bluuebunny/crossref_metadata_2025_split huggingface dataset:
65-PUB: Relationship between Dietary and Metabolic Control in Patients with DM in Guangdong Province
Authors: CHEN XUANRONG , JIANG WEI , XIONG FEI , YANG LI , XU WEN , ZENG LONGYI , CHINA NATIONAL DIABETIC CHRONIC COMPLICATIONSSTUDY GROUP THE 
Published: June 2024

Objective: This subanalysis of a cross-sectional, nationwide study was conducted to assess the dietary status and the relationship between dietary and metabolic control in patients with DM in Guangdong Province.
Methods: Data of 1623 residents with DM (48.2% male, average HbA1c: 7.6%, average calorie intake: 1869 kcal/day) in Guangdong aged 18-74 years were included. Participants were asked to finish the questionnaires including the information of consumption of different food components. Blood glucose, HbA1c, lipids, and uric acid were also measured.
Results: Among all subjects, 55.5% had hypertension, 92.7% had dyslipidemia. And 46.6% of the subjects were with HbA1c&lt;7%, 35.7% with blood pressure&lt;130/80mmHg, and 7.1% met blood lipid control target. Only 1.7% of the subjects met all three above metabolic targets. The consumption of vegetables and livestock meat in urban areas was lower significantly, while the other food components were higher significantly in urban areas than those in rural areas. As shown in Table 1, the consumptions of food components were significantly different between subjects with optimal glycemic control, achieving LDL-C target, or with normal uric acid levels and those with poor metabolic control.
Conclusion: The metabolic control in patients with DM in Guangdong Province was still unsatisfactory. The consumption of different food components may affect the metabolic status.

Disclosure
X. Chen: None. W. Jiang: None. F. Xiong: None. L. Yang: None. W. Xu: None. L. Zeng: None.
655-P: Realizing the Hidden Emotional Burden—Systematic Detection of Diabetes Distress in Adults with Type 1 Diabetes in Routine Consultations
Authors: STENOV VIBEKE , CHRISTENSEN JETTE N. , DUE-CHRISTENSEN METTE , CLEAL BRYAN 
Published: June 2024

It is estimated that up to 40 % of people with type 1 diabetes (PWT1D) experience diabetes distress (DD) resulting in decreased quality of life and increased HbA1c. Aligned with international guidelines recommending annual DD screening in PWT1D, this study aimed to pilot test methods for nurses to systematically detect and address DD in routine consultations.
The pilot test involved 30 consultations incorporating: 1) DD screening using a validated short-form measure, the Type 1 Diabetes Distress Scale-7, capturing the most common sources of DD, 2) test of a dialogue tool supporting nurses in addressing DD, 3) semi-structured interviews with 30 PWT1D after DD screening, 4) post-consultation evaluation questionnaires for nurses. Interviews were analyzed using thematic text condensation and descriptive statistics were used for questionnaires.
The mean age and diabetes duration of PWT1D were 47 and 26 years, respectively. Fifteen participants were women. Of the 30 participants included, 53% of participants reported moderate to high DD. All PWT1D expressed very high satisfaction with discussing psychological aspects of diabetes in consultations. Analysis of interviews revealed three themes: 1) detecting sources of DD framed and structured content of crucial conversations, 2) addressing DD revealed a hidden mental burden, and 3) engaging in discussions about DD enhanced emotional well-being. Approximately 80% of the nurses reported successful dialogue about DD and 71% found the screening and dialogue tool to be a good conversation starter.
This study showed that methods for systematically detecting and addressing DD in clinical settings were useful and acceptable. Future research should explore methods for upscaling and implementing DD screening tools, ensuring a widespread and systematic approach to detect PWT1D with DD in consultations and referring to relevant treatments reducing DD in PWT1D.

Disclosure
V. Stenov: None. J.N. Christensen: None. M. Due-Christensen: Stock/Shareholder; Novo Nordisk A/S. Research Support; Novo Nordisk Foundation. B. Cleal: None.

Funding
The Juvenile Diabetes Research Foundation (201309274): Novo Nordisk Foundation (0079851)
656-P: Adapting a Personalized Text Messaging Intervention to Improve Diabetes Medication Adherence in a Spanish-Speaking Population
Authors: SEIGLIE JACQUELINE A. , TOBOLSKY SETH , CRESPO TREVINO RICAURTE , JANE CROMER SARA , MEDINA BAEZ ARANTXA , CALVERLEY MELISSA M. , LARKIN MARY E. , WEXLER DEBORAH J. , MAYBERRY LINDSAY S. 
Published: June 2024

Introduction & Objective: Medication non-adherence is a key modifiable contributor to suboptimal glycemic management among Latino adults with type 2 diabetes, but tools that address commonly reported barriers to diabetes medication adherence in this population are lacking. REACH is a text messaging platform based on the Information-Motivation-Behavioral skills (IMB) model that addresses barriers to adherence and can improve both adherence and HbA1c but is only available in English. We aimed to identify barriers to diabetes medication adherence among Latino adults with type 2 diabetes to adapt REACH to REACH-Español.
Methods: Latino adults with type 2 diabetes were invited to participate in focus groups. First, we did a free listing discussion of barriers to diabetes medication adherence, then asked participants to rank 40 barriers to diabetes medication adherence according to personal relevance (“never,” ”sometimes,” or “always”). We identified the most prevalent barriers and categorized them according to the IMB model.
Results: A total of 18 participants attended one of three focus groups. Mean age was 63.3 years and 55.0% were female. Mean HbA1c was 8.3% and mean diabetes duration was 21 years. Among the top five barriers, 80% corresponded to the Information domain: brand medication better than generic, don’t understand purpose of diabetes medication, don’t understand dose changes, and doubt that medications will improve diabetes control or prevent complications.
Conclusions: Diabetes medication adherence barriers that relate to information gaps are common in this population and can inform tailored text messaging for this intervention to reduce barriers to adherence.

Disclosure
J.A. Seiglie: Consultant; BDMT Global, Techspert.io. S. Tobolsky: None. R. Crespo Trevino: None. S. Cromer: Other Relationship; Johnson & Johnson Medical Devices Companies. Advisory Panel; Alexion Pharmaceuticals, Inc. Other Relationship; Wolters Kluwer Health. A. Medina Baez: None. M.M. Calverley: None. M.E. Larkin: None. D.J. Wexler: Other Relationship; Novo Nordisk. L.S. Mayberry: Consultant; Cecelia Health. Research Support; Hemsley Charitable Trust.

Funding
NIH/NIDDK (K23DK135798) MGH Physician Scientist Development Award
657-P: Association between Sleep and Glycemic Variability in People with Type 2 Diabetes in Real-Life Setting
Authors: YUAN JINJIN , WANG JINLE , WANG YUEYING , LIU FAN , ZHANG JIAHUI , ZHU BINGQIAN 
Published: June 2024

Objective: Glucose variability (GV) is an important indicator for glycemic control. This study aimed to investigate the association between sleep and GV among people with T2D.
Methods: A correlational design was used. Data were collected during 7 days in real-life setting. Sleep and GV were assessed simultaneously using Actigraphy and CGM. Sleep parameters were derived from Actigraphy using default algorithm. GV was quantified as standard deviation (SD) and coefficient of variation (CV) of glucose, percentage of time in range (TIR), time above range (TAR), time below range (TBR), mean amplitude of glycemic excursion (MAGE) during rest interval at night. Associations were examined using linear mixed-effect models.
Results: Fifty participants (60.1 years, 27 females) were recruited and 295-night data were analyzed. Controlling for covariates, longer wake after sleep onset was associated with higher SD, CV, and MAGE (coefficient=0.003, p=0.023; coefficient=0.001, p=0.002; coefficient=0.009, p=0.006), and lower TIR (coefficient=-0.001, p=0.049). Higher sleep efficiency was associated with lower SD, CV, MAGE, and TAR (coefficient=-1.003, p=0.049; coefficient=-0.174, p=0.005; coefficient=-3.758, p=0.012; coefficient=-0.396, p=0.031), and higher TIR (coefficient=0.437, p=0.020). Higher sleep fragmentation index was associated with higher TAR (coefficient=0.002, p=0.045). Earlier sleep timing (sleep midpoint&lt;4:00 am) compared to late sleep timing, was associated with lower nighttime TAR (coefficient=-0.092, p=0.017). Shorter sleep duration (&lt;8h) compared to longer, was associated with lower SD and MAGE (coefficient=-0.609, p&lt;0.001; coefficient=-1.624, p&lt;0.001).
Conclusions: At the individual level, better sleep is associated with lower GV, supporting the importance of sleep in optimizing glycemic control. Interventional studies are needed to reveal the causal relationship.

Disclosure
J. Yuan: None. J. Wang: None. Y. Wang: None. F. Liu: None. J. Zhang: None. B. Zhu: None.

Funding
National Natural Science Foundation of China (71904119)
659-P: Racial and Ethnic Differences in Risky Behavior and Sedentation among Young Adults with Diabetes
Authors: JACOBS MOLLY M. , BURCH ASHLEY 
Published: June 2024

Background: A healthy lifestyle plays a key role in managing diabetes and limiting long-run complications. Using a nationally representative panel data set of youth and young adults, this study examined racial and ethnic differences in risky behaviors (smoking, alcohol consumption, marijuana use, sexual activity, fast food consumption) and sedentation (hours of television, exercise frequency) among respondents aged 18 to 43 with diabetes.
Methods: Among the 12,300 respondents in Waves III (2001-02), IV (2008-09), and V (2016-18) of the National Longitudinal Study of Adolescent to Adult Health (ADD Health), 780 (6.34%) had been diagnosed with diabetes. Stratified, mixed effects regression models assessed racial and ethnic differences in risky behavior and sedentation accounting for heterogeneity in age, sex, income, region of residence, education, and health insurance. Odds ratios and marginal effects quantified the comparative differentials between groups.
Results: The sample of young adults with diabetes was 39.51% male and 60.49% female and composed of 61.28% White, 22.24% Black, 3.36% other racial groups, and 12.85% Hispanic. Respondents ranged in age from 18-27 (Wave III), 25-34 (Wave IV), and 33-43 (Wave IV). Relative to Whites, Blacks reported smoking cigarettes 4.32 (SE=1.01) less days per month and were less likely to use marijuana (OR=0.41, CI=0.35, 0.48), but were significantly more likely to use alcohol (OR=1.53, CI=1.21, 1.86) and consume fast food (OR=1.76, CI=1.45, 2.05). Other racial groups, compared to Whites, were more likely to exercise (1.25, CI=1.01, 1.50), while Hispanics watched an average of 5.37 (SE=5.46) more hours of television each week.
Conclusions: Results suggest racial and ethnic differences in risky behavior patterns among young adults with diabetes which may explain differences in later-life complications and mortality.

Disclosure
M.M. Jacobs: None. A. Burch: None.
666-P: CGMs, Pumps, and Insulin Pen Access Assessment of Pediatric Type 1 Diabetes Population at a Southeastern Academic Medical Center
Authors: HALL MEGAN , RODRIGUEZ CARLA , MALONEY MADISON G. , GONDER-FREDERICK LINDA 
Published: June 2024

Introduction & Objective: Academic medical centers have identified disparities in access to diabetes technology among adults but pediatric population access is understudied. This analysis performed a self-assessment of potential inequities in access to diabetes technology at this medical center, including CGMs, insulin pumps, and insulin pens for pediatric patients.
Methods: This study analyzed deidentified EMR data using multivariable logistic regressions to determine the association of social determinants (age, sex, race-ethnicity, insurance, and neighborhood socioeconomic disadvantage) with technology use among pediatric patients (ages ≤18) with T1D.
Results: Of 332 patients with T1D seen at UVA Health in 2022, 229 accessed CGMs, 57 used pumps, and 115 used insulin pens. For CGMs, public insurance and uninsured status related to lesser use/access. Pens appear to be accessed more equitably. (See Figure 1.)
Conclusion: CGMs are by far the most utilized technology in this pediatric population, followed by pens. Barriers to pump usage in this population need to be better understood but this center's small sample size makes the extent of inequities in access unclear.

Disclosure
M. Hall: None. C. Rodriguez: None. M.G. Maloney: None. L. Gonder-Frederick: None.

Funding
Lomar Foundation
675-P: Relationship between Perceived Technology Burden and Diabetes Distress in Closed-Loop Control (CLC) System Use
Authors: GANJIARJENAKI MOHAMMADREZA , FERNANDES MOURA B BATISTA ANNANDA , GONDER-FREDERICK LINDA 
Published: June 2024

The influence of CLC systems on quality-of-life factors is complex. This study investigates the dynamic relationship between diabetes distress and perceived technology burden in CLC users over a 26-wk period. The study utilized data from clinical trial NCT03563313, in which individuals with T1D used CLC systems. Diabetes distress and technology burden were assessed at three-time points: baseline (wk 0), mid-study (wk 13), and study end (wk 26). Cross-lagged panel models were tested in structural equations to explore the temporal dynamics between diabetes distress and technology burden throughout the research. The structural equation model shown in Figure 1 demonstrated a good fit to the data, with a non-significant chi-square (p = 0.18), Comparative Fit Index of 0.99, Tucker-Lewis Index of 0.98, and Root Mean Square Error of Approximation of 0.07. The model and significant autoregressive and cross-lagged paths indicate that increases in perceived technology burden are associated with subsequent increased diabetes distress. These results show that rising technology burden from CLC predicts higher diabetes distress, impacting life quality and CLC continuation.

Disclosure
M. Ganjiarjenaki: None. A. Fernandes Moura B Batista: None. L. Gonder-Frederick: None.
696-P: Women Benefit from Community-Based Peer Support for Diabetes Management in Shanghai, China
Authors: LIU YUEXING , CAI CHUN , WU XIAOYU , TANG PATRICK Y. , COUFAL MUCHIEH M. , SHEN LI , FISHER EDWIN B. , JIA WEIPING 
Published: June 2024

Women face varied challenges in diabetes management. These call for examination of women’s responses to diabetes management and support programs. A community-based peer support program was implemented in 12 Intervention Communities (ICs) with 4 Comparison Communities (CCs) in Shanghai, China from 2019-2021.
Women constituted 56.8% of the sample in ICs but 46.4% in CCs (p = 0.003), indicating advantages of the program in recruiting women. Accordingly, all analyses controlled for variables associated with gender differences: age, diabetes duration, baseline BMI.
Analyses of clinical/quality of life changes controlled for corresponding baseline measures.At baseline, women had lower HbA1c (7.44% vs 7.63%) and FPG (7.74 vs 8.12 mmol/L), but slightly higher SBP (138.25 vs 136.12 mmHg). Women scored slightly higher on a four item measure of diabetes distress, (1.17 vs 1.15, range = 1-3) and on the PHQ8 measure of depressed mood (1.96 vs 1.33).
Among all participants (all ps ≤ 0.04), ICs exceeded CCs on beneficial changes in HbA1c (-0.06% vs. 0.22%) including among those with HbA1c ≥ 8% at baseline (-0.76% vs. -0.41%), FPG (-0.04 vs. 0.76 mmol/L), among those with FPG &gt; 7 mmol/L at baseline (-0.54 vs. -0.06 mmol/L), and both diabetes distress (-0.07 vs. 0.06) and PHQ8 (-0.49 vs. 0.54).
Among women, ICs exceeded CCs for change in HbA1c (-0.12% vs. 0.15%), FPG (-0.15 vs. 1.12 mmol/L) and among those ≥ FPG 7 mmol/L at baseline (-0.74 vs. 0.39 mmol/L), and both diabetes distress (-0.06 vs. 0.11) and PHQ8 (-0.55 vs. 0.93) (all ps≤0.008). For men, ICs differed significantly from CCs for only two variables, less worsening for both HbA1c (0.02 vs. 0.28) and FPG (0.10 vs. 0.46) (ps ≤ 0.028).
Summarizing, women showed beneficial changes, including HbA1c, FPG, diabetes distress, and PHQ8. Community based peer support for diabetes management may offer both clinical and quality-of-life benefits for women, in spite of other biological and social challenges to diabetes and its management that women face.

Disclosure
Y. Liu: None. C. Cai: None. X. Wu: None. P.Y. Tang: None. M.M. Coufal: None. L. Shen: None. E.B. Fisher: None. W. Jia: None.

Funding
Shanghai Key Discipline of Public Health Grants Award No. GWVI-11.1-20, and Shanghai Municipal Grants Award No. GWIV-3.1 to Professor Weiping Jia as principal investigator, Shanghai Municipal Health Commission “Health Promotion Talent” grant No. JKKPYC-2022-12 to Dr. Yuexing Liu as principal investigator, and by grants from The Merck Foundation and from Sanofi China, both to Professor Edwin Fisher as principal investigator, and by the UNC-Michigan Community, Family, and Peer Support Core of the Michigan Center for Diabetes Translational Research, P30 DK092926.
7-PUB: Student-Led Initiative Addressing Health Care Gaps in South Carolina Free Medical Clinics
Authors: LUNT ANNABELLE , BECKER MADELINE E. , PARKER MARTINEZ O. , REESE MOLLIE 
Published: June 2024

Introduction & Objective: Diabetes is a leading cause of death in South Carolina and disproportionally affects those of lower socioeconomic status. Medical Students Making Change (MSMC) is an initiative at the University of South Carolina that aims to improve lifestyle management and glycemic control in uninsured patients with diabetes. Via an innovative telehealth approach, this project provides patients guidance to address and identify health disparities affecting their chronic condition. We hypothesize that this intervention will significantly reduce hemoglobin A1c and improve patient confidence in managing their diabetes over a six-month period.
Methods: Patients with newly diagnosed or uncontrolled diabetes in two free medical clinics are paired with a medical student volunteer who follows them over the course of six months with biweekly telephone visits. Visits primarily focus on diabetic education, lifestyle goals, and barriers to care. Hemoglobin A1cs are obtained at enrollment, three months, and six months.
Results: Patient screening began in August 2023 and was performed regardless medical history of diabetes. Currently, 46 patients have been screened: 14 patients are enrolled with a baseline A1c of 10.3; 15 patients are not enrolled despite A1c values &gt;6.5%; and 16 patients did not meet A1c requirements for enrollment. Patient barriers most identified included food insecurity, exercise ability, and lack of transportation.
Conclusion: Our initiative promotes longitudinal relationships allowing patients the education and resources needed to manage their diabetes. From our pilot study, we gained resources to increase monitoring for appropriate follow up A1cs and increase screening among all clinic patients regardless of medical history of diabetes. As the current results highlight the need for increased diabetic screening, the goal of this project is to make a significant impact on diabetes outcomes and reduce healthcare barriers for this vulnerable population.

Disclosure
A. Lunt: None. M.E. Becker: None. O. Martinez: None. M. Reese: None.
702-P: Prescription Medication Use for Treatment of Mental Health Conditions among Adults With and Without Diabetes, 1999–2020
Authors: RUTKOWSKI RACHEL E. , BULLARD KAI M. , ROLKA DEBORAH B. 
Published: June 2024

Introduction & Objective: Mental health conditions, such as depression and anxiety, can adversely affect one’s quality of life. Prescription medication and other therapeutic measures are often needed for treatment. The purpose of this study is to estimate the prevalence and trends of psychotherapeutic medication use, and associated clinical and sociodemographic factors, among US adults with and without diabetes.
Methods: Data from 57,083 non-pregnant adults (≥20 years) in the 1999-March 2020 National Health and Nutrition Examination Survey were analyzed. Diabetes status was based on self-reported diagnosis or HbA1c level ≥6.5%. Prescriptions for anti-depressants, stimulants, anti-psychotics, anti-stimulants, anti-anxiety (anxiolytics, sedatives, and hypnotics), and psychotherapeutic combinations taken in the past 30 days were assessed with a medication container inventory and classified using the Lexicon Plus classification system. Predictive margin percentages and ratios with 95% confidence intervals were calculated from multivariable logistic regression models adjusted for age, race and ethnicity, sex, BMI, and time to assess the association of diabetes status and medication use.
Results: During 1999-March 2020, the covariate adjusted percentages of US adults reporting use of psychotherapeutic medications was 20.1% (95% CI: 18.8-21.5) for those with diabetes and 15.5% (95% CI: 14.9-16.2) for those without diabetes. The highest ratio of psychotherapeutic medication use among those with diabetes compared to those without was observed for stimulants (2.3, 95% CI: 1.8-2.9), followed by anti-depressants (1.6, 95% CI: 1.5-1.7), anti-psychotics (1.6, 95% CI: 1.3-1.9), and lastly anti-anxiety (1.3, 95% CI: 1.2-1.5).
Conclusion: Our study findings support an association of diabetes and mental health prescription drug usage. Adults with diabetes have higher observed prevalence of taking psychotherapeutic medications.

Disclosure
R.E. Rutkowski: None. K.M. Bullard: None. D.B. Rolka: None.
710-P: Social Determinants of Health (SDOH)—The Importance of Screening, Resource Delivery, and Follow-up
Authors: HOLLY SARAH L. , SEGAWA MAI , DEANNA LAUREN , VELASQUEZ ROXANNA E. , ROBERTS JASMINE , MAJIDI SHIDEH 
Published: June 2024

Introduction: The significant transition that a family must undergo after a diabetes diagnosis can be particularly difficult for families facing other barriers and disparities. Patients with adverse SDOH may endure negative impacts to their diabetes care and management. Assessing and addressing these underlying determinants, particularly during new diagnosis, is critical to identifying barriers to care as early as possible and working towards equitable care. SDOH screening, resource delivery, and follow-up were established in a large academic center.
Methods: A literature review of SDOH screens was conducted with subsequent edits by the diabetes social workers (SW). The screen targets 10 domains of SDOH and is administered by the SW to caregivers at time of diabetes diagnosis. Caregivers who identify a barrier(s) are provided with a list of tailored resources by the SW. One week after resources are provided, the diabetes health coach (HC) checks in via phone to assess resource utilization and/or if additional help is needed.
Results: Thirty SDOH screens have been completed to date with 11 caregivers identifying a barrier(s). Twenty-six total barriers were identified across all domains with 22 subsequent resources provided. Food insecurity and mental health were among the most identified SDOH barriers. The HC assessed resource utilization and/or provided additional assistance to 9 of the 11 caregivers. All 9 caregivers reported successful utilization of the SDOH resource(s).
Conclusions: Health disparities in care must be and can be addressed as early as diagnosis so proper care, resources, and follow-up can be put in place to meet the needs of families and improve diabetes outcomes. The combination of a comprehensive set of SDOH resources and supportive follow-up is necessary to offsetting disparities. Further expansion of this initiative will include periodic screening beyond the time of diagnosis, continued resource follow-up, and impact evaluation on diabetes outcomes.

Disclosure
S.L. Holly: None. M. Segawa: None. L. DeAnna: None. R.E. Velasquez: None. J. Roberts: None. S. Majidi: Other Relationship; Sanofi.

Funding
CareFirst