bluuebunny/crossref_metadata_2025_split huggingface dataset:
677-P: Diabetes Distress, Strengths, and Glycemic Outcomes in Young Adults (YA) with Type 1 Diabetes (T1D) Transferring to Adult Care
Authors: CAMEY STEPHANIE , CARREON SAMANTHA A. , MINARD CHARLES G. , LYONS SARAH , STREISAND RANDI , TANG TRICIA S. , MCKAY SIRIPOOM , ANDERSON-THOMAS BARBARA J. , DEVARAJ SRIDEVI , HILLIARD MARISA E. 
Published: June 2024

Introduction & Objective: Transfer from pediatric to adult care is challenging and YA with T1D are at risk for suboptimal outcomes. Protective factors are less studied during this vulnerable period. We aimed to explore associations between psychosocial factors and HbA1c as YA with T1D left pediatric care.
Methods: At baseline of an RCT, n=100 YA (Mean age=19.9±1.3 yrs, HbA1c=8.8±2.0%, 56% pump, 76% CGM) self-reported demographic/clinical variables and completed measures of diabetes strengths and diabetes distress. HbA1c was from electronic health records or dried blood spot. Multiple regressions evaluated associations between diabetes strengths, diabetes distress, and HbA1c, controlling for covariates.
Results: Domains of diabetes distress (management r=0.51; powerlessness r=0.19) and strengths (diabetes-related confidence r= -0.25) significantly correlated with HbA1c. The full regression model (Table) explained 39% of variance in HbA1c; public insurance, non-Hispanic ethnicity, no pump use, and higher diabetes distress significantly predicted higher HbA1c.
Conclusion: When leaving pediatrics, diabetes distress appears particularly relevant to glycemic outcomes, outweighing diabetes strengths. Addressing diabetes distress and supporting device use in culturally-informed ways may help improve glycemic outcomes as YA with T1D transfer to adult care.

Disclosure
S. Camey: None. S.A. Carreon: None. C.G. Minard: None. S. Lyons: None. R. Streisand: None. T.S. Tang: None. S. Mckay: None. B.J. Anderson-Thomas: None. S. Devaraj: None. M.E. Hilliard: None.

Funding
National Institutes of Diabetes and Digestive and Kidney Disease (1R01DK119246); National Institute of Diabetes and Digestive and Kidney Disease (K26 DK138332)
679-P: "COVID Is Not My Concern; Diabetes Is"—Understanding COVID-19 Vaccine Hesitancy among Underserved Adults with Diabetes Using the 3 Cs Model
Authors: MAIZEL JENNIFER , BAUTISTA TAIS A. , PRUDE ISA N. , FILIPP STEPHANIE L. , HECHAVARRIA MELANIE , HALLER MICHAEL J. , WESTEN SARAH , DIXON BRITTNEY , MAAHS DAVID M. , LAL RAYHAN , ADDALA ANANTA , WALKER ASHBY F. 
Published: June 2024

Introduction & Objective: People with diabetes have increased risks for severe COVID-19 illness and are a priority group for vaccination. This study aimed to determine reasons for COVID-19 vaccine hesitancy among underserved adults with diabetes.
Methods: A survey of adults with insulin-requiring diabetes (n=450) receiving care at federally qualified health centers in CA and FL examined COVID-19 vaccine uptake and reasons for hesitancy. Surveys were completed from Nov. 2021-Jul. 2022. This study analyzed open-ended responses to a question assessing why patients were not vaccinated for COVID-19. Out of 80 patients who reported being unvaccinated, 67 answered the open-ended question (mean age=46.6 ± 15.1 years, 65.7% female). A thematic analysis using the 3 Cs of Vaccine Hesitancy Model (complacency, confidence, and convenience reasons) was used. Reasons for hesitancy that did not fit the 3 Cs were coded as demographic or unspecific. Descriptive statistics (n, %) determined the frequency of reasons reported; some patients noted multiple reasons.
Results: Patients reported 80 reasons for vaccine hesitancy. Most were lack of confidence (n=31, 38.8%), e.g., misinformation, distrust in research, and fears about vaccine efficacy and safety, or were unspecific (n=29, 36.3%), e.g., “I don’t want it”. Convenience reasons (n=11, 13.8%) included scheduling, eligibility, and health issues, e.g., vaccine allergies or surgeries. Complacency reasons (n=7, 8.8%) included low concern about COVID-19 compared to diabetes and low COVID-19 exposure due to limited social outings. Demographic reasons (n=2, 2.5%) were due to religious views.
Conclusion: COVID-19 vaccine hesitancy among underserved adults with diabetes can be attributed to various factors e.g., distrust in research, inconvenience, higher concern about diabetes management, and religious views. Multilevel interventions are needed to reduce vaccine hesitancy among this population.

Disclosure
J. Maizel: None. T.A. Bautista: None. I.N. Prude: None. S.L. Filipp: None. M. Hechavarria: None. M.J. Haller: Consultant; Sanofi. Advisory Panel; SAB Biotherapeutics, Inc. Consultant; MannKind Corporation. S. Westen: None. B. Dixon: None. D.M. Maahs: Advisory Panel; Medtronic. Consultant; Abbott, LifeScan Diabetes Institute, Sanofi, Provention Bio, Inc., Bayer Inc., Kriya Therapeutics, BioSpex. R. Lal: Consultant; Abbott, Adaptyx Biosciences, Biolinq, Capillary Biomedical, Inc., Deep Valley Labs, Gluroo, PhysioLogic Devices, Portal Insulin, Tidepool. Advisory Panel; Lilly Diabetes. A. Addala: None. A.F. Walker: None.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust (G-2005-03934)
682-P: The Diabetes Management Questionnaire (DMQ) Is a Valid Measure of Self-Management in Emerging Adults (EAs) with Type 1 Diabetes (T1D)
Authors: VITALE REBECCA J. , TINSLEY LIANE J. , VOLKENING LISA K. , GARVEY KATHARINE , LAFFEL LORI M. 
Published: June 2024

Aim: EAs with T1D may benefit from innovative diabetes treatments, given their challenges in meeting glycemic targets. Thus, a measure of self-management responsive to newer regimens is important for this population. In this study, performance of the DMQ, initially validated in 8-18 year olds, was evaluated in EAs.
Methods: EAs (ages 18-25) with T1D completed an online study, providing demographic and diabetes management data along with survey responses. Surveys included DMQ, RISQ (measure of self-care readiness), and PAID-EA (measure of diabetes distress in EAs). The 20-item DMQ assesses self-care over the past month with response options on a 5-point Likert scale. Total scores range from 0-100; higher scores indicate greater self-management. We assessed internal consistency (Cronbach’s alpha, item-to-total correlations) and concurrent validity of the DMQ.
Results: The sample of 141 EAs (30% male, 61% female, 9% trans/non-binary) had mean age 21.5 ± 2.2 years and T1D duration 12.2 ± 5.4 years; 84% were non-Hispanic white and 57% were students. Self-reported A1c was 7.3 ± 0.9%; 93% used CGM, 79% used a pump, and 68% used AID. DMQ Cronbach’s α was 0.86. Item-to-total correlations were all &gt;0.2 aside from 1 item regarding ketone monitoring. DMQ scores were inversely correlated with A1c (r=-.26, p&lt;.01), and diabetes distress (PAID-EA, r=-.26, p&lt;.01), and positively correlated with CGM TIR (r=.22, p=.02) and self-care readiness (RISQ, r=.36, p&lt;.01). DMQ did not correlate with age (p=.27) or T1D duration (p=.19). DMQ-EA scores did not differ by pump use (p=.99) or gender (p=.05), but scores were higher among CGM users than non-users (74 vs. 60, p&lt;.01).
Conclusion: The DMQ, completed in &lt;5 minutes, demonstrated strong psychometric properties as a measure of self-care in EAs with T1D. An up-to-date adherence survey that performs well in emerging adults using advanced diabetes technologies offers measurement opportunities in research and clinical settings.

Disclosure
R.J. Vitale: None. L.J. Tinsley: None. L.K. Volkening: None. K. Garvey: Advisory Panel; Sanofi. L.M. Laffel: Consultant; Dexcom, Inc. Advisory Panel; Medscape, Medtronic, Vertex Pharmaceuticals Incorporated. Consultant; Novo Nordisk. Advisory Panel; Lilly Diabetes, Provention Bio, Inc., Sanofi-Aventis U.S., Janssen Pharmaceuticals, Inc., MannKind Corporation.

Funding
Endocrine Fellows Foundation; NIH (T32DK007529NIH P30DK036836); Iacocca Foundation Senior Postdoctoral Fellowship
69-OR: Preclinical Studies Indicate That Insparin Is a New Class of Antidiabetes Agent
Authors: DHURANDHAR NIKHIL , HEGDE VIJAY 
Published: June 2024

Introduction and Objectives: We observed that human adenovirus-36 (Ad36) infection improves glycemic control in mice via the product of its E4orf1 gene (termed Insparin). Our objective was to determine Insparin’s potential as an anti-diabetic agent for humans. We conducted a series of studies over the years as described below.
Methods: 1) We used various cell lines to identify the molecular pathway underlying the glycemic effect of Insparin. 2) As a proof of concept, transgenic or vector-mediated delivery of Insparin was used in various animal models of hyperglycemia to test efficacy of glycemic improvement and safety. 3) The FDA has approved drugs that are delivered via nanoparticles. For practical therapeutic use of Insparin in humans, efficacy of nanoparticle-based delivery of Insparin was tested in animal models.
Results: 1) Insparin upregulates glucose uptake in fat cells and skeletal muscle cells, in insulin independent manner, and reduces glucose release by hepatocytes. In a cell, via its PDF protein binding motif, Insparin binds with Drosophila Disk Large Protein (DLG1), activates Ras and in turn upregulates Phosphatidyl inositol kinase (PI3K). Upregulation of PI3K pathway leads to activation of downstream molecular partners, resulting in membrane translocation of Glucose transporter 4 and uptake of glucose. 2) High fat fed mice inducibly expressing Insparin in adipose tissue, or receiving viral vector-mediated Insparin, show lower endogenous insulin secretion and yet, faster clearance of glucose load from the blood, and reduced fat accumulation and inflammation in the liver. No overt signs of adverse effects are noted. 3) Nanoparticle mediated delivery of Insparin improves glucose clearance and reduces HbA1c levels in high fat fed mice.
Conclusion: Preclinical studies show that Insparin is a new class of agent that acts through DLG1 to improve diabetes or fatty liver and spares endogenous insulin. Clinical studies are needed to test safety and then efficacy of Insparin.

Disclosure
N. Dhurandhar: Advisory Panel; Medifast, Inc. Research Support; Insparin Inc, Borealis Foods, National Cattleman's Beef Association, Novo Nordisk. V. Hegde: Research Support; Insparin Therapeutics.

Funding
Insparin Therapeutics
732-P: Relationships among Food Addiction and Glycemic Control in Patients with Type 2 Diabetes Mellitus and Healthy Controls
Authors: SMELTZER JOLENE T. , KUMAR RAJESH , FONG TIM W. , WOO MARY A. , CHOI SARAH E. 
Published: June 2024

Introduction/Objective: Unhealthy food behaviors (such as food addiction [FA]) are associated with poor glycemic control and health outcomes in type 2 diabetes (T2DM). However, little is known about the associations of FA with glycemic status in T2DM. This study examined the relationships between FA and glycemic outcome (A1c) in persons with T2DM compared to healthy controls.
Methods: Sixty-four participants (32 T2DM, 32 healthy controls) between the ages 40-65 years completed the Yale Food Addiction Scale 2.0 (YFAS) and A1c was measured by finger stick blood test. Spearman’s rho correlation analyses of YFAS (FA diagnoses, total score, and symptomatology) and A1c variables were conducted.
Results: No group differences were found in the prevalence of FA diagnosis, YFAS 2.0 total scores between the groups. There were positive correlations/higher A1c (poorer glycemic control) between two FA symptomatologies (higher food tolerance; food use in physically hazardous situations) (r= 0.254, r= 0.417, P &lt;0.05).
Conclusion: In this study, persons with food tolerance and/or consumed foods during hazardous situations had poorer glycemic outcomes. Screening people with T2DM with a subset of questions from YFAS 2.0 that are linked to A1c could identify FA behaviors that may impact glycemic management and help to identify potential interventions which could optimize T2DM care and diet self-management and eventually improve outcomes in individuals with T2DM.

Disclosure
J.T. Smeltzer: None. R. Kumar: None. T.W. Fong: None. M.A. Woo: None. S.E. Choi: None.

Funding
National Institutes of Health (1R01 NR017190-01)
742-P: A Phase 3 Evaluation of cAMP Signaling Biased GLP-1 Analog Ecnoglutide (XW003) in Adults with Type 2 Diabetes
Authors: ZHU DALONG , WANG WEIMIN , TONG GUOYU , MA JIANHUA , WEN BINHONG , ZHENG XIN , SHI BIMIN , PANG SHUGUANG , BING SHAOHUI , ZHENG QING , LEI GUAN , JIANG FEIFEI , LIU XINGQUAN , BU YUE , NING JING , ZHU ZHIYI , YANG LIU , YANG MING , FENAUX MARTIJN , JUNAIDI MOHAMMED K. , XU SUSAN 
Published: June 2024

Introduction & Objective: Ecnoglutide (XW003) is a cAMP signaling biased GLP-1 analog being developed for the treatment of type 2 diabetes mellitus (T2DM) and obesity. The primary objective of this study was to evaluate the efficacy of ecnoglutide administered for 24 weeks in adults with T2DM.
Methods: We conducted a Phase 3 randomized, double-blind, placebo-controlled study of ecnoglutide, enrolling 211 adults with T2DM at 33 sites in China. Participants were randomized to receive 0.6 or 1.2 mg ecnoglutide or placebo as once weekly injections for 24 weeks, including dose escalation. All participants then received ecnoglutide (0.6 or 1.2 mg) for a total duration of 52 weeks. Change in mean HbA1c, body weight, and BMI, as well as safety and tolerability were evaluated.
Results: At baseline, participants had mean HbA1c of 8.54, 8.51, and 8.51% and BMI of 27.2, 26.4, and 27.2 kg/m2, for ecnoglutide 0.6, 1.2 mg, and placebo groups, respectively. After 24 weeks, participants receiving ecnoglutide achieved significant HbA1c reductions of 1.96 to 2.43% from baseline (P≤0.0003 for both cohorts vs placebo). At 24 weeks, 76.1% of participants receiving 1.2 mg ecnoglutide achieved HbA1c ≤6.5%, 35.2% had HbA1c &lt;5.7%, and 43.7% had body weight reductions ≥5% from baseline. Ecnoglutide was safe and well tolerated. The proportion of participants reporting any adverse event (AE) ranged from 77.5 to 78.3% for ecnoglutide groups and 60.6% for placebo. Four (2.9%) treatment-related ≥Grade 3 AEs and one (0.7%) treatment-related serious AE occurred in the ecnoglutide groups. One participant from each cohort discontinued due to an AE. The most frequently reported AEs were decreased appetite, diarrhea, and nausea, which were mostly mild to moderate and transient.
Conclusion: Ecnoglutide resulted in robust HbA1c declines of up to 2.43% from baseline after 24 weeks of treatment in adults with T2DM, with up to 35.2% of participants reaching normoglycemia (HbA1c &lt;5.7%) and 43.7% with weight reductions ≥5%.

Disclosure
D. Zhu: None. W. Wang: None. G. Tong: None. J. Ma: None. B. Wen: None. X. Zheng: None. B. Shi: None. S. Pang: None. S. Bing: Employee; Sciwind Biosciences, Keymed Biosciences. Q. Zheng: Employee; Sciwind Biosciences. G. Lei: None. F. Jiang: Employee; Sciwind Biosciences, PrimeGene Biosciences. X. Liu: None. Y. Bu: None. J. Ning: None. Z. Zhu: None. L. Yang: Employee; Sciwind Biosciences. M. Yang: Employee; Sciwind Biosciences. M. Fenaux: None. M.K. Junaidi: None. S. Xu: None.

Funding
Sciwind Biosciences
77-OR: Time in Range Is Associated with Glucagon/C-Peptide Index Ratio in Type 2 Diabetes Patients
Authors: KAMIGISHI MIKI , CHUJO DAISUKE , TAKIKAWA AKIKO , INAGAWA SHINYA , ENKAKU ASAKO , OHGAKU SEIICHIRO , SATO ATSUSHI , MATSUKOSHI SHINNOSUKE , HONOKI HISAE , FUJISAKA SHIHO , TOBE KAZUYUKI 
Published: June 2024

Introduction & Objective: Paradoxical increase of postprandial glucagon is considered to be a factor inducing hyperglycemia in type 2 diabetes (T2D). Although continuous glucose monitoring (CGM) is often used to evaluate glycemic control in T2D patients, no studies on the association between glycemic stability and functional balance of pancreatic alpha to beta cells have been reported. We aimed to investigate the association between CGM data and the ratio of glucagon to insulin secretion.
Methods: We recruited 62 T2D patients who were admitted to our hospital, and patients with &lt;45 ml/min/1.73 m2 of eGFR were excluded. We analyzed the data obtained from CGM, including time in range (TIR), time below range (TBR), time above range (TAR), average glucose (AVG), and standard deviation of glucose (SD), and the ratio of plasma glucagon level to C-peptide index (G-CPIR) before and after meal tolerance test or other metabolic factors.
Results: Postprandial G-CPIR was inversely correlated with TIR (r = -0.230, P = 0.009), correlated with TAR (r = 0.234, P = 0.014), and AVG (r = 0.251, P = 0.006). Upon comparing the CGM data between the group with high postprandial G-CPIR (HG group) and low G-CPIR (LG group), divided using the median values, TIR was significantly lower (62.4±21.5 vs. 78.5±18.8, P = 0.0053), AVG (166.7±33.5 vs. 145.5±27.9, P = 0.0153) and SD (46.2±14.3 vs. 38.2±11.8, P = 0.0310) were higher than those in LG group. Body fat mass was inversely correlated with SD (r = -0.448, P = 0.014), and subcutaneous fat area (SFA) and visceral fat area (VFA) were correlated with TIR (SFA: r = 0.339, P = 0.006, VFA: r = 0.310, P = 0.032), inversely correlated with TAR (SFA: r = -0.326, P = 0.010, VFA: r = -0.298, P = 0.040) and SD (SFA: r = -0.411, P = 0.001, VFA: r = -0.454, P = 0.001).
Conclusion: Our study suggests that CGM indicators, including TIR, are associated with the functional balance of pancreatic alpha to beta cells and body fat mass.

Disclosure
M. Kamigishi: None. D. Chujo: Research Support; Kyowa Kirin Co., Ltd. A. Takikawa: None. S. Inagawa: None. A. Enkaku: None. S. Ohgaku: None. A. Sato: None. S. Matsukoshi: None. H. Honoki: None. S. Fujisaka: None. K. Tobe: None.
8-OR: Longitudinal Patterns of Heterogeneity in Metabolic Decompensation among Diabetes Prevention Program Outcomes Study (DPPOS) Participants over 20 Years
Authors: KOBAYASHI EMILY , LINDEN NATHANIEL , EDELSTEIN SHARON , TEMPROSA MARINELLA , RANGAMANI PADMINI , MAJITHIA AMIT R. , DIABETES PREVENTION PROGRAM RESEARCH GROUP THE 
Published: June 2024

Introduction & Objective: Type 2 Diabetes (T2D) complications cause morbidity and mortality, but occur heterogeneously among those at risk. While some individuals maintain stable health over time, others decompensate. Using data from the DPPOS, this study aimed to identify unbiased, data driven subgroups of adults at risk for T2D with heterogeneous metabolic trajectories and clinical outcomes over time.
Methods: Data from 1736 DPP participants over 39 semi-annual visits with repeated clinical parameters (glycemia, insulin, lipids, body mass index (BMI), waist circumference, blood pressure (BP), microalbuminuria (MA) and eGFR) were analyzed. A 3-dimensional tensor of individuals x clinical parameters x visits was constructed. Nonnegative tensor decomposition was performed and the resulting factors were clustered using K-means. Cohesion and separation were computed to select an optimal number of clusters. Cumulative incidence of T2D and kidney dysfunction (eGFR &lt; 60 mL/min) were tabulated for each cluster.
Results: Nine longitudinal clusters of varying sizes were identified. One cluster represented a healthy group with stable clinical parameters (n=556). Kidney dysfunction was found in two clusters with differing patterns and trajectories: 1) slowly declining eGFR without MA or T2D (n=198), 2) MA, elevated BP and delayed eGFR decline (n=138). Other clusters segregated by patterns of glycemia and insulin resistance (IR) ranging from stable IR, glycemia and elevated BMI (n=253), to rapidly accelerating IR, dysglycemia and T2D (n=34).
Conclusion: Temporal trajectories of clinical parameters revealed marked heterogeneity in metabolic decompensation over time for DPPOS participants. A minority had accelerated metabolic and renal decompensation, important groups to target for early intervention. These groups also form the basis for novel biomarker discovery efforts to improve prediction of future complications.

Disclosure
E. Kobayashi: None. N. Linden: None. S. Edelstein: None. M. Temprosa: None. P. Rangamani: None. A.R. Majithia: None.
835-P: A Unique Form of Pancreatogenic Diabetes—Experiences with the Treatment of Patients Who Underwent Pancreatectomy
Authors: KIS JANOS T. , SZEMÁN ANDREA , ARAPOVICSNE DR KISS KRISZTINA , GROSZ ANDREA J. , MÉSZÁROS PÉTER , DUBOCZKI ZSOLT , HARDY VAJK , SCHANDL LASZLO , WINKLER GABOR T. 
Published: June 2024

Objective: Pancreatogenic diabetes (T3cDM) is most often caused by chronic pancreatitis, pancreatic cancer, hemochromatosis, cystic fibrosis, and most rarely by pancreas removal. It is often associated with T2DM, so several parallel pathological processes are behind hyperglycemia, in which case it cannot be clearly established to what extent each disease process (pancreatic disease, insulin resistance, T2DM, etc.) is involved in the development of hyperglycemia.
Methods: T3cDM in patients with total pancreatic resection is of purely pancreatogenic origin. Our working group created a register for patients who underwent pancreatic resections to optimize the treatment of this most fragile type of diabetes.
Results: So far, 49 (22M, 67 years) patients who did not have diabetes before pancreatectomy have been added to our database. The average total daily insulin requirement of the patients was 34 U (bolus: 23.3 U, basal:10.6 U). The imbalanced (68%) bolus requirement is explained by the fact that the daily carbohydrate intake often had to be increased to over 300 grams, even with massive pancreatic enzyme replacement. The most proven treatment was human fast-acting insulin given in addition to iGlar300 or degludec base. After six months, the average HbA1c value of the patients was 7.3%, and the average weight loss was 2.6 kg. Due to acute complications of diabetes, none of the patients was admitted to ER.
Conclusion: To our knowledge, our registry is the only database that collects and follows data of patients who underwent total pancreatectomy. Despite the unique challenges (insulin, glucagon, and digestive enzyme deficiency immediately after surgery, weight loss, gastric dissection), satisfactory metabolic control was achieved by educating the patients and their relatives. Our experiences with patients who underwent total pancreatectomy can benefit the care of T3cDM of another origin.

Disclosure
J.T. Kis: None. A. Szemán: None. K. Arapovicsne Dr Kiss: None. A.J. Grosz: None. P. Mészáros: None. Z. Duboczki: None. V. Hardy: None. L. Schandl: None. G.T. Winkler: None.