bluuebunny/crossref_metadata_2025_split huggingface dataset:
561-P: Advancing Clinical Proficiency in Insulin Management through Case-Based Education
Authors: TAMAS MARGERY J. , BEYER MICHAEL , NOVAK LUCIA M. , O'BRIEN SARAH , DREW HEATHER N. 
Published: June 2024

Objectives: Advances in mealtime insulin therapy and delivery technology can improve postprandial glucose, yet many healthcare professionals (HCPs) have significant knowledge and skills deficits regarding the fundamentals of prandial insulin therapy. This accredited educational activity sought to improve HCPs' ability to use newer types of prandial insulin, engage in patient-centered discussions, and adjust insulin doses.
Methods: The online activity emphasized case-based teaching using standardized patient-provider videos to simulate telehealth visits. HCPs applied the latest evidence (via case scenarios) to real-life management of patients with insulin-treated diabetes. Interpretation of ambulatory blood glucose records and insulin dosing was emphasized. Point-of-care practice aids were provided to reinforce and enhance translation into clinical practice.
Results: Participation: 3,013 US-based HCPs - 30% endocrinologists, 40% PCPs, 27% NPs/PAs, 3% other HCPs
Assessment - Pre- (N=602) and post- (N=460)
Skills Enhancement:&lt;ul&gt;54% absolute gain in ability to incorporate newer options and advances in mealtime insulin (25% to 78%)&lt;/ul&gt;&lt;ul&gt;50% absolute gain in ability to engage in patient-centered discussions (29% to 79%)&lt;/ul&gt;Impact on Practice:&lt;ul&gt;28% absolute gain in intention to frequently or always assess time in range (TIR) as a measure of glycemic control (63% to 91%)&lt;/ul&gt;&lt;ul&gt;41% absolute gain in intention to frequently or always use continuous glucose monitoring to assess blood glucose patterns (47% to 88%)&lt;/ul&gt;&lt;ul&gt;18% absolute gain in willingness to ask patients frequently or always about their preferences for monitoring and insulin delivery devices (78% to 96%)&lt;/ul&gt;Conclusion: Simulated telehealth visits with case-based teaching improved HCPs’ insulin administration skills and patient-centered practices. The substantial participation from diverse HCP backgrounds and the demonstrated improvements in key competencies underscore the initiative's relevance and effectiveness.

Disclosure
M.J. Tamas: None. M. Beyer: None. L.M. Novak: Speaker's Bureau; Abbott. Consultant; Abbott. Advisory Panel; Ascensia Diabetes Care, Boehringer-Ingelheim. Speaker's Bureau; BI Lilly Aliance. Advisory Panel; Medtronic, Novo Nordisk. Consultant; Novo Nordisk. Speaker's Bureau; Novo Nordisk, Sanofi, Xeris Pharmaceuticals, Inc. S. O'Brien: None. H.N. Drew: None.

Funding
Lilly (A-30576)
573-P: Survey-Based Analysis of Type 1 Diabetes Mellitus Patient Training Experience with Omnipod 5 Pump
Authors: BHARGAVA KAVERI , BASINA MARINA 
Published: June 2024

Introduction & Objective: Given the recent FDA-approval of Omnipod 5 pump system (OP5), there is little information regarding its best pump training practices. We conducted a patient survey to evaluate educational needs, training satisfaction, and need for additional pump training sessions.
Methods: Following IRB approval, an online REDCap survey was sent via email to patients of an outpatient endocrinology clinic. Patients over 18 years with Type 1 Diabetes who were prescribed OP5 were included. Formal in person or virtual pump training was offered and conducted by the same certified clinic pump trainer for those who opted for it.
Results: Out of 181 invitations sent, 33 survey responses were received (18.2% response rate). Patients were analyzed in two groups: formally trained (FT) (16/33; 48.5%) and self-trained (ST) using online resources (17/33; 51.5%). Results shown in Table 1.
Conclusions: Our survey demonstrated similar patients’ satisfaction with ST and FT methods. Both groups preferred at least 1-2 additional training sessions. Patients’ satisfaction with ST has not been previously evaluated. Considering individual variability in learning needs, different assimilation of new information, availability of the online materials, allocation of the resources, and time constraints, ST can be a viable option for some patients with additional follow up or ongoing training sessions. Larger and longer studies are needed.

Disclosure
K. Bhargava: None. M. Basina: None.
594-P: Exercise Timing Has Limited Effect on Glycemic Profile in a Cluster of Well-Controlled Youth with Type 1 Diabetes
Authors: CODELLA ROBERTO , DELLA GUARDIA LUCIO , BASSI MARTA , MINUTO NICOLA , BISIO AMBRA , RUGGERI PIERO , FAELLI EMANUELA , MAGGI DAVIDE 
Published: June 2024

Identifying the best exercise timing to mitigate hypoglycemia is critical for patients with type 1 diabetes (T1D). Despite the established health benefits, concerns persist regarding post-exercise glucose stabilization in this population. In a cross-sectional design of one hundred well-compensated individuals from Northwest Italy (55% female, 45% male; age: 16 ± 6 years; HbA1c: 6.8 ± 1%), physical activity (PA), glycemic profiles, and psychometric traits were monitored. The timing, duration, intensity, and volume of PA were derived from a 7-day training log. Glycemic control was assessed through continuous glucose monitoring, including time in range (TIR; 70-180 mg/dL), time below range (TBR; &lt;70 mg/dL), time below the extreme hypoglycemia range (TBER; &lt;54 mg/dL), time above range (TAR; 180-250 mg/dL), time &gt;250 mg/dL, mean glycemia (MGLU), and total daily insulin dose. Subjects were categorized based on the prevalent timing of exercise into three groups: morning (6am - 12pm), afternoon (12pm - 6pm), and night (6pm - 12 am). Non-exercising days (NO-activity) for each subject were also considered. The mixed model analysis for fixed effects revealed that TIR, TAR, TBER, and MGLU were significantly influenced by the timing of exercise. However, post-hoc analysis indicated that this difference was observed only when comparing NO-activity vs afternoon exercise. Pairwise comparisons showed no significant differences in TIR, TAR, TBER, and MGLU when comparing exercise timing (morning vs afternoon vs night). Additionally, active participants exhibited better quality of life, reduced fear of hypoglycemia, and improved diabetes management self-efficacy compared to their less active counterparts. The findings suggest that exercise timing may be secondary to the overarching goal of helping individuals with T1D develop a consistent and adherent exercise routine. This insight is valuable in guiding recommendations for managing glycemic control in T1D.

Disclosure
R. Codella: None. L. Della Guardia: None. M. Bassi: Speaker's Bureau; Movi spa. N. Minuto: Consultant; Novo Nordisk A/S. A. Bisio: None. P. Ruggeri: None. E. Faelli: None. D. Maggi: Consultant; Bayer Inc.
6-OR: Renal Cell Type—Associated Therapeutic Effects of Semaglutide in a Mouse Model of Hypertension-Accelerated Diabetic Kidney Disease
Authors: TOZZI MARCO , HANSEN HENRIK H. , CHRISTENSEN MICHAEL 
Published: June 2024

Introduction & Objective: Emerging evidence suggests that glucagon-like peptide-1 receptor (GLP-1R) agonists improve cardiovascular and renal outcomes in type 2 diabetes patients, however, their mode of action at the kidney level is presently unclear. Using paired bulk and single-nucleus RNA sequencing (RNAseq), we profiled renal transcriptome signatures of the long-acting GLP-1R agonist semaglutide alone and in combination with an ACE inhibitor in a state-of-the-art mouse model of hypertension-accelerated advanced DKD.
Methods: Female db/db mice received a single i.v. injection of renin-encoding adeno-associated virus (ReninAAV) followed by uninephrectomy (UNx) one week later. Six weeks post-UNx, db/db UNx-ReninAAV mice were administered (q.d.) vehicle, semaglutide (30 nmol/kg, s.c.) or semaglutide (30 nmol/kg, s.c.) + lisinopril (30 mg/kg, p.o.) for 11 weeks. Endpoints included blood pressure, urine biochemistry, kidney histology and paired bulk and single-nucleus RNAseq.
Results: Semaglutide improved hyperglycemia, hypertension and albuminuria concurrent with reduction in glomerulosclerosis severity in db/db ReninAAV-UNx mice. Co-administration of lisinopril further reduced hypertension and glomerulosclerosis. Renal transcriptome changes induced by semaglutide mono- and combination treatment were primarily linked to the immune system and extracellular matrix remodeling. Combined semaglutide and lisinopril administration resulted in more widespread transcriptome changes in several renal cell types, including macrophages, mesangial cells, podocytes and proximal tubule cells.
Conclusion: Semaglutide improves disease hallmarks in the db/db ReninAAV-UNx mouse model of advanced DKD associated with modulation of several renal cell types. Therapeutic outcomes and renal transcriptome signatures were further improved by combined antihypertensive standard-of-care.

Disclosure
M. Tozzi: None. H.H. Hansen: Employee; Gubra. M. Christensen: Employee; Gubra.
614-P: Effects of Umami Stimulation on Oral Environment of Type 2 Diabetes Mellitus Patients
Authors: SAKAI CHIEKO , HORIKOSHI YOSUKE , MIZUTA EINOSUKE , MATSURA TATSUYA , HANAKI KEIICHI 
Published: June 2024

Objectives: Patients with type 2 diabetes (T2D) are at high risk for reduced saliva volume as well as periodontal diseases, and often have dysgeusia. This study investigated whether umami stimulation could effectively ameliorate these conditions in T2D by improving the oral environment and reducing the preference for sweet taste.
Methods: Participants were 21 patients (18 men, 3 women) with T2D who were not receiving pharmacotherapy. The mean age was 61.6 ± 12.6 years (range, 34-79), mean body mass index (BMI) was 26.9 ± 5.8 kg/m2, and mean hemoglobin A1c (HbA1c) was 6.9 ± 0.7%. After patients ingested umami substances for 3 months, we evaluated recognition thresholds for sweet taste, changes in the oral environment, and clinical indices. Measurements before and after diet therapy were compared.
Results: Thresholds for sweet taste did not change significantly (before diet therapy, 4.2 ± 1.1 vs. after diet therapy, 3.2 ±1.1), but sensitivity (perception) to sweet taste showed a tendency to become stronger. The oral environment showed increased saliva volume (2.68 ± 0.9 vs. 3.24 ± 1.7 mL), decreased salivary hemoglobin (3.02 ± 2.1 vs. 2.1 ± 1.1 μg/mL), and decreased salivary lactate dehydrogenase (156.5 ± 95.5 vs. 152.5 ± 61.5 U/L). Clinical indices showed the significant reduction of body weight (71.5 ± 13.5 vs. 70.9 ± 13.4 kg; p &lt; 0.05) and BMI (26.9 ± 5.8 vs. 26.6 ± 5.7 kg/m2; p &lt; 0.05). HbA1c values decreased (6.9 ± 0.7 vs. 6.8 ± 0.6%). Fasting blood glucose (139.3 ± 24.2 vs. 122.3 ± 16.8 mg/dL; p &lt; 0.05) and tumor necrosis factor-α (0.85 ± 0.4 vs. 0.71 ± 0.3 pg/mL; p &lt; 0.05) decreased significantly.
Conclusion: These results suggest that umami stimulation effectively alters oral environment, reduces sweet taste preference, and improves type 2 diabetic condition.

Disclosure
C. Sakai: None. Y. Horikoshi: None. E. Mizuta: None. T. Matsura: None. K. Hanaki: None.

Funding
Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Numbers 19K10851 (C.S.) and 22K10781 (C.S.).
62-OR: Continuous Glucose Monitoring in Pregnancies with Type 1 Diabetes—A Retrospective Study
Authors: FISHER STEPHANIE A. , VILLA TAMAYO MARIA F. , PAVAN JACOPO , MOSCOSO-VASQUEZ MARCELA , FABRIS CHIARA , CONBOY NATALIE , NIZNIK CHARLOTTE M. , YEE LYNN D. , KOHN MICHAEL A. , KOBAYASHI EMILY , MAJITHIA AMIT R. , HUANG JINGTONG , TIAN TIFFANY , AARON RACHEL , KLONOFF DAVID C. 
Published: June 2024

Introduction & Objective: Prior studies do not identify if continuous glucose monitor (CGM) metrics at a critical gestational age (GA) can distinguish risk of adverse pregnancy outcomes (APOs). We evaluated 3rd trimester CGM metrics by GA and APO status in gravidas with type 1 diabetes (T1D).
Methods: Dexcom G6 CGM data from singleton pregnancies with T1D (2018-2022) were retrospectively analyzed. Time in, above, and below range 63-140 mg/dL (TIR, TAR, TBR) and glycemic variability (CV) were computed in 2-week CGM intervals from 28°-396 weeksdays. APOs were hypertensive disorders of pregnancy (HDP), large for gestational age (LGA), NICU admission, neonatal hypoglycemia (NH), and respiratory distress syndrome (RDS). Linear mixed-effects models were fitted on CGM metrics with GA, APO status, and their interaction as fixed effects.
Results: In 86 pregnancies (1st trimester mean HbA1c 6.1%, BMI 25 kg/m2), 71% had at least 1 APO. At 28° weeks, pregnancies with HDP, NICU, or RDS, had higher TAR (p&lt;0.01) and lower TIR (p&lt;0.05). TIR evolution across the 3rd trimester differed in the presence vs. absence of HDP (p&lt;0.05; Figure), with greatest interaction at 28°-316 weeks. Evolution of all metrics differed in the presence vs. absence of RDS (p&lt;0.05), with greatest interaction at 28°-336 weeks.
Conclusion: The early 3rd trimester, a period of peak insulin resistance, is a critical window to optimize CGM metrics to mitigate APO risk.

Disclosure
S.A. Fisher: None. M.F. Villa Tamayo: Research Support; Dexcom, Inc. J. Pavan: Other Relationship; Dexcom, Inc. M. Moscoso-Vasquez: Research Support; Dexcom, Inc. Other Relationship; Dexcom, Inc. C. Fabris: Research Support; Novo Nordisk A/S. Other Relationship; Novo Nordisk A/S, Dexcom, Inc. N. Conboy: None. C.M. Niznik: None. L.D. Yee: None. M.A. Kohn: None. E. Kobayashi: None. A.R. Majithia: None. J. Huang: None. T. Tian: None. R. Aaron: None. D.C. Klonoff: Consultant; Afon Technology Ltd, Better Therapeutics, Inc, Glucotrack, LIfecare, Nevro Corp., Novo Nordisk, Samsung, Thirdwayv Inc.
635-P: Impact of Vitamin D Supplementation on Insulin Resistance amongst People with Type 2 Diabetes in India
Authors: MAHESHWARI ANUJ , TEWARI AJOY , CHAVDA VIPUL 
Published: June 2024

Introduction & Objective: Vitamin D appears to play a crucial role in regulating various events responsible for normal insulin sensitivity and pancreatic β-cell function. Deficiency in Vitamin D has been associated with increased Insulin Resistance (IR) and an elevated risk of developing T2D. This study aims to evaluate the impact of treating Vitamin D (Vit D) deficiency on IR in T2DM patients.
Methods: This prospective, observational, multicentric, real-world study conducted across 34 sites in India enrolled T2d patients meeting the inclusion criteria (Age: 18-60 yrs, Vit D (25-OH) Insufficiency &lt;30 ng/ml, HbA1C: 6.5% - 9%, ). Vit D 60k units of softgel capsules, once a week for 12 weeks. Vit D3 levels and HOMA-IR were reassessed. The baseline sample consisted of 402 patients, with 313 after 12 weeks follow-up.
Results: The mean duration of T2DM is 5.0 yrs, with 53% of the patients being male. Patient’s average age is 48 yrs and mean BMI is 27.6 kg/m­­2. Baseline HOMA-IR and vit D levels exhibit a poor correlation (r2=0.03%, p=0.75). 35.8% have High HOMA IR level (&gt;=2.0), 32.3% between 1 and 1.99 and 31.9% have HOMA IR &lt;1.0.After 12 weeks, the impact was assessed based on medication compliance (through patient feedback and change in Vit D levels). In the compliant group (147, 47%), vitamin levels increased from 16.7ng/mL to 40.4ng/mL. In contrast, for the non-compliant group (166, 53%), Vit D levels remained the same (19.7ng/mL Vs 20.1ng/mL). HOMA-IR change is not significant: compliant group - 2.5 to 2.3, p=0.32 and non-compliant group: 1.9 to 2.0, p=0.53. The correlation (r2=0.6%) between change in HOMA IR and Change in Vit D is also poor.
Conclusion: The null hypothesis, positing no direct clinical correlation between the increase in Vit D levels and HOMA-IR, is accepted. The poor correlations underscore the multifaceted nature of the association between Vit D supplementation, IR and T2DM, prompting further research to unravel the indirect correlations and implications for clinical practice.

Disclosure
A. Maheshwari: None. A. Tewari: None. V. Chavda: None.
688-P: Psychosocial Protective and Risk Factors and Transition Readiness in Young Adults (YA) with Type 1 Diabetes (T1D)
Authors: ESHTEHARDI SAHAR S. , MINARD CHARLES G. , CARREON SAMANTHA A. , LYONS SARAH , MCKAY SIRIPOOM , STREISAND RANDI , ANDERSON-THOMAS BARBARA J. , TANG TRICIA S. , HILLIARD MARISA E. 
Published: June 2024

Introduction & Objective: Transition readiness is how prepared a YA is to move from pediatric to adult care and is linked to self-management and diabetes outcomes. Though barriers to transition are documented, less is known about psychosocial factors associated with transition readiness. We evaluated diabetes strengths and diabetes distress in relation to diabetes-specific transition readiness in YAs nearing transfer to adult care.
Methods: At baseline of an intervention RCT, 100 YA with T1D (Mean age=19.9±1.3, 42% male, HbA1c=8.8±2.0%, 52% pump, 76% CGM) self-reported on demographics, clinical variables, and measures of diabetes strengths, diabetes distress, and 3 domains of transition readiness (health behaviors, knowledge, navigation). After identifying significant covariates via ANOVAs, separate regression models tested diabetes strengths and diabetes distress in relation to transition readiness (each domain separately and summed).
Results: Models explained 12-18.5% of the variance in scores (Table). Greater diabetes strengths and female gender were independently associated with higher transition readiness scores.
Conclusion: Diabetes strengths may play a protective role in the context of transition-related challenges. Supporting YA strengths as part of a comprehensive preparation program may support transition readiness as YAs prepare to leave pediatric T1D care.

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

Funding
National Institute of Diabetes and Digestive and Kidney Disease (1R01DK119246); National Institute of Diabetes and Digestive and Kidney Disease (K26 DK138332)
692-P: Work or Wellness? Examining Challenges of Low Wage Workers with Type 2 Diabetes
Authors: SCHLESINGER PENELOPE , ASANTE PRINCESS , LIPSKA KASIA J. , KEENE DANYA 
Published: June 2024

Introduction & Objective: There is a preponderance of evidence regarding the impact of social determinants of health (SDOH) on diabetes management and outcomes. However, absent from this literature is attention to employment and workplace conditions as determinants of health. Responding to this gap, this study examines whether and how employment experiences and work environments impact diabetes self-management for people in low wage jobs.
Methods: We conducted qualitative interviews (N=115) with 41 participants who are enrolled in a study about housing and diabetes outcomes. Initial interviews focused on broad experiences of diabetes management, economic precarity, and housing. Work and employment emerged as important topics and we conducted an additional 15 interviews to explore these topics in-depth. We analyzed the data using inductive coding and memo writing techniques.
Results: The average age of participants was 51 with a range from 24 to 70. 70% (29) of participants identify as African American, 15% (6) as white and 15% (6) as other. 63% (26) identified as female and 37% (15) as male. Interview participants described work schedules and environments that were not conducive to diabetes management. Participants revealed that they often struggled to balance demands of work with diabetes self-management and often felt like they were failing to successfully manage their nutrition, consistent medication and insulin intake, exercise, stress, and sleep which all factor into diabetes outcomes.
Conclusion: Our findings suggest the need for improved support systems for low wage workers with diabetes to help mitigate disparities in diabetes outcomes.

Disclosure
P. Schlesinger: None. P. Asante: None. K.J. Lipska: None. D. Keene: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK124500)
693-P: Association of Resilience with Hemoglobin A1c and Mental Health Symptoms in Youth and Young Adults with Diabetes
Authors: JULCEUS EMMANUEL F. , MENDOZA JASON A. , FLORY KATE , FRONGILLO EDWARD A. , MERCHANT ANWAR , MALIK FAISAL , COOPER DANIEL K. , REBOUSSIN BETH A. , SAUDER KATHERINE A. , BELLATORRE ANNA , LIESE ANGELA D. 
Published: June 2024

Introduction & Objective: Studies on resilience in youth and young adults (YYA) with diabetes are scarce. We assessed if resilience was associated with hemoglobin A1c (HbA1c), depressive symptoms, anxiety, and disordered eating behaviors in YYA with type 1 (T1D) and type 2 diabetes (T2D).
Methods: A cross-sectional analysis of the multicenter SEARCH Food Security Cohort study follow-up 2 (2019-2021) was conducted including 762 YYA with T1D and 103 YYA with T2D. Resilience was assessed with the Connor-Davidson Resilience scale; depressive symptoms, anxiety and disordered eating behaviors were assessed with the Center for Epidemiological Studies-Depression scale (clinical cutoff of ≥24 for youth and ≥16 for young adults), the Generalized Anxiety Disorder screener (≥10), and the Diabetes Eating Problem Survey-Revised (≥20). Logistic regression models were performed to examine associations between resilience and the above diabetes-related outcomes, adjusting for sociodemographic and clinical factors.
Results: YYA were on average 25.1 years old, 60.0% female, 71.2% Non-Hispanic White, and classified by tertiles of resilience into low (n=276), intermediate (n=316) and high (n=273) resilience. Among YYA with T1D, compared to those with high resilience, those with low resilience had elevated odds of HbA1c &gt;9% (OR 2.3, 95% CI 1.3-4.1), depressive symptoms (OR 16.5, 95% CI 10.0-27.2), anxiety (OR 7.9, 95% CI 4.8-12.9) and disordered eating behaviors (OR 8.7, 95% CI 4.5-16.6), likewise for those with intermediate resilience. Among YYA with T2D, those with low resilience had higher odds of depressive symptoms (OR 6.5, 95% CI 1.4-29.1) than those with high resilience, but no difference in odds of HbA1c &gt;9%, anxiety or disordered eating behaviors.
Conclusion: Given the potentially cross-cutting impact of resilience on quality of life, mental health, and diabetes self-management in YYA with diabetes, strategies to enhance resilience should be explored.

Disclosure
E.F. Julceus: None. J.A. Mendoza: None. K. Flory: None. E.A. Frongillo: None. A. Merchant: None. F. Malik: None. D.K. Cooper: None. B.A. Reboussin: None. K.A. Sauder: None. A. Bellatorre: None. A.D. Liese: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK117461)