:1 to two 12-day courses of teplizumab or PBO. The PP population excluded those who received incorrect treatment, took prohibited medications, became pregnant, or had &lt;80% treatment compliance.
Results: In the PP analysis, teplizumab showed consistent results in reduced insulin dose, and greater % time in range (TIR) vs the PBO group (Table); HbA1c levels were not significantly different between groups.
Conclusions: Participants treated with teplizumab showed greater β-cell function preservation and clinically relevant metabolic outcomes including lower insulin doses and greater TIR vs PBO.

Disclosure
K.C. Herold: Consultant; Sanofi. C. Dayan: Consultant; Provention Bio, Inc., Sanofi. Other Relationship; Dompé. Advisory Panel; Avotres Inc., Amgen Inc. L. Chatenoud: Consultant; Provention Bio, Inc., Sanofi. S.E. Gitelman: Advisory Panel; Abata Therapeutics, Avotres Inc., Genentech, Inc., GentiBio, SAB Biotherapeutics, Inc., Sanofi. Z. Sumnik: None. K.M. Simmons: Advisory Panel; Provention Bio, Inc. Consultant; Provention Bio, Inc. Research Support; Provention Bio, Inc., Novartis AG. Consultant; Medtronic. A. Szypowska: Speaker's Bureau; Abbott. Advisory Panel; Dexcom, Inc., Medtronic. Speaker's Bureau; Sanofi, Novo Nordisk. Advisory Panel; SYNOPIS Pharma, Proglikemia. Research Support; Provention Bio, Inc. L. Knecht: Employee; Sanofi, Provention Bio, Inc. E. Niemoeller: Employee; Sanofi-Aventis Deutschland GmbH. Stock/Shareholder; Sanofi. W. Tian: Employee; Sanofi. E.L. Ramos: None.

Funding
Provention Bio, a Sanofi company
706-P: Incidence of Those Who Delay in Seeking Treatment in Treatment-Naive Type 2 Diabetes Mellitus Patients—A Clinic-Based Cross-Sectional Descriptive Study in India
Authors: PATIL SHUBHASHREE M. , SABOO BHARAT , PATIL AASHNA , AHMED JAMIL AHMED ANSARI AYAZ , GANGURDE APARNA C. , SANGHAVI PRITI , SINGH MRINALINI , BAGRI SEEMA A. , DBRITTO SYBAL N. , SURYA SHAIKH RUKIYA M. , SHAH TANUJA N. , KOLHE CHARUSHEELA N. , BAMBHANIA HARDIK T. , GAJARE ROHINI S. , JASHNANI SEEMA M. , SHAH KINNARY R. , SHAH PRANJALI K. , KHOT SANJYOTI S. 
Published: June 2024

Objective: This clinic-based cross-sectional descriptive study aimed to assess the incidence of delayed treatment-seeking behavior among treatment-naive patients with Type 2 Diabetes Mellitus (T2DM) in India.
Methods: This multi-centric, prospective cross sectional real world study was conducted across 20 sites in Mumbai, a metro in western India. Drug naive T2DM Patients who come to study sites for routine consultation were enrolled into the study post taking a study participation consent. Data from 7th September ‘23 to 31st December ‘23 analyzed.
Results: In this study involving 269 enrolled patients (average age 46.3 years, 58% male), the mean HbA1c was 9.5%. Notably, 30% reported delaying treatment by over 3 months after diagnosis. The distribution of the time of diagnosis was as follows: within a month - 41%, 1-2 months - 29%, 3-6 months - 12%, and &gt;6 months - 19%. The mean delay period was 2.2 months. Among patients who delayed treatment, 57% have tried alternative treatments and 43% had relied on lifestyle/diet changes only. Among the alternative treatments tried, 70% had tried Ayurveda, 18% had used homemade remedies, and 12% had tried Homeopathy.
Conclusion: The study highlights a substantial delay in seeking treatment among newly diagnosed T2DM patients in a Metro in India where access to specialists is good. These delays lead to poorer initial glycemic control. This study emphasizes the importance of enhanced population education to start early intervention in the management of T2DM to prevent complications and improve long-term outcomes.

Disclosure
S.M. Patil: None. B. Saboo: None. A. Patil: None. A. Ansari: None. A.C. Gangurde: None. P. Sanghavi: None. M. Singh: None. S.A. Bagri: None. S.N. Dbritto: None. R.M. Surya Shaikh: None. T.N. Shah: None. C.N. Kolhe: None. H.T. Bambhania: None. R.S. Gajare: None. S.M. Jashnani: None. K.R. Shah: None. P.K. Shah: None. S.S. Khot: None.