bluuebunny/crossref_metadata_2025_split huggingface dataset:
1197-P: Effect of the "Kids in Control of Food" Program on Glycemia in Youth with Type 1 Diabetes—A Retrospective Analysis
Authors: ALMATROOK REEM , ALLAHOU BADREYA , RAHME ZAHRA , TAHA NEHAD , ALSARRAF ALI , ALMAHDI MARIA 
Published: June 2024

Introduction: Kuwait has one of the highest global incidence rates of T1D, many of which are poorly controlled. Therefore, the Dasman Diabetes Institute (DDI) has culturally adapted the Kids in Control of Food (KICk-OFF) program, aiming to improve glycemic control. The objective is to investigate the effect of the program on HbA1c in youth with T1D in Kuwait.
Methods: Data were analyzed retrospectively from 138 participants aged 11-16 years (mean age ± SD: 13.6 ± 1.9 years, 49.3% girls) that attended the program since 2019. The 4-day structured program focused on dose adjustment, carb counting, and sick/exercise day rules. Also, participants are required to attend a 1-day refresher course after 6 months. Paired t-tests were conducted using SAS software, with a significance level set at p &lt;0.05.
Results: Six months after completing the program, there was a significant reduction in HbA1c, from 9.3% ± 1.8 to 8.9% ± 1.7 (p-value &lt;0.001). Only 28% of participants attended the refresher course. Attendance was more likely among participants who did not achieve a reduction in HbA1c after 6 months (p-value &lt;0.001) (Table 1).
Conclusion: The culturally adapted KICk-OFF program shows potential for improving HbA1c in youth with T1D. Better strategies are needed to improve attendance to the refresher course, regardless of HbA1c change. Further investigations with a larger sample and longer follow-up are warranted.

Disclosure
R. Almatrook: None. B. Allahou: None. Z. Rahme: None. N. Taha: None. A. Alsarraf: None. M. Almahdi: None.
1203-P: Multiomics Imbalances Are Associated with Glycemic Control in Patients with Type 1 Diabetes
Authors: GU ZHAOHE , TAN HUILING , PAN LANXIN , ZHENG XUEYING , WANG XULIN , WANG JING , WENG JIANPING , DING YU , LUO SIHUI 
Published: June 2024

Introduction: Previous studies have indicated associations between the gut microbiota, metabolites, lipids and the onset of type 1 diabetes (T1D). We aimed to further investigate the characteristics of the gut microbiota, metabolites, and lipids in patients with T1D at different glycemic levels.
Methods: We divided 72 patients with T1D into two groups based on hemoglobin A1c (HbA1c) levels : one group with good glycemic control (GC, HbA1c &lt; 7%, n=36) and another with poor glycemic control (PGC, HbA1c ≥ 7%, n=36). We conducted 16S rRNA sequence analysis of their fecal microbiota and analyzed serum metabolites and lipids. Differential expression of microbiota, metabolites, and lipids was identified, and we annotated associated pathways through differential metabolite and lipid analysis.
Results: The two groups with different glycemic control statuses exhibited distinct characteristics in microbiota, metabolites, and lipids. linear discriminant analysis, shapley additive explanations algorithm and machine learning algorithms revealed the enrichment of Bacteroides_nordii, Bacteroides_cellulosilyticus in the GC group, while Bacteroides_coprocola and Sutterella_wadsworthensis enriched in the PGC group. Functionally, several metabolic sets like fatty acid biosynthesis, glycerol phosphate shuttle and glycerolipid metabolism were different between two groups. Correlation analyses were performed between microbiota and metabolites/lipids. Bacteroides. nordii was negatively associated with D-fructose(hit by starch and sucrose metabolism) and MG(16:0)(hit by glycerolipid metabolism) while Bacteroides_coprocola was positively associated with benzoquinone(hit by glycerol phosphate shuttle).
Conclusions: We found evidence from a multi-omics perspective demonstrating the association between the multi-omics profiles of individuals with T1D and their glucose control status.

Disclosure
Z. Gu: None. H. Tan: None. L. Pan: None. X. Zheng: None. X. Wang: None. J. Wang: None. J. Weng: None. Y. Ding: None. S. Luo: None.

Funding
The National Natural Science Foundation (82100822), the Strategic Priority Research Program of Chinese Academy of Sciences (XDB38000000), the Program for Innovative Research Team of The First Affiliated Hospital of USTC (CXGG02), and the Anhui Provincial Natural Science Foundation (2008085MH248, 2008085MH278).
1205-P: Exocrine Function in Individuals at High Risk for Type 1 Diabetes
Authors: MORNEAULT-GILL KAYLA , GUYOT MICHAEL , GESTON JARET , GEORGAS CHRISTOPHER , CAMPBELL-THOMPSON MARTHA , HALLER MICHAEL J. , BRUGGEMAN BRITTANY S. 
Published: June 2024

Introduction: The prevalence of exocrine pancreatic insufficiency (EPI) in type 1 diabetes (T1D) is approximately 33%. We are investigating the timing of exocrine pancreatic loss in the pre-T1D period. We hypothesize that fecal elastase (FE-1) will be reduced prior to Stage 1 T1D and its rate of decline used to predict disease onset.
Methods: From two parallel nested case control studies within the TEDDY study, we compare longitudinal FE-1 levels in subjects who develop T1D by age 4 (Cohort A) and who develop persistent multiple islet autoantibodies by age 4 but have not developed dysglycemia or T1D by age 6 (Cohort B) with their respective autoantibody negative euglycemic controls. We included subjects with available sample prior to key endpoints. We excluded subjects with prematurity, pancreatic disease, or medical conditions associated with EPI.
Results: About1187 blinded samples from cases and controls have been evaluated. The median FE-1 level is 958 mcg/g with an interquartile range of 594-1480. 1.8% of samples meet criteria for EPI, defined by FE-1 less than 200 mcg/g.
Conclusion: The low percentage of EPI found, along with the range of FE-1 values, agrees with previous literature (Penno et al). Our study is ongoing as there are about 4700 samples to be run. We hypothesize that future results will demonstrate the efficacy of using FE-1 as a predictive biomarker for T1D progression.

Disclosure
K. Morneault-Gill: None. M. Guyot: None. J. Geston: None. C. Georgas: None. M. Campbell-Thompson: None. M.J. Haller: Consultant; Sanofi. Advisory Panel; SAB Biotherapeutics, Inc. Consultant; MannKind Corporation. B.S. Bruggeman: Research Support; Tandem Diabetes Care, Inc.

Funding
National Institute of Health (NIH NIDDK R03DK129971 and NIH K23DK131363), Pediatric Endocrine Society Clinical Scholar Award
1213-P: The Effect of Bile Acid–RNA Methylation on Intergenerational Inheritance of Diabetes Mellitus by Microbiota Vertical Transmission
Authors: XIE QINYUAN , YUAN HUIJUAN 
Published: June 2024

Introduction & Objective: Maternal hyperglycemia during pregnancy (HIP) poses health risks to mothers and offspring, with unclear mechanisms. Our previous studies have confirmed that dysregulated vertical transmission of microbiota is one of the causes of abnormal glucose metabolism in offspring. This study further explored the effect of microbiota transmission on progeny glucose metabolism and elucidate the mechanism.
Methods: The feces of HIP mother mice in the previous study were colonized into germ-free mice, and after the difference in glucose metabolism, they were impregnated to produce offspring. OGTT were used to evaluate progeny glucose metabolism, 16S rRNA sequencing was used to detect fecal microbiota, and bile acid profiles of fecal metabolites were detected by targeting bile acid metabolites. To screen possible pathways using transcriptomic sequencing of the mouse liver for further validation at the protein and gene levels.
Results: The colonization of germ-free maternal mice with HIP’s microbiota adversely affected glucose metabolism, liver development, and RNA methylation levels in offspring. The vertical transmission of key bacteria such as Bifidobacterium choerinum is consistent with the intergenerational inheritance of abnormal glucose metabolism. Also, a significant descending of bile acid HDCA in maternal and offspring mice was observed, leading to an impaired bile acid gut-liver axis and aberrent gene expression in bile acid metabolism. Validation experiments showed the impact of varying HDCA levels on RNA methylation levels and key metabolic factors in liver cells. HDCA concentration was significantly positively correlated with the expression of SOCS3, INSR, etc. in hepatocytes.
Conclusion: Abnormal microbiota transmission caused dysregulated microbiota and reduced HDCA in HIP’s offspring, while HDCA induced elevated RNA methylation, improving metabolic gene expression.

Disclosure
Q. Xie: None. H. Yuan: None.
122-OR: ADA Presidents' Select Abstract: Lower Plasma Levels of Truncated Apolipoprotein C-I Are Associated with Increased Risk of Diabetes—Multiethnic Study of Atherosclerosis
Authors: KOSKA JURAJ , HU YUEMING , BILLHEIMER DEAN , NEDELKOV DOBRIN , BUDOFF MATTHEW , BERTONI ALAIN , MCCLELLAND ROBYN , REAVEN PETER 
Published: June 2024

Apolipoprotein C-I (apoC-I) is a key regulator of triglyceride and HDL metabolism. Preclinical data also indicate a role of apoC-I in insulin resistance (IR) and hyperglycemia. In circulation, apoC-I appears as native (C-I) and truncated (C-I’) proteoform. Higher ratio of C-I’ to C-I (C-I’/C-I) is associated with more favorable cardiometabolic risk profiles. We now tested if C-I’/C-I is associated with longitudinal changes in fasting glucose (FG) and IR, and incident diabetes. ApoC-I proteoforms were measured by mass spectrometry immunoassay in plasma from 4,747 participants of the Multi-Ethnic Study of Atherosclerosis that were without diabetes at baseline. IR estimated by HOMA-IR was measured at baseline and at ~10-year follow-up. FG and incident diabetes (FG &gt; 6.99 mmol/l or on diabetes medications) were evaluated for up to 16 years. Lower baseline C-I’/C-I was associated with greater longitudinal increases in FG and IR (by 2.7% [95%CI: 1.5, 3.9] and 4.3% [1.1, 7.3] per 1 SD decrease in C-I’/C-I), and increased risk of diabetes (n=768 events) after adjusting for baseline age, sex, race & ethnicity, income, education, BMI, systolic BP, FG, fasting insulin, antihypertensives and statins use, eGFR and plasma lipids (Hazard ratio: 1.19 [95% CI: 1.10, 1.28]). The association with diabetes was stronger in those with normal than impaired FG (1.20 [1.08, 1.33] vs. 1.09 [0.96, 1.23], p-interaction 0.023). Total apoC-I concentrations were not associated with changes in FG and IR in all models, and with incident diabetes upon adjusting for risk factors.
In conclusion, lower posttranslational apoC-I truncation was associated, independently of typical diabetes risk factors, with greater worsening of IR, greater increase in FG and higher risk of diabetes. The relationship of lower C-I’/C-I with diabetes risk appeared present prior to development of impaired FG. In contrast, total apoC-I concentrations were not related to worsening of glucose metabolism.

Disclosure
J. Koska: None. Y. Hu: None. D. Billheimer: None. D. Nedelkov: None. M. Budoff: Speaker's Bureau; Boehringer-Ingelheim, Lilly Diabetes, AstraZeneca. A. Bertoni: None. R. McClelland: None. P. Reaven: Research Support; Dexcom, Inc.

Funding
National Heart, Lung, and Blood Institute (R01-HL-138969)
1222-P: The Association between Perioperative Continuous Glucose Monitoring Metric and Post–Cesarean Section Infection in Pregnancy—A Prospective, Observational Cohort Study
Authors: LIU YUJIE , DING YU , GONG YIXIN , WEI TIAN , CHEN SUYU , ZHENG XUEYING , LUO SIHUI , WENG JIANPING 
Published: June 2024

Background and Aims: Hyperglycemia has been identified as a risk factor for infection after operation. However, the association between maternal peri-operative glucose level and post-cesarean section infection has yet to be elucidated. We used CGM to profile maternal peri-operative glucose characteristics and determine the effect on post-cesarean section infection.
Materials and Methods: This is a prospective, observational cohort study with 227 pregnant women who wore CGM before cesarean section during 2020-2022 in China. The primary outcome was maternal infection within 6 weeks after cesarean section. The definition of maternal infection was one or more than one of the following: surgical site infection (SSI), endometritis, urinary tract infection, and febrile morbidity. Logistic regression models were used to evaluate the association between CGM metrics and maternal infection with estimated risk ratios (RRs) and 95% CIs.
Results: Of the 227 studied women, 110 (48.25%) were categorized into the hyperglycemia in pregnancy (HIP) group, and 118 (51.75%) were in the non-HIP group. The incidence of post-cesarean section infection was significantly higher in the HIP group (17.43%) compared with the non-HIP group (7.63%, RR2.46, 95%CI(1.307-4.651)). Women who had post-operative infection had a significantly higher level of 3 post-operation-days(PODS) mean glucose (5.20 vs. 4.79, adjusted RR 1.03,P=0.017), glucose management indicator (5.54 vs. 5.37, adjusted RR 1.29,95% CI(1.22-10.85)), estimated HbA1c (4.89 vs. 4.63, adjusted RR 1.93,P=0.016), TAR10.0 (3.68 vs. 1.84, adjusted RR 1.17, 95% CI(1.01-1.39)), and TAR7.0 (15.68 vs. 9.98, adjusted RR 1.04, 95% CI(1.00-1.09)).
Conclusion: Women with HIP had higher incidence of post-cesarean section infection. Post-operative glucose hyperglycemia, estimated by CGM metrics, was significantly associated with post-cesarean section infection.

Disclosure
Y. Liu: None. Y. Ding: None. Y. Gong: None. T. Wei: None. S. Chen: None. X. Zheng: None. S. Luo: None. J. Weng: None.
1235-P: Gestational Diabetes Mellitus in Georgia, United States—Agreement between Maternal Self-Report and Birth Certificate Documentation
Authors: VUNCANNON DANIELLE M. , CHANDRASEKARAN SUCHITRA , LUONG JACKIE , STEVENSON INDIA C. , JOHNSON LESLIE C.M. 
Published: June 2024

Introduction: The true prevalence of gestational diabetes mellitus (GDM) in Georgia is unknown. This study aimed to report rates of GDM using two existent data sources, and to examine concordance between data that was self-reported versus abstracted from medical records.
Methods: For this mixed methods study, interviews with healthcare professionals (n=12) and 2017-2020 data from the Pregnancy Risk Assessment Monitoring System (PRAMS) for Georgia were triangulated to explain concordance in GDM diagnosis observed between PRAMS self-report and birth certificate data. Self-reported clinical outcomes, including attendance at the postpartum visit and completion of the postpartum glucose tolerance test (GTT), were compared between groups using Chi-squared tests. A content analysis of the interview data was conducted to provide context for the quantitative findings.
Results: The PRAMS sample included 3,164 individuals. 392 self-reported GDM (n=392/3,164, 12.4%) while 209 had GDM based on birth certificate data (n=209/3,164, 6.6%). 34.6% had concordant diagnoses. There was no difference in postpartum visit attendance for those who were concordant (n=137/154, 89.0%) vs. discordant (n=252/291, 86.6%). GTT completion was also similar for concordant (n=76/154, 49.4%) vs. discordant (n=137/291, 47.1%). Interview data emphasized that many patients with GDM are not well educated about the condition, with patients commonly not reporting having experienced GDM during postpartum encounters. These findings suggest that data discordance may result from recall bias, misunderstanding around GDM, and data quality issues.
Conclusion: In Georgia, rates of GDM range from 6.6-12.4% with higher rates reflecting self-reported diagnoses. Rates of concordance were low, but clinical outcomes were not notably different between groups. High rates of discordance indicate a need to improve methods for tracking and reporting GDM data.

Disclosure
D.M. Vuncannon: None. S. Chandrasekaran: None. J. Luong: None. I.C. Stevenson: None. L.C.M. Johnson: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (P30DK111024)
1256-P: Studying Mortality in Patients with Diabetes over 75 Years
Authors: KOIDE SAKIHO , ITOU TAKAYA , KOJIMA HIDEOMI , MUKAI TOMOMI , NAKASONE YASUTO , MIYAKOSHI TAKAHIRO , YAMASHITA KOH , AIZAWA TORU 
Published: June 2024

Introduction & Objective: In general, less stringent glucose management is recommended for elderly patients with diabetes. Yet, little has been known regarding actual incidence of adverse events as a function of glucose for patients over 75 years (the old-old). Aim of this study was to clarify total mortality rate (MR) and the MR related to diabetes as a function of glucose in the old-old patients with diabetes.
Methods: Consecutive 3172 patients with diabetes over 75 years who visited A hospital as new patients during 2012 and 2020 were retrospectively analysed. Of these, 1459 have been followed up for the mean of 4.1 years or until death whichever comes first. The average HbA1c obtained from the initial and the last sample was taken as the mean HbA1c of each patient. The use of oral hypoglycemic agents (OHA) and insulin, one year after the initial visit were registered in which SU, DPP4i, biguanide and SGLT2i were differentiated. Cox proportional hazards model was used to calculate hazard ratio (HR) for total or diabetes-related (stroke, coronary events and renal failure) death associated with Quartile (Q) of HbA1c. The rest (N=1703) dropped out during the study.
Results: The drop-outs and the study subjects were not significantly different. HR was J-shaped for total death and skewed U-shaped for diabetes-related death (Fig. 1).
Conclusion: Mild hyperglycemia is not associated with increased mortality in the old-old.

Disclosure
S. Koide: None. T. Itou: None. H. Kojima: None. T. Mukai: None. Y. Nakasone: None. T. Miyakoshi: None. K. Yamashita: None. T. AIzawa: None.
1258-P: Racial/Ethnic Disparities in Life Years Lost (LYL) to Type 2 Diabetes (T2D) in Medicare Beneficiaries in the United States
Authors: WANG YU , SHAO YIXUE , CHENG YILING , IMPERATORE GIUSEPPINA , LUMAN ELIZABETH , HOLLIDAY CHRISTOPHER S. , ZHANG PING 
Published: June 2024

Introduction & Objective: Racial/ethnic variation in LYL due to T2D is unclear. We estimated LYL due to T2D by race/ethnicity among Medicare beneficiaries.
Methods: Using 100% 2001-2021 Medicare claims, we identified 3,040,965 people with incident T2D using International Classification of Diseases codes and matched them with people without diabetes by race/ethnicity (White, Black, Hispanic, Asian/Pacific Islander, American Indian /Alaska Native), age, sex, and comorbidities. We followed them until death, disenrollment, or 12/31/2021. We modeled the survival rate with polynomial regression. LYL due to T2D was calculated as the difference between the aggregated annual survival rates of the two cohorts. Race/ethnic differences in LYL were compared by each sex (men and women)-age (70, 75, 80 and 85 years) group.
Results: LYL due to T2D decrease by age of diagnosis (Figure). Race/ethnic disparity in LYL vary by sex and age of diagnosis. White or American Indian /Alaska Native women had the most LYL. In men, group with the most LYL depended on the age of diagnosis.
Conclusion: T2D reduces life years differently across racial/ethnic groups. Our results could help estimate potential life years gained for Medicare programs that target various racial/ethnic groups.

Disclosure
Y. Wang: None. Y. Shao: Employee; Biogen. Y. Cheng: None. G. Imperatore: None. E. Luman: None. C.S. Holliday: None. P. Zhang: None.
1262-P: Effect of Cardiovascular Risk Factor Control on Mortality in Older Adults—Findings from the Costa Rican Longevity and Healthy Aging Study
Authors: CALVO MARIN JAVIER , TORREALBA-ACOSTA GABRIEL , ERNEST-SUAREZ KENNETH 
Published: June 2024

Introduction: The Costa Rican Longevity and Healthy Aging Study prospective cohort examined older adults' health status in Costa Rica. We investigated the influence of goal attainment on controlling cardiovascular risk factors (CVRFs): BMI, A1C, exercise, blood pressure, and smoking, along with their correlation with all-cause mortality.
Methodology: Survival data from the initial 2005 visit to 2019 included 1943 participants. Categorization was based on meeting targets for five CVRFs. Hazard ratios for all-cause mortality were estimated, adjusting for age, sex, C-reactive protein category, and history of previous cardiovascular events.
Results: The mean age for the cohort was 73.3 years, with 54.0% females. More than 2 hours of weekly exercise, controlled BMI, and A1C reduced all-cause mortality (aHR 0.77, 0.78, 0.72, respectively, p&lt;0.001) (Figure 1a). Additionally, having 4 (aHR 0.50, p=0.035) or 5 (aHR 0.34, p=0.007) controlled CVRFs reduced overall mortality within the cohort.
Conclusions: A controlled A1C and BMI and engaging in exercise correlated with reduced mortality in the Costa Rican elderly population. Additionally, aHRs for all-cause mortality decreased as more CVRFs were controlled, emphasizing the crucial role of managing these multiple factors in this population.

Disclosure
J. Calvo Marin: Speaker's Bureau; Novo Nordisk, AstraZeneca. G. Torrealba-Acosta: None. K. Ernest-Suarez: Advisory Panel; Janssen Pharmaceuticals, Inc. Consultant; Janssen Pharmaceuticals, Inc. Speaker's Bureau; Janssen Pharmaceuticals, Inc. Advisory Panel; Pfizer Inc. Speaker's Bureau; Pfizer Inc. Advisory Panel; AstraZeneca. Consultant; AstraZeneca. Speaker's Bureau; AstraZeneca. Advisory Panel; Takeda Canada. Speaker's Bureau; Sandoz.
1263-P: Determinants of Cardiovascular Risk Factors in the Aging Costa Rican Population—Insights from an Ordered Logistic Regression Model in the Costa Rican Longevity and Healthy Aging Study
Authors: CALVO MARIN JAVIER , TORREALBA-ACOSTA GABRIEL , ERNEST-SUAREZ KENNETH 
Published: June 2024

Introduction: The Costa Rican Longevity and Healthy Aging Study (CRELES), initiated in 2005, captures the health and lifestyle of elderly Costa Ricans with survival data up to 2019. We explored the association between sociodemographic and clinical variables and the number of controlled cardiovascular risk factors (CVRFs).
Methodology: From CRELES, 1943 participants were categorized for meeting targets for none to 5 CVRFs, which included A1c, blood pressure, exercise, BMI, and smoking. We modeled the association between sociodemographic and clinical variables and the number of controlled CVRFs through ordered logistic regression.
Results: Participants with 0, 1, 2, 3, 4, and 5 controlled CVRFs constituted 0.8%, 13.3%, 32.1%, 35.8%, 15.0%, and 3.0%, respectively. Males were less likely to have more controlled CVRFs (OR: 0.479, 95% CI: 0.359-0.638, p&lt;0.001). Conversely, a never-smoker status (OR: 10.2, 95% CI: 7.5-14.0, p&lt;0.001) and not having diabetes (OR: 3.1, 95% CI: 2.1-4.5, p&lt;0.001), had a higher likelihood of having more controlled CVRFs (see Table 1).
Conclusions: Female sex, increased education, living without diabetes, and non-smoking status were associated with a greater likelihood of having more controlled CVRFs.

Disclosure
J. Calvo Marin: Speaker's Bureau; Novo Nordisk, AstraZeneca. G. Torrealba-Acosta: None. K. Ernest-Suarez: Advisory Panel; Janssen Pharmaceuticals, Inc. Consultant; Janssen Pharmaceuticals, Inc. Speaker's Bureau; Janssen Pharmaceuticals, Inc. Advisory Panel; Pfizer Inc. Speaker's Bureau; Pfizer Inc. Advisory Panel; AstraZeneca. Consultant; AstraZeneca. Speaker's Bureau; AstraZeneca. Advisory Panel; Takeda Canada. Speaker's Bureau; Sandoz.