bluuebunny/crossref_metadata_2025_split huggingface dataset:
577-P: Employee Diabetes Program Effects on Time to Reach Glycemic Goals and Improved Care in the Ambulatory Care Setting
Authors: HABIB HELEN A. , SAAD NASSER , HUGHES LUCILLE 
Published: June 2024

Introduction & Objective: Employer based diabetes programs have been created to maximize diabetes related outcomes and increase value based care. The aim of this program is to provide sustained multidisciplinary diabetes education enforcing the ADA Standards of Care to those with our employer based health plan. Waived copays on diabetes medications and supplies was incorporated to increase engagement.
Methods: This ambulatory diabetes program included those 18 years of age or older with diabetes and our employer based health plan. The program is a voluntary, opt-in program. Persons with diabetes included those who enrolled between November 2022 and October 2023. Interventions with recommendations were communicated to the person with diabetes’ providers related to their diabetes and cardiovascular related management. Outcomes related to mean changes in person weight and A1C for those actively engaged in the program were evaluated.
Results: A total of 247 adults were initially enrolled in the employee diabetes program. The baseline A1C was 116 with A1C &lt;7%, 59 with A1C ≥7- ≤ 8%, 30 with A1C &gt; 8- ≤ 9%, and 42 persons with A1C &gt;9% respectively. There were 1,131 initial interventions made in relation to their diabetes and cardiovascular medications/supplies, immunization, preventative medication, laboratory and referral recommendations. In the final outcome analysis, 208 persons were included due to continued active engagement in the program. The mean change in weight from baseline was found to be -1.75 kg (-1.73%) and the mean change in A1C from baseline was -0.94 (-9.71%).
Conclusion: Our employee diabetes program showed a trend toward improved persons with diabetes outcomes with active engagement up to one year. The waived copay financial incentive related to diabetes medications and supplies motivated follow-up engagement and numerically lead to a reduction in weight and A1C values. Further examination is planned for new and those with continued enrollment.

Disclosure
H.A. Habib: None. N. Saad: None. L. Hughes: Advisory Panel; embecta.
580-P: Dialogues in Diabetes—Addressing Knowledge and Behavior Gaps among Clinicians Who Care for Patients with Diabetes and Obesity
Authors: ROBINSON KATIE , FREDERICK JENNIFER , ESGRO ROBERT A. , COLLIER HANNAH 
Published: June 2024

Rationale: While obesity management may be beneficial in the treatment of type 2 diabetes (T2D), achieving weight loss required to achieve these benefits is difficult. New incretin-based options can help treat both conditions, but clinicians lack awareness of and comfort in using these agents.
Methods: Vindico provided a continuing education (CE) e-monograph designed for primary care providers (PCPs) and endocrinologists who treat patients with diabetes. Baseline knowledge and behaviors as well as educational impact were assessed via pre- and post-test.
Results: A total of 1,692 PCPs and 535 specialists read the monograph. Baseline knowledge was low (average 36% correct) on all topics and was similar between cohorts, except regarding multi-receptor agonism and the impact on weight and A1C, on which specialists scored higher than PCPs (54% vs. 41%). Both cohorts scored lowest regarding the use of incretin-based therapies. Despite this, baseline reported use of incretin-based therapies was high, suggesting that while providers think they are practicing the latest evidence-based care, they may not be. Post-learning, there was 44% relative increase in knowledge, demonstrating large gains in knowledge across cohorts and topics. These knowledge gains translated into 72% of endocrinologists and 70% of PCPs having high levels of post-education confidence regarding the use of new incretin-based options as well as increased preparedness to implement new incretin-based options into practice. Because of the education provided, over 12,000 patients with diabetes and overweight or obesity per week are 56% more likely to receive the latest evidence-based care.
Conclusion: In our dataset, providers had inadequate baseline knowledge regarding the burden of obesity in patients with diabetes and new strategies for weight loss. The findings illustrate the benefit of targeted CE on clinician knowledge, behaviors, and confidence towards improved patient outcomes.

Disclosure
K. Robinson: None. J. Frederick: None. R.A. Esgro: None. H. Collier: None.

Funding
This activity was supported by an educational grant from Lilly.
581-P: Effects of Recommending Clinic Visit to People with Diabetes Detected during Health Checkups on Remission—A Cluster Randomized Trial
Authors: KIMURA DAICHI , KATO KIMINORI , FUJIHARA KAZUYA , SONE HIROHITO 
Published: June 2024

Our recent study revealed that diabetes remission is more likely to occur when disease duration is short and HbA1c is low. We conducted a cluster randomized trial to determine whether encouraging people with diabetes to visit a clinic after a health checkup is effective for remission.
A total of 1,185 people (51y, 78% male) who diagnosed as diabetes at a workplace health checkup by any of three criiteria (HbA1c≥6.5%, FPG≥126 mg/dL, or postprandial PG ≥200 mg/dL) were cluster-randomized into two groups by workplaces.
While those in the control group received only the checkup results, those in the intervention group was additionally given a referral letter to a clinic.
In addition, those who still did not visit the clinic were encouraged to do so through health checkup centers, and the remission rates were compared between the groups. Remission was defined as no longer meeting the above three conditions. The remission rate at one year was significantly higher in the intervention group, 32%, compared to 25% in the non-intervention group (p=0.007). Significant predictors of remission by multivariate logistic analysis were age, exercise and the intervention. The intervention significantly increased remission by 1.4-fold, even after adjusted by initiation of diabetes medications.
These results suggest that the intervention increased remission through lifestyle modification.

Disclosure
D. Kimura: None. K. Kato: None. K. Fujihara: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.
59-OR: Improving Diabetic Kidney Disease Screening in a Veterans Affairs Primary Care Clinic
Authors: HARRIS ANDREW T. , FRANGELLA KRISTINA P. , SANTIAGO LUIS R. , EROSSY PETER J. , FALCK-YTTER CORINNA , DESAI NIRAJ , EDMISTON ELIZABETH 
Published: June 2024

Introduction & Objective: Diabetic Kidney Disease (DKD) is a major cause of end stage renal disease. Up to half of Americans with DKD are unaware of the diagnosis and community screening rates for albuminuria varies widely. Using Lean quality improvement methods, we aimed to improve our DKD screening rate to greater than 60%.
Methods: An interdisciplinary team was formed in December 2022 at a large, urban VA medical center serving approximately 20,000 Veterans with diabetes. Successful DKD screening was defined as annual serum estimated glomerular filtration rate (eGFR) and urine albumin-to-creatine ratio (UACR). Sequential interventions included provider education, system-wide monthly population health reports, elimination of ability to select incorrect lab orders, electronic reminders in EMR, and templated EMR notes to capture outside testing.
Results: Screening rates for DKD improved from 54.8% to 71.3% in November 2023. Baseline drivers of poor screening included unawareness of need for UACR screening, ordering urine albumin without urine creatinine, failure to inform Veterans that a urine test was ordered, and Veterans’ inability to produce a urine sample.
Conclusion: Lean methodology combined with strong change management increased UACR screening rates for DKD. Education can be effective when combined with timely supportive system interventions and regular feedback on outcomes.

Disclosure
A.T. Harris: None. K.P. Frangella: None. L.R. Santiago: None. P.J. Erossy: None. C. Falck-Ytter: None. N. Desai: None. E. Edmiston: None.
593-P: Glycemic Effect of Free-Living Activities in Adults with Type 1 Diabetes
Authors: DHALIWAL MEHAK P. , TANG KENAN , AIELLO ELEONORA M. , QIN YAO 
Published: June 2024

Introduction: This work analyzes data from the free living exercise sessions of the T1DEXI study to evaluate the effect of several factors on the change in glucose levels (ΔCGM) of Type-1 diabetes (T1D) subjects during physical activity.
Methods: We calculate ΔCGM as the difference in glucose readings 10 minutes before and after each exercise session. We use the Analysis of Variance (ANOVA) method for measuring the statistical significance of the impact of various relevant factors on ΔCGM.
Results: We analyzed 11,743 free living exercise sessions, comprising 48 different activity types, for 502 T1D patients.
Overall, there was an average drop in glucose of 19.98 ± 48.48 mg/dL after the free-living exercise sessions. Figure 1 shows the variation of ΔCGM after exercise with different factors.
Figure 1 shows a greater ΔCGM for increasing session durations (p&lt;0.01), for higher initial glucose at the start of the session (p&lt;0.01), for age group (p=0.01) and HbA1c group (p=0.06). Figure 1 also shows that carb intake before the session leads to a smaller glucose drop (p &lt; 0.01) but during the session indicates a significantly higher glucose drop (p&lt;0.01). Male participants had a larger drop than female participants (p=0.06).
Conclusion: The results obtained suggest that session duration increases the drop in glucose, while the CHO intake attenuates it, and individual-level factors (HbA1c, gender, age) have a significant impact on the ΔCGM.

Disclosure
M.P. Dhaliwal: Consultant; Tidepool. K. Tang: Consultant; Tidepool. E.M. Aiello: Other Relationship; Tidepool. Y. Qin: None.

Funding
The Leona M. & Harry B. Helmsley Charitable Trust (2404-06905)
6-PUB: Prevention of Severe Lower Extremity Artery Disease in Patients with Diabetes—Analysis of Factors Using a Large Database
Authors: HORII TAKESHI , MIHARA KIYOSHI 
Published: June 2024

Lower extremity artery disease (LEAD) leading to comprehensive chronic lower limb ischemia has been reported to increase the risk of lower limb amputation and death from macrovascular disease in patients with type 1 diabetes(T1D) and type 2 diabetes(T2D). Due to the lack of large-scale studies on LEAD in Asians with diabetes, we investigated factors that may reduce LEAD severity. This cross-sectional study was performed using data from the Medical Data Vision administrative claims database. Wound care was defined as the severity of LEAD. Factors associated with reducing the severity of LEAD was analyzed using logistic analysis with the presence of wound care as the objective variable and patient background, presence and frequency of diabetes educational hospitalization, and concomitant medications as explanatory variables. The study population consisted of 282,353 patients with LEAD disease. Wound care was performed on 32,978 patients (5.4%). Multivariate analysis was performed, and the results were as follows: once (OR: 0.26), twice (OR: 12.6), three or more times (OR: 8.3) with no diabetes education hospitalization as the reference. As &lt;65 years of age as reference, patients aged 65-74 years (OR: 0.60), ≥75 years (OR: 0.38), and T1D as reference, T2D (OR: 1.68). SUs, metformin, SGLT2is, GLP-1s, DPP-4is, CCBs, angiotensin receptor-neprilysin inhibitors, statins, and fibrates significantly reduced OR. This study also allowed us to identify patient backgrounds predisposed to LEAD severity and medications that may reduce severity of LEAD. In addition to the implementation of educational hospitalization, this study will help in the selection of drugs to reduce the severity of LEAD.

Disclosure
T. Horii: None. K. Mihara: None.
60-PUB: Simultaneous Analysis of Serum Monosaccharides Levels among Adults of Self-Reported Diabetes Status using Non-Derivatized LC-MS/MS Method
Authors: TSE CHUI , ZHANG LI , DANILENKO ULIANA , DAHYA KOMAL , SUGAHARA OTOE , POKUAH FIDELIA , VESPER HUBERT 
Published: June 2024

Introduction and Objective: Glucose is the major biomarker for diagnosis and management of diabetes. Fructose is sometimes used to replace glucose and reduce glucose intake. Increased consumption of fructose was shown to contribute to non-alcoholic fatty liver disease (NAFLD). To better understand the associations between monosaccharides levels in blood and metabolic diseases in human, a high-throughput LC-MS/MS method was developed for simultaneous measurement of monosaccharides.
Methods: In this study, we measured serum monosaccharides concentrations in 100 non-fasting adult donors with self-reported diabetes status using a LC-MS/MS method for glucose, fructose, mannose, and galactose. We evaluated the correlations among monosaccharide concentrations, self-reported age, gender, BMI, and diabetes status in donors.
Results: All monosaccharides, except for galactose, were detected in all blood samples. The mean glucose concentration from donors with self-reported diabetes was significantly higher than the donors without diabetes (164.53 mg/dL vs 90.23 mg/dL, p &lt;0.001). The same distribution was observed for mannose concentration between the two groups (2.25 mg/dL with diabetes vs 1.30 mg/dL without diabetes, p &lt;0.001). No significant difference for fructose concentration was observed between both groups. However, the mean ratios of fructose to glucose concentrations were significantly lower in donors with self-reported diabetes than those without (0.004 vs 0.014, p &lt;0.001).
Conclusion: The use of our recently developed high-throughput LC-MS/MS can simultaneously measure concentrations of multiple monosaccharides in human serum. The method can be used to investigate for the roles of these monosaccharides in metabolic diseases in large epidemiological studies.

Disclosure
C. Tse: None. L. Zhang: None. U. Danilenko: None. K. Dahya: None. O. Sugahara: None. F. Pokuah: None. H. Vesper: None.
606-P: Mitigating Type 2 Diabetes Risks—A 12-Week At-Home Physical Activity Intervention for Improving Metabolic Health in the Growing Asian Immigrant Community
Authors: KUERBAN ALIYA 
Published: June 2024

Introduction & Objective: As the immigrant community experiences rapid growth in the U.S., Asians encounter diverse health challenges, with a notable focus on addressing type 2 diabetes (T2D). Enhancing muscle mass has been identified as a means to alleviate insulin resistance and, consequently, enhance metabolic health. This study aims to evaluate the effectiveness of a 12-week structured at-home physical activity program on the metabolic health of Asian adults, acknowledging its potential to reduce T2D risks by promoting overall metabolic well-being.
Methods: Participants, aged 18 to 80, were selected through convenient sampling from a local church with a predominantly Chinese ethnic congregation. Inclusion criteria focused on age, while individuals with a BMI over 70 or serious medical conditions hindering participation in the physical activity program (twice a week for 12 weeks) and a 30-minute weekly aerobic exercise were excluded.
Results: Out of 18 recruited individuals (mean age 50.4), 16 adhered to the exercise regimen throughout the 12 weeks, with four completing 85% or more of the program. Fourteen individuals returned for the final assessment. A majority (84.6%) demonstrated increased sit-down and stand-up rates in 30 seconds, while half exhibited improved hand grip strength, notably in the left hand. Other metabolic measurements did not show significant changes.
Conclusion: This study reveals that a cost-effective, convenient at-home structured physical activity program significantly enhances lower extremity strength and handgrip strength among Asian adults over 12 weeks, offering valuable insights for addressing health challenges, particularly T2D, in this demographic.

Disclosure
A. Kuerban: None.
609-P: Effects of Oligomalt (OM), a New Slowly Digestible Carbohydrate (SDC), on Postprandial (PP) Glucose, Insulin, and GLP-1 Trajectories Compared with Maltodextrin (MD) in People with Obesity (PwO) or Type 2 Diabetes (T2D)—A Double-Blind RCT
Authors: ERIK JOHANSEN ODD , NEUTEL JOEL M. , GUPTA SANJAY , MARIANI BARBARA , UFHEIL GERHARD , PERRIN EMILIE , OCAMPO NAOMI , VON EYNATTEN MAXIMILIAN 
Published: June 2024

Introduction & Objective: to assess glucometabolic effects of OM, a novel fully digestible SDC.
Methods: In a cross-over RCT, we tested 33g and 50g of OM/MD in PwO (n=26, mean age 44 yrs, BMI 29.9 kg/m2, HbA1c 5.3%), and 50g in people with T2D (n=22, age 61 yrs, BMI 31.8 kg/m2, HbA1c 7.4%). OM/MD was dissolved in water (300mL) and consumed fasted. The primary exploratory endpoint was the incremental area under the curve (iAUC) for glucose, assessed by frequent blood sampling over 3h. Insulin and GLP-1 were also assessed. Analysis was performed by a mixed model (LS mean [95% CI]).
Results: OM elicited a significantly lower PP glucose response vs MD, for both doses in PwO (Fig) (e.g., 0-60 min 33g: ΔGlu iAUC -38% [-12.95 (-19.50, -6.41) mg/dLxh, p=0.0002]; 50g: -28% [-10.07 (-16.52, -3.61), p=0.0027]), as well as for PP insulin response (-60% to -38% across dose, and time periods, Fig [all p &lt;0.05]). The 0-90 min PP GLP-1 response with OM relative to MD was smaller (50g: -24.2% [p=0.0425]; 33g: -22.7% [p=0.1883]), whereas 90-180 min larger (Fig; 50g: +408.6% [p&lt;0.0001]; 33g: +308.0% [p=0.0036]. Patterns were similar in people with T2D.
Conclusion: The results underscore a slow hydrolysis of OM, and support it`s glucometabolic advantages over MD, hence representing a healthier carbohydrate.

Disclosure
O. Johansen: Employee; Nestlé Health Science. J.M. Neutel: None. S. Gupta: None. B. Mariani: None. G. Ufheil: Employee; Nestlé Health Science. E. Perrin: Other Relationship; Nestlé Health Science. N. Ocampo: None. M. von Eynatten: Employee; Nestlé Health Science.
61-OR: Effectiveness of Telemedicine plus Conventional Care vs. Conventional Care Alone in Reducing Complications of Diabetes—A Pilot Study
Authors: KESAVADEV JOTHYDEV , SHANKAR ARUN , SANAL GEETHU , JOTHYDEV KRISHNADEV , BASANTH ANJANA , RAJ K SOURAV , JOTHYDEV SUNITHA 
Published: June 2024

Telehealth interventions are increasingly recognized as effective strategies for improving health and ensuring better patient outcomes. This study focuses on Diabetes Tele-Management System (DTMS®), a comprehensive telemedicine program established in Kerala, India in 1997. In this cross-sectional study, T2D for &gt;10yrs were divided into 2groups. One group received Conventional Care (CC): minimum of three physical visits per year. Another group received Telemedicine as an add-on to Conventional Care (TCC): same physical visits plus at least two telemedicine consultations per month. TCC group (n=59; age: 59.86±10.91yrs; 52.5% females; duration: 14.78±3.69yrs) exhibited a 48.4% lower proportion of complications than the CC group (n=65; age: 56.18±10.5yrs; 55.4% females; duration: 11.19±4.57yrs) (p &lt; 0.05). All the subjects were literate with nearly 50 % being graduates. Neuropathy was the most common complication observed, followed by CAD. (Figure) This study over 8-10yrs of follow-up demonstrates that integrating telemedicine with conventional care significantly reduces micro and macrovascular complications in T2D by 48.4 % compared to conventional care. This model may be recommended as a standard of care in diabetes based on evolving evidence as a highly cost-effective strategy.

Disclosure
J. Kesavadev: None. A. Shankar: None. G. Sanal: None. K. Jothydev: None. A. Basanth: None. S. Raj K: None. S. Jothydev: None.
612-P: Impact of Continuous Glucose Monitoring (CGM) vs. Blood Glucose Monitoring (BGM) on Dietary Adherence and Weight during a Medically Supervised Ketogenic Diet Program (MSKDP) in People with Type 2 Diabetes (T2D)
Authors: WILLIS HOLLY J. , MCKENZIE AMY L. , ROBERTS CAROLINE G.P. , ASCHE STEPHEN E. , KRIZKA SHANNON , ADAMS REBECCA N. , VOLK BRITTANIE M. , ZOLLER ALISON R. , ATHINARAYANAN SHAMINIE J. , BERGENSTAL RICHARD M. 
Published: June 2024

Introduction: Lifestyle-based interventions that promote nutritional ketosis can be effective for T2D management. This three-month trial compared use of CGM or BGM to support a MSKDP delivered via continuous remote care.
Methods: In this randomized trial, CGM (N=81) or BGM (N=82) data were used by participants and the care team to support dietary adherence and medication management decisions. Differences in 90-day mean blood beta-hydroxybutyrate (BHB) levels and in changes in dietary intake and weight from baseline to three months (Base to M3) were assessed. This is a secondary and exploratory outcome analysis.
Results: Participants in CGM and BGM arms were not different at baseline (Mean + SD): 53 + 10 years old; 10 + 8 years with T2D; HbA1c 8.1% + 1.2%; taking 2.2 + 1.0 diabetes medications. The 90-day mean BHB levels were 0.54 mmol/L for CGM and 0.48 mmol/L for BGM; p=0.24. Energy and carbohydrate intake decreased significantly (Base to M3), with no differences between arms. Weight change did not differ between arms. See Table 1. Mean 90-day BHB levels were negatively correlated with carbohydrate intake (r= -0.26; p=0.02) and weight change (r= -0.28; p=0.01) at M3.
Conclusion: The MSKDP led to large decreases in energy and carbohydrate intake, and both CGM and BGM led to similar BHB levels and weight change.

Disclosure
H.J. Willis: Research Support; Abbott. Other Relationship; Abbott. Research Support; Academy of Nutrition and Dietetics, Dexcom, Inc. A.L. McKenzie: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. Employee; Abbott. C.G.P. Roberts: Other Relationship; Virta Health Corp. S.E. Asche: Stock/Shareholder; Gilead Sciences, Inc., AbbVie Inc., GlaxoSmithKline plc. S. Krizka: None. R.N. Adams: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. B.M. Volk: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. A.R. Zoller: Employee; Virta Health Corp. Stock/Shareholder; Virta Health Corp. S.J. Athinarayanan: Employee; Virta Health Corp. R.M. Bergenstal: Other Relationship; Abbott. Research Support; Arkray Marketing. Consultant; Ascensia Diabetes Care, Bigfoot Biomedical, Inc., CeQur. Other Relationship; Dexcom, Inc., Eli Lilly and Company. Consultant; embecta, Hygieia. Research Support; Insulet Corporation. Consultant; MannKind Corporation. Other Relationship; Medtronic, Novo Nordisk. Consultant; Onduo LLC, Roche Diabetes Care. Other Relationship; Sanofi. Research Support; Tandem Diabetes Care, Inc. Other Relationship; UnitedHealth Group. Consultant; Vertex Pharmaceuticals Incorporated, Zealand Pharma A/S.

Funding
Abbott Diabetes Care