bluuebunny/crossref_metadata_2025_split huggingface dataset:
689-P: Type 2 Diabetes Risk Perception and Health Behaviors among Women with History of Gestational Diabetes Mellitus
Authors: MALONE ALLYSON , TURK NORMAN , KENRIK DURU O. , WISK LAUREN E. , MANGIONE CAROL , PAGE JESSICA , THOMAS SAMUEL C. , HAN CHRISTINA S. , VU AMANDA V. , MADIEVSKY RUTH , NORRIS KEITH C. , MOIN TANNAZ 
Published: June 2024

Introduction & Objective: Women with a history of gestational diabetes mellitus (GDM) are at high risk of developing type 2 diabetes (T2D). Our goal was to examine the association between perceived risk of developing T2D and health behaviors in this population.
Methods: We analyzed surveys and electronic health records of participants in the GRAND Study, a multisite RCT testing the effectiveness of shared decision-making for women with elevated body mass index (BMI), prediabetes and history of GDM. Data on demographics, health behaviors, and perceived T2D risk were self-reported. We ran four regressions to examine the association between women’s perceived risk of developing T2D and four key health behaviors: 1) physical activity levels, 2) sugar-sweetened beverage consumption, 3) ultra-processed food consumption, and 4) consumption of meals prepared outside the home. All models were adjusted for age, race, ethnicity, income, A1c, BMI, family history of T2D, and study arm.
Results: Our sample included 165 women with a history of GDM, prediabetes, with mean age 41.3 (± 5.6 years) and mean BMI 32.1 (± 6.9 kg/m2). Perceived risk of developing T2D was not significantly associated with physical activity, consumption of sugar-sweetened beverages, or meals prepared outside of the home (p&gt;0.05). However, women reporting lower perceived T2D risk had 2.9 times the odds of less frequent ultra-processed food consumption than those with higher perceived risk (p=.029). Higher BMI was significantly associated with increased consumption of sugar-sweetened beverages (p=0.005), but not other health behaviors.
Conclusion: We found perceived risk of developing T2D was significantly associated with ultra-processed food consumption but not physical activity, consumption of sugar-sweetened beverages, or meals prepared outside the home. Women with GDM are at high risk of developing T2D and may benefit from tailored interventions promoting health behavior changes shown to lower T2D risk.

Disclosure
A. Malone: None. N. Turk: None. O. Duru: Consultant; ExactCare Pharmacy. L.E. Wisk: None. C. Mangione: None. J. Page: None. S.C. Thomas: Stock/Shareholder; PocketRN. C.S. Han: None. A.V. Vu: None. R. Madievsky: None. K.C. Norris: None. T. Moin: None.

Funding
National Institutes of Health (R01DK127733)
691-P: The Use of Peer Connector Guides to Support an Emerging Adult Type 1 Diabetes Intervention
Authors: SHAH NAZEEN , RODRIGUEZ GONZALES BRUNO , IACOB ELI , LITCHMAN MICHELLE L. , BLANCHETTE JULIA E. , MARIE MORAITIS ANN , ALLEN NANCY A. 
Published: June 2024

Introduction & Objective: The Diabetes - Connecting Online Peers to Enhance Support (D-COPES) pilot intervention engages emerging adults (EA) with type 1 diabetes (T1D) through group discussion using topic guides with a peer connector (PC). Topic guides are comprised of questions and credible online resources to facilitate group discussion around a specific diabetes topic. This study assessed topic guide use throughout D-COPES.
Methods: An EA focus group (N=6) determined the initial set of topic guides and additional guides were developed throughout the pilot as requested by PC. The PC worked with their group to select topics the EA wanted to discuss throughout 6 virtual sessions. There were 6 PC who led 14 group sessions. Each session focused on 1-2 topics. A subset of participants were interviewed to understand the value of the 21 topic guides.
Results: Considering the topic guide options, the most frequently discussed were diabetes burnout (N=13), diabetes technology (N=10), navigating insurance and the healthcare system (N=10), relationship with food (N=9), physical activity (N=8) and traveling with diabetes (N=8). Interviewed participants (N=14) appreciated the comprehensive list of topics to choose from and found them to be useful. Topic discussions provided social support not found in other clinical settings. Occasionally a topic such as menstruation with diabetes was uncomfortable to discuss in mixed-gender groups, for some.
Conclusion: Topic guides help spark discourse of daily struggles EA with T1D face, providing avenues for social support. The most frequently discussed topic guides highlight the unaddressed education needs within EA with T1D.

Disclosure
N. Shah: None. B. Rodriguez Gonzales: None. E. Iacob: None. M.L. Litchman: Research Support; American Diabetes Association, Association of Diabetes Care & Education Specialists, Dexcom, Inc. Other Relationship; Association of Diabetes Care & Education Specialists. Research Support; National Institutes of Health. J.E. Blanchette: Speaker's Bureau; Insulet Corporation. Board Member; Juvenile Diabetes Research Foundation (JDRF). Research Support; American Heart Association, Association of Diabetes Care & Education Specialists, National Institute of Diabetes and Digestive and Kidney Diseases, Leona M. and Harry B. Helmsley Charitable Trust. Advisory Panel; LifeScan Diabetes Institute. Consultant; WellDoc. Advisory Panel; Cardinal Health/Edgepark. A. Moraitis: None. N.A. Allen: Research Support; Dexcom, Inc. Consultant; Diathrive Health.

Funding
Franklin S. Ivory and Rachael C. Ivory Foundation
697-P: Evaluation of Acceptance and Commitment Therapy on Glycemic Control in Type 2 Diabetes Patients
Authors: MAKINO HISASHI , OYA AIKO , SHIMA TAIKI , TSUDA NATSUMI , KOEZUKA RYO , TOCHIYA MAYU , OHATA YOKO , TAMANAHA TAMIKO , NOGUCHI MICHIO , HOSODA KIMINORI 
Published: June 2024

Background and Aim: Acceptance and commitment therapy (ACT) is a psychological intervention using uses mindfulness strategies and acceptance along with commitment and behavior. In this study, we aimed to assess the effects of group-based ACT on self-management of patients with diabetes.
Methods: One hundred and six patients with type2 diabetes were randomly assigned either to the education alone (conventional group, n = 53) to a combination of education and 4-hour ACT workshop (ACT group, n = 53). Observation period was 12 months, and both groups were allowed to change hypoglycemic drugs after 6 months. The primary outcome was HbA1c change after 6 months. Major secondary outcome was HbA1c change after 12 months, change of body weight, carolie intake, and physical activity.
Results: After 6 and 12 months, there was no significant difference of HbA1c change between conventional group and ACT group. In patients with a low degree of psychological diabetes avoidance as assessed by acceptance and action diabetes questionary (AADQ) score, HbA1c reduction of ACT group tended to be greater than conventional group. There was no significant difference of body weight change between the two groups. Carolie intake after 12 months in ACT group was significantly lower than conventional group, whereas there was no significant difference of physical activity.
Conclusions: In this study, a single 4-hour workshop intervention did not significantly reduce HbA1c, although it did reduce caloric intake. However, in patients with high AADQ scores, a single workshop intervention may be effective in lowering HbA1c.

Disclosure
H. Makino: None. A. Oya: None. T. Shima: None. N. Tsuda: None. R. Koezuka: None. M. Tochiya: None. Y. Ohata: None. T. Tamanaha: None. M. Noguchi: None. K. Hosoda: None.
698-P: "Come to a Conclusion Together"—Feedback on the Collaboration around Technology Using Community Health Workers in Type 1 Diabetes (T1D-CATCH) Study
Authors: FINNAN MOLLY , ADAMU ASUMAWU , MATHIAS PRIYANKA M. , SANCHEZ STEVEN , TALLA ASTOU , LONG JUDITH A. , AGARWAL SHIVANI 
Published: June 2024

Background: Diabetes technology is now considered a standard of care for T1D; however, its adoption remains limited in minoritized populations. Community health workers (CHWs) engender trust by providing: unique assistance, social needs support, and extra healthcare system navigation. The T1D-CATCH intervention aims to enhance core CHW roles, adding specialty T1D support to increase diabetes technology use.
Methods: In this ongoing randomized controlled trial testing the efficacy of T1D-CATCH, we report preliminary qualitative findings from post-intervention interviews with participants who have completed the intervention. We conducted semi-structured individual interviews, which were audio-recorded, transcribed, and analyzed by two independent coders utilizing a deductive coding approach.
Results: We included 11 participants who completed the intervention (mean age 25 yrs, 73% female, n=4 Hispanic, n=7 non-Hispanic Black). Common themes identified included high satisfaction and increased engagement with diabetes self-management, attributed to the increased flexibility in communication methods and scheduling offered by CHWs compared to healthcare providers. Participants saw CHWs as a valuable source of information and a tangible resource for unmet social needs. Participants also noted enhanced trust in the healthcare system due to shared decision-making, increasing their likelihood to adopt diabetes technology. Overall, participants noted that improvement in communication methods with the CHW and extra outreach for social needs management and diabetes technology navigation changed their self-perception of diabetes and improved self-management.
Conclusions: In this initial sample of study completers, the T1D-CATCH intervention appears to be feasible and acceptable, and may provide a new resource to improve diabetes technology uptake and self-management in minoritized young adults with T1D.

Disclosure
M. Finnan: None. A. Adamu: None. P.M. Mathias: None. S. Sanchez: None. A. Talla: None. J.A. Long: None. S. Agarwal: Research Support; Dexcom, Inc. Advisory Panel; Medtronic. Consultant; Beta Bionics, Inc.

Funding
National Institutes of Health (R01DK132302)
704-P: Unearthing Implicit Beliefs—Beyond Symptoms in Social Determinants of Health in Immigrants and Refugees with Type 2 Diabetes
Authors: ALI ASMA , VIVIAN EVA M. , CHEWNING BETTY A. 
Published: June 2024

Background: Social determinants of health (SDOH) account for 50% of health outcomes compared to 20% by clinical care. This work highlights SDOH in Muslims with type 2 diabetes (T2D) who receive healthcare services in the US.
Methods: Semi-structured qualitative one-hour interviews were conducted with adult Muslim participants diagnosed with T2D for at least 6 months and using diabetes oral medications and/or injections. Maximum variation sampling captured the Muslim population’s heterogeneity with five groups who spoke different languages with different countries of origin.
Results: Twenty-two participants, mostly immigrants or refugees, were included. Themes were distributed across the 5 main SDOH domains. Economic stability included low income and/or working in demanding stressful jobs or multiple employments that hindered access to healthy food. Low education and limited English proficiency hindered patient-provider communication or ability to read instructions on medication bottles. Factors related to healthcare access and quality included health knowledge and advocating for oneself with providers. Neighbourhood and built environment themes included harsh winter weather, lack of access to convenient transportation, and lack of understanding about public transportation systems. Varying social support by family and friends were important to facilitate healthy behaviours and access to care.
Conclusions: Building compassionate trust-based relationships with patients is key. Healthcare providers can use cues to investigate SDOH. For instance, in addition to the regular SDOH screening, a missed appointment can be a cue to ask about transportation access or the convenience of the appointment time.

Disclosure
A. Ali: None. E.M. Vivian: None. B.A. Chewning: None.

Funding
This work is supported by the Small Grant Funding by the Department of Family Medicine and Community Health at the University of Wisconsin-Madison. Dr. Ali was supported by the University of Wisconsin Primary Care Research Fellowship, funded by grant T32HP10010 from the Health Resources and Services Administration.
729-P: Interactive, Online, Case-Based Education Effective at Improving Clinical Competence Related to Staging and Comprehensively Treating Type 1 Diabetes
Authors: LARKIN AMY , LE ANNE 
Published: June 2024

Introduction: We sought to determine if interactive, case-based, online continuing medical education (CME) could improve the competence and confidence of diabetologists/endocrinologists (D/Es) and pediatricians related to T1D.
Methods: Educational design included a “test, then teach” approach to elicit cognitive dissonance, with evidence-based feedback provided following each learner response. A repeated pairs pre-/post-assessment study design and a McNemar’s test (P &lt;.05 is considered significant) assessed educational effect, with Cohen’s d being used to assess educational impact (&lt;0.2 modest effect, 0.2-0.49 small effect, 0.5-0.79 moderate effect and &gt;0.8 extensive effect). Data collected April 24, 2023 through June 15, 2023.
Results: 102 D/Es and 168 pediatricians were included. Matched learner data indicate that overall 79% D/Es and 77% of pediatricians improved their competence from pre-to-post (both P&lt;.001 with extensive overall impacts in both groups 1.12-1.29). 53% of D/Es (P&lt;.001) and 49% of pediatricians (P&lt;.001) improved at correctly staging a patient with T1D. 18% of D/Es (P&lt;.001) and 35% of pediatricians (P&lt;.001) improved at accurately treating a patient with stage 2 T1D. 44% of D/Es (P&lt;.001) and 36% of pediatricians (P&lt;.001) improved at identifying best practices for educating a patient with T1D. Overall, 50% of D/Es and 45% of pediatricians reported increased confidence in implementing new preventive treatment approaches for the management of early-stage T1D.
Conclusion: This study demonstrates the success of interactive, case-based, online CME on improving competence and confidence of D/Es and pediatricians related to staging and comprehensively treating/delaying/preventing T1D. Case-based education with interactive polling questions and detailed explanations related to best choices should be employed more often to help clinicians apply guidelines into practice to improve patient care.

Disclosure
A. Larkin: None. A. Le: None.

Funding
Developed through an independent educational grant from Provention Bio, a Sanofi Company.
73-PUB: Endogenous GIP Lowers Plasma Glucose during Fasting in Obese Individuals
Authors: KOEFOED-HANSEN FREDERIKKE , SHEYMA KIZILKAYA HÜSÜN , HELSTED MADS M. , SØRUM NIKOLAJ E. , HARTMANN BOLETTE , KNOP FILIP KRAG K. , GASBJERG LÆRKE S. 
Published: June 2024

The incretin hormone glucose-dependent insulinotropic polypeptide (GIP) is secreted from enteroendocrine K cells in the small intestine following food intake. Exogenous GIP stimulates glucagon secretion during fasting at low blood sugar and exerts anabolic effects in fat and bone in healthy individuals. Using the GIP receptor antagonist GIP(3-30)NH2, we investigated the effects of endogenous GIP in humans during fasting.
In a randomized, placebo-controlled, double-blind, crossover study comprising two experimental days, 12 healthy participants (7 men, 5 women; mean (±SEM) age 35±4 years; mean BMI 38 ±1.6 kg/m2; mean body fat percentage 37 ± 2.2%) received 180-minute infusions of GIP(3-30)NH2 (1,000 pmol/kg/min) and placebo (saline), respectively, after 10 hours of fasting. An ad libitum meal was provided at time 180 min, during continuous infusion.
Comparing paired values for each participant, baseline-subtracted plasma glucose was higher during GIP(3-30)NH2infusion compared to placebo (mean bsAUC0-180 (±SEM) -53.6 ± 12.2 vs. -31.7 ± 6.6 min×mmol/L, P = 0.031) whereas systolic blood pressure (P = 0.44), diastolic blood pressure (P = 0.59), pulse rate (P = 0.92) and ad libitum food intake (P = 0.31) were unaffected.
In conclusion, endogenous GIP seem to have glucose-lowering effects in obese individuals in the fasting state.

Disclosure
F. Koefoed-Hansen: None. H. Kizilkaya: None. M.M. Helsted: None. N.E. Sørum: None. B. Hartmann: Board Member; Bainan Biotech. F.K. Knop: Advisory Panel; AstraZeneca. Consultant; AstraZeneca. Speaker's Bureau; AstraZeneca. Advisory Panel; Boehringer-Ingelheim. Consultant; Boehringer-Ingelheim. Speaker's Bureau; Boehringer-Ingelheim. Advisory Panel; Eli Lilly and Company. Consultant; Eli Lilly and Company. Speaker's Bureau; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. Advisory Panel; Novo Nordisk A/S. Consultant; Novo Nordisk A/S. Employee; Novo Nordisk A/S. Research Support; Novo Nordisk A/S. Speaker's Bureau; Novo Nordisk A/S. Stock/Shareholder; Novo Nordisk A/S. Advisory Panel; Sanofi. Speaker's Bureau; Lundbeck. Advisory Panel; Zealand Pharma A/S. Consultant; Zealand Pharma A/S. Research Support; Zealand Pharma A/S. Speaker's Bureau; Zealand Pharma A/S. Stock/Shareholder; Zealand Pharma A/S. L.S. Gasbjerg: Stock/Shareholder; Antag Therapeutics.
734-P: Use of GLP-1 Agonists and Perioperative Complications in Patients Undergoing Elective Surgery
Authors: MENDEZ CARLOS E. , THORGERSON ABIGAIL , DAWSON APRILL Z. , NELSON VICTORIA , BEHRENS ALLISON , PFEIFER KURT 
Published: June 2024

A preoperative diabetes optimization program (PreDOP) is available at our institution for elective surgical patients with A1c&gt; 8%. We previously reported on the positive impact of PreDOP on participants on whom medications, including GLP-1 agonists, were used to optimize glycemic control preoperatively. However, in June 2023 the American Society of Anesthesiologists recommended avoidance of GLP-1 agonists preoperatively due to concerns of possible complications related to delayed gastric emptying. Based on this, we extracted EPIC medical record data for adult surgical patients who participated in PreDOP between January 2016 and June 2023 (n=161), and identified those with an active prescription of a GLP-1 agonist at the time of surgery. Before June 2023, patients managed with GLP-1 agonists were not instructed to hold therapy before surgery. Table 1 shows sample characteristics of the study cohort by use of GLP-1 agonists (yes/no). Patients who received GLP-1 agonists were significantly more obese and had a higher BMI compared to those who did not. However, there were no significant differences in level of glycemic control before and at the time of surgery. Moreover, rates of perioperative complications, including any type of pneumonia within 30 days of surgery were not significantly different. In this review, use of GLP-1 agonists was not associated with increased risk of perioperative complications.

Disclosure
C.E. Mendez: Consultant; Siemens Healthcare Diagnostics. A. Thorgerson: None. A.Z. Dawson: None. V. Nelson: None. A. Behrens: None. K. Pfeifer: None.
736-P: Comparison of Semaglutide vs. Tirzepatide Therapy in Adults with Type 1 Diabetes (T1D)
Authors: GEBRE HENON , SNELL-BERGEON JANET K. , SHAH VIRAL N. 
Published: June 2024

Introduction & Objective: Glucagon-like peptide receptor agonist (GLP-1R) semaglutide and a dual incretin agonist, tirzepatide are approved for the treatment of type 2 diabetes and obesity. However, little is known about the efficacy of GLP-1RA in T1D. This real-world study compared the efficacy of semaglutide and tirzepatide in adults with T1D.
Methods: Clinic patients with T1D who were treated with a GLP-1RA were identified from the electronic health record at the time of drug initiation and were followed up to 9 months. An age, sex, race and BMI-matched control group was selected from patients who were not treated with a GLP-1RA, matched to semaglutide users. Linear mixed models were used to compare anthropometric and glycemic outcomes over time by group.
Results: At baseline, HbA1c and total insulin dose were higher in controls than in both GLP-1RA groups, and BMI was higher in tirzepatide users (Table 1a). There was significantly more weight loss in the semaglutide and tirzepatide groups than the control group, with an average weight loss of more than 10% in tirzepatide users and more than 6% weight loss in semaglutide users by 9 months (Table 1b). Semaglutide users had an average 0.40% improvement in HbA1c, and tirzepatide users had an average 0.67% improvement in HbA1c (Table 1b).
Conclusion: Semaglutide and tirzepatide reduced weight and improved HbA1c in adults with T1D, with greater weight loss efficacy for tirzepatide.

Disclosure
H. Gebre: None. J.K. Snell-Bergeon: None. V.N. Shah: Consultant; Dexcom, Inc., Insulet Corporation. Research Support; Insulet Corporation. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Sanofi, Medscape. Consultant; embecta, Tandem Diabetes Care, Inc.
75-PUB: The Sartorius Fat Fraction Is Independently Associated with Myocardial Fibrosis in Chinese Patients with Obesity
Authors: WANG ZIXUAN , YUE JIANG , ZHAO HANG , JIANG MENG , BU JUN , MA JING 
Published: June 2024

Objective: The study aimed to investigate the correlation between intramuscular adipose tissue (IMAT) accumulation in lower extremities and the myocardial tissue-level characteristics detected by MRI in Chinese individuals with obesity.
Methods: A cross-sectional analysis was performed in 51 Chinese adults with obesity (BMI ≥ 28 kg/m2), comprising 34 males and 17 females. All the patients underwent clinical assessment, anthropometric measurement, oral glucose tolerance test (OGTT) and laboratory assays. MRI was applied to access the IMAT content in lower extremities and cardiac magnetic resonance was utilized for all participants. Myocardial tissue-level characteristic, such as extra-cellular volume fraction (ECV), was measured as indicator of myocardial fibrosis. The relationship between the IMAT content of the lower extremities and myocardial dysfunction was further assessed.
Results: Fifty-one subjects were included in this study, with 27 individuals classified as having normal glucose tolerance (NGT) and 24 individuals with impaired glucose regulation (IGR). We found that the levels of aspartate aminotransferase (AST) and triglycerides (TG) were higher in IGR group compared to those in NGT group (both P &lt;0.05). Additionally, higher fat accumulation was noted in vastus lateralis, vastus intermedius, biceps femoris, semitendinosus, adductor magnus, gracilis, and sartorius in patients with IGR as opposed to those with NGT (all P &lt; 0.05). The ECV in IGR group was higher than that in NGT group. Multivariate regression analysis identified increased IMAT in sartorius may be an independent risk factor for myocardial fibrosis after adjustment for age, gender, BMI, NEFA (odds ratio: 1.22, 95% CI: 1.02-1.46, P = 0.028).
Conclusion: In Chinese subjects with obesity, an increase in adipose tissue accumulation of sartorius was associated with myocardial fibrosis. It may independently serve as one of possible risk factors for myocardial fibrosis in the obesity.

Disclosure
Z. Wang: None. J. Yue: None. H. Zhao: None. M. Jiang: None. J. Bu: None. J. Ma: None.