bluuebunny/crossref_metadata_2025_split huggingface dataset:
1236-P: Gestational Diabetes Mellitus in Georgia, United States—Factors Associated with Postpartum Glucose Tolerance Testing Completion
Authors: VUNCANNON DANIELLE M. , JOHNSON LESLIE C.M. , LUONG JACKIE , CHANDRASEKARAN SUCHITRA 
Published: June 2024

Introduction: National guidelines outline completion of postpartum glucose tolerance testing (GTT) as standard of care for those with gestational diabetes mellitus (GDM). Existing surveillance in Georgia has not evaluated factors associated with GTT completion for the state.
Methods: This retrospective cohort study included all patients with GDM identified on birth certificate data in the state of Georgia from 2017-2020. Georgia Pregnancy Risk Assessment Monitoring System data and birth certificate data were used to evaluate patient factors associated with GTT completion. Associations between patient factors and GTT completion were analyzed using Chi-squared tests. The association between ethnicity and GTT completion was further analyzed using Poisson regression.
Results: The GDM rate was 6.61% within the study timeframe. Patients with GDM had high attendance of postpartum care (88.7%); however, only 47.9% of patients overall or 53.2% who attended postpartum care completed GTT. There was no difference between those who did vs. did not complete GTT for maternal age, race, payor status, or comorbidities. Completion rates were higher among those with higher levels of education (54.0% if &gt;16 vs. 24.1% if &lt;12 years) and lower in rural vs. urban residents (43.3% vs. 48.6%). Hispanic women had lower rates of postpartum care attendance (69.0%) and were less likely to complete GTT (13.8%). Odds of GTT completion were lower for Hispanic women even when controlling for education and insurance status (incidence rate ratio 0.91, 95% CI 0.84-0.99).
Conclusion: In Georgia, attendance of postpartum care was high; however, GTT completion rates were unacceptably low. Hispanic ethnicity, lower levels of maternal education, and rural residence were associated with decreased completion rates. These data demonstrate a significant lack of concordance with recommended GDM care guidelines in Georgia and serve as a call to action to standardize care across the state.

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

Funding
National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (P30DK111024)
1257-P: Post-void Residual Urine in Men and Women with Long-Standing Type 1 Diabetes (T1D)—The UroEDIC Study
Authors: BRAFFETT BARBARA H. , IPPOLITO GIULIA M. , AMIGHI ARASH , WESSELLS HUNTER , TRAPANI VICTORIA R. , JACOBSON ALAN M. , BUSUI RODICA , SARMA ARUNA V. 
Published: June 2024

Introduction & Objectives: Diabetic cystopathy, characterized by diminished bladder sensation, poor contractility, and increased post-void residual (PVR) urine &gt;100 mL, is understudied in T1D. We describe the distribution of PVR in men and women with T1D enrolled in the Epidemiology of Diabetes Interventions and Complications (EDIC) UroEDIC ancillary study.
Methods: PVR was measured using BladderScan BVI 3000 (Verathon Inc., Bothell, WA) in 450 men and 413 women. Lower urinary tract symptoms (LUTS) were defined by the American Urological Association Symptom Index (AUASI). Kidney disease was defined as an estimated glomerular filtration rate &lt;60 mL/min/1.73 m2, neuropathy by symptoms, signs, and abnormal electrophysiology, and cognitive impairment by a decline &gt;1 SD from baseline in psychomotor and mental efficiency.
Results: Mean (SD) age and T1D duration were 63 (7) and 42 (5) years, respectively. Men had significantly higher PVR than women (median [IQR] = 27 [5-94] vs. 5 [1-37] mL, p&lt;0.0001; PVR &gt;100 mL = 23% vs. 9%, p&lt;0.0001). Chronic urinary retention (&gt;300 mL) was present in 4% of men and 1% of women. Older age was associated with higher PVR in men (p=0.01), but not women (p=0.52). Men with vs. without PVR &gt;100 mL had higher median AUASI scores for urgency (p=0.01) and weak stream (p&lt;0.0001). There were no significant differences in AUASI scores for women with and without elevated PVR. Among men, higher PVR volumes were associated with a history of kidney disease (p&lt;0.01), confirmed clinical neuropathy (p&lt;0.001), and cognitive impairment (p=0.03). There were no significant associations between PVR and HbA1c in both men and women.
Conclusion: PVR in long-standing T1D varies by sex. Findings suggest that aging, LUTS, kidney disease, and neuropathy are important factors associated with higher PVR in men only. These findings emphasize the need for sex-specific diagnostic strategies to target optimized interventions for bladder dysfunction at the point of care in men and women with T1D.

Disclosure
B.H. Braffett: None. G.M. Ippolito: None. A. Amighi: None. H. Wessells: None. V.R. Trapani: None. A.M. Jacobson: None. R. Busui: Board Member; American Diabetes Association. Consultant; Procter & Gamble, AstraZeneca, Averitas Pharma, Inc., Bayer Inc., Lexicon Pharmaceuticals, Inc., Nevro Corp., Ono Pharmaceutical Co., Ltd., Novo Nordisk, Roche Diagnostics. Advisory Panel; ADA/ACC Diabetes by Heart Program. A.V. Sarma: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK116723-01A1)
1284-P: Prevalence of Cardiovascular Risk in Type 1 Diabetes Mellitus in China—Findings from a National Cross-Sectional Study
Authors: WANG WEIHAO , GUO LIXIN , PAN QI 
Published: June 2024

Background: The 2019 ESC/EASD recommendations classified cardiovascular risk (CV) in diabetes mellitus (DM). The CV risk assessment and stratification were essential for identifying persons with a very high risk of CVD and active targeted interventions. The purpose of this research is to fill in the lack of epidemiological data on the classification of individuals with a very high cardiovascular risk in patients with type 1 diabetes mellitus (T1DM) from different regions across China.
Methods: This multicenter, cross-sectional, non-interventional study gathered information such as disease duration, body mass index (BMI), traget organ damage including atherosclerotic heart disease, impaired renal function, left ventricular hypertrophy and retinopathy, from outclinic patients by trained doctors. We use the 2019 ESC/EASD standards divided T1DM patients into two categories: with a very high risk and else.
Results: A total of 38260 participants from more than 2,000 hospitals in 30 provinces of China were enrolled from 2020 to 2022, of which 54.81% of T1DM were at very high CV risk. The proportions of very high-risk T1DM were higher in Northeast (72.70%), Southwest (69.99%) and Central (54.41%), while the lowest was Southern China (47.03%). The proportion of very high risk of CV risk in T1DM increased with age and BMI, 33.61% in those among &lt;35 years old subgroups, while in 35-65 years old were 59.57% and among &gt; 65 years old was 70.80%. (P &lt; 0.0001). Male and smoker showed increased prevalence of the very high CV risk in T1DM (P &lt; 0.0001).
Conclusion: This study is the largest observational study of CV risk assessment in T1DM patients in China. The CV risk situation of diabetic patients in China is critical, and comprehensive control and management of CV-related risk factors such as blood pressure, BMI, and lipids in DM patients need to be strengthened so as to reduce the risk of cardiovascular events and death.

Disclosure
W. Wang: None. L. Guo: Consultant; Abbott, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Eli Lilly and Company, Hengrui (USA) Ltd., Dreisamtech, Dongbao, Gan & Lee, Hansoh. Q. Pan: None.

Funding
This study was supported by Beijing Great Physician Commonwealth Foundation "CV Risk Evaluation" program
1291-P: Early-Onset Type 2 Diabetes in the U.S.—Prevalence from National Health and Nutrition Examination Survey (NHANES) 1999–2020 Data
Authors: LEE CLARE , BOYE KRISTINA , BERGMAN BRANDON , WILLIAMSON SUZANNE E. , NELSON DAVID R. 
Published: June 2024

Early-onset T2D, defined as diagnosed before age 40, is increasingly prevalent and may be a more aggressive disease than later-onset T2D, with faster beta cell deterioration, that is less responsive to medications. We estimated the prevalence of diagnosed and undiagnosed early-onset T2D in the US between 1999 and 2020 using the nationally representative NHANES database.
Data from a longitudinal series of cross-sectional surveys of US participants conducted every two years from 1999-2020 were analyzed retrospectively. Participants with early-onset T2D were identified based on a diagnosis of T2D before age 40 (diagnosed T2D), or a fasting glucose ≥126 mg/dL or HbA1c ≥6.5% in those aged &lt;40 years without a T2D diagnosis (undiagnosed T2D).
The estimated number of participants with undiagnosed and diagnosed early-onset T2D in the US increased from 493,000 and 3,869,000 during the 1999-2000 survey cycle to 1,112,000 and 5,560,000 during 2017-2020, respectively (Figure). The prevalence rate for undiagnosed early-onset T2D increased significantly by 46% per 10-year time-period between 1999 and 2020 (OR 1.461, p&lt;0.05), whereas the rate for diagnosed early-onset T2D remained stable.
NHANES data indicate that undiagnosed early-onset T2D is increasing in prevalence over time in the US, suggesting more attention is needed to diagnose and treat younger adults with T2D to improve health outcomes.

Disclosure
C. Lee: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. K. Boye: Employee; Eli Lilly and Company. B. Bergman: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. S.E. Williamson: Consultant; Eli Lilly and Company, Takeda Pharmaceutical Company Limited, GlaxoSmithKline plc, Novo Nordisk, Lundbeck. D.R. Nelson: Employee; Eli Lilly and Company.

Funding
Eli Lilly and Company
1297-P: Hypergliptinemia —A Compensatory Phenomenon Observed in Asian Population with Newly Diagnosed Type 2 Diabetes Mellitus
Authors: CHIN CHONG SHIAU , SUKOR NORLELA , ROBERT SARAH A. , FONG NG KIM , KAMARUDDIN NOR A. 
Published: June 2024

Introduction & Objective: Impaired glucagon-like peptide-1 (GLP-1) secretion in Western patients contributes to the incretin defect in type 2 diabetes mellitus (T2DM). However, several studies from East Asia suggested preserved GLP-1 levels in T2DM. We aimed to resolve these conflicting findings by investigating GLP-1 levels during oral glucose tolerance test (OGTT) among subjects with normal glucose tolerance (NGT) and T2DM.
Methods: A total of 120 subjects consisting of NGT (n=58) and T2DM (n=62) had their plasma total GLP-1 concentrations measured at 0, 30 and 120 min following a 75 g OGTT. Homeostasis model assessment of insulin resistance (HOMA-IR), HOMA of insulin sensitivity (HOMA-IS) and triglyceride glucose (TyG) index were calculated. All the above parameters were subsequently assessed in T2DM subjects of &lt;1 year vs ≥ 1 year of disease duration to elicit if there are any subtle differences in their respective GLP-1 responses.
Results: Total GLP-1 levels at fasting (fGLP-1) and 30 min (GLP-130min) were significantly higher in T2DM than NGT (fGLP-1 27.18±11.56 pmol/L vs. 16.24 ±7.79 pmol/L, p&lt;0.005; GLP-130min 50.22±18.03 pmol/L vs. 31.44 ±22.59 pmol/L, p&lt;0.001; respectively). The GLP-1 levels were positively correlated with HOMA-IR and TyG index but negatively correlated with HOMA-IS. T2DM subjects with disease duration &lt; 1 year had higher GLP-1 response than those with disease duration ≥1 year (GLP-130min 55.33±18.09 pmol/L vs. 46.02±17.12 pmol/L, p&lt;0.05).
Conclusion: The augmented GLP-1 levels in T2DM represents an adaptive compensatory response to increasing insulin resistance, a phenomenon we aptly refer to as “hypergliptinemia”. However, this phenomenon is transient as the incretin response started to diminish after one year of diagnosis in keeping with the progressive nature of T2DM.

Disclosure
S. Chong: None. N. Sukor: None. S.A. Robert: None. K. Ng: None. N.A. Kamaruddin: Speaker's Bureau; Boehringer-Ingelheim, Novo Nordisk, AstraZeneca.

Funding
Universiti Kebangsaan Malaysia (GUP-2017-066); Malaysian Endocrine and Metabolic Society (L12-MEMS6)
1302-P: Long-COVID in Type 1 and Type 2 Diabetes—Prevalence, Clinical Outcomes, and Inflammatory Marker Responses
Authors: O'DOHERTY EMER , ADAM ATIF , SHALIT ALMOG , SHAH HETAL , KING GEORGE L. , MIDDELBEEK ROELAND J.W. 
Published: June 2024

Introduction: Diabetes significantly impacts COVID-19 morbidity and mortality, with the long-term sequelae ('long-COVID') in diabetes poorly understood. This study examines the prevalence and clinical outcomes of long-COVID, and the influence of pharmacotherapy, such as metformin use, on COVID-19 symptom persistence. Another objective is to determine inflammatory cytokine concentrations in patients with long-COVID.
Methods: Adult T1D and T2D patients at Joslin Diabetes Center, USA, were surveyed for COVID-19 history with EMRs providing demographic and clinical data. Blood samples were analyzed using Elecsys Anti-SARS-CoV-2 (Roche, Indianapolis) and V-Plex assays (MSD, Rockville) for COVID-19 antibodies and cytokines, respectively.
Results: Among 358 patients (162 T1D, 196 T2D), T2D patients were older (62.8 years, SD 11.9) compared to T1D patients 47.4 years, SD 15.6; p&lt;0.001). The majority were White, with a higher proportion of Asian Americans among T2D (4% vs. 27%, p&lt;0.001). Long-COVID was reported by 30% of T2D and 13% of T1D patients (p=0.002). Comparing T1D and T2D patients with long COVID, T2D patients exhibited higher HbA1c values by 1.1% (SD: 0.48) (p=0.03). No difference in HBA1c was seen in patients with T1D. In T1D, significant increases in IL-1b, IL-6 (p&lt;0.001 each), and TNF-a (p=0.003) were observed, with no change in IL-10 (p=0.62). T2D patients with long-COVID had increased TNF-α (p=0.01) and decreased IL-10 (p=0.04). Additionally, Metformin initiation was linked to a 48% reduced likelihood of long-COVID (p=0.04).
Conclusion: Long-COVID manifests differently in T1D and T2D, with distinct cytokine changes suggesting unique inflammatory responses. In T2D, patients with long-COVID exhibit worse glycemic control and metformin may play a potentially protective role. Ongoing research is needed to determine the relationship between metformin use and inflammatory markers in long-COVID.

Disclosure
E. O'Doherty: None. A. Adam: None. A. Shalit: None. H. Shah: None. G.L. King: None. R.J.W. Middelbeek: Research Support; Novo Nordisk.
1313-P: Association between Changes in Metabolic Syndrome (MetS) Status and Development of Cardiovascular Diseases (CVD)
Authors: TAKIZAWA HIROKI , FUJIHARA KAZUYA , MITSUMA YURIE , GOTO WAKANA , YAMAMOTO MASAHIKO , OSAWA TAEKO , SUZUKI HIROSHI , MATSUBAYASHI YASUHIRO , YAMADA TAKAHO , KODAMA SATORU , SONE HIROHITO 
Published: June 2024

We previously determined cut-off values for MetS components to predict CVD and proposed newly optimized criteria for MetS in Japanese. Since MetS status changes over time, we investigated associations between changes in MetS and CVD risk using current and optimized criteria. We divided 201,007 men and 99,579 women without prior CVD into 4 groups according to MetS status at 2 points (beginning and end of baseline) during a 2-year baseline period (MetS-free, MetS-developed, MetS-remission, MetS-persisted). After baseline, incidence of CVD was followed up. Association between changes in MetS and incident CVD was analyzed by a multivariate Cox regression model. During a median follow-up of 5.0 y, 2,831 men and 330 women developed CVD. Compared with the MetS-free group, MetS-developed and MetS-persisted groups had an increased risk of CVD by any criterion (Fig). With optimized criteria, HR was higher in men with MetS-persisted than in women. Compared with MetS-persisted, MetS-remission had decreased CVD risk by any criterion in men but in women it was associated with decreased CVD risk only by optimized criteria. MetS-developed by any criterion was associated with increased CVD risk in both sexes. MetS-remission by newly optimized criteria was associated with reduced CVD risk in both sexes, suggesting changes in MetS status by optimized criteria are strongly related to CVD risk.

Disclosure
H. Takizawa: None. K. Fujihara: None. Y. Mitsuma: None. W. Goto: None. M. Yamamoto: None. T. Osawa: None. H. Suzuki: None. Y. Matsubayashi: None. T. Yamada: None. S. Kodama: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.
1327-P: Novel Subgroups of the Three-Year Risk of Incident Diabetes and Complications in Chinese Diabetes-Free Adults
Authors: GUO LIXIN , WANG WEIHAO 
Published: June 2024

Aims: The aim of this study was to analyze common clinical indicators in diabetes-free cohorts population using innovative clustering methods to derive characteristic clusters and to assess the utility for stratified prediction of diabetes risk and complications.
Methods: We analyzed the data of 13,829 diabetes-free adults from a physical examination cohort of 51,400 people follow-up from 2014 to present in Kunshan, China, and used the Ensemble clustering based on ending indicators and Weighted Naive Bayesian Classification method to select the most important variables from the candidate variables and assessed the 3-year risk of diabetes and the complications.
Result: We screened 13 clinically important variables. In the Kunshan cohort we identified 3 clusters. Cluster 2 (n=4,622) was characterized by the worst control of glucose and lipid metabolism, highest risk of diabetes and complications of FLD. Cluster 3 (n=2,456) was characterized by the oldest age, the highest SBP, BMI, waist circumference, intermediate risk of diabetes and the highest risk of CVD and stroke. Cluster 1 (n=6,751) population had good indicators and a low risk of diabetes and complications such as CVD, FLD and stroke. In the post-correction cox survival analysis for FLD, taking cluster 1 as the reference, HR of cluster 2 was 2.357(95% CI: 2.161-2.571, p&lt;0.001) and HR of cluster 3 was 1.903(95% CI: 1.718-2.108, p&lt;0.001). In the post-correction cox survival analysis of CVD, HR of cluster 2 was 1.193 (95% CI: 0.975-1.459, p=0.087) and HR of cluster 3 was 1.295 (95% CI: 1.041-1.611, p=0.02). The risk of diabetes and CVD predicted by PRS was consistent with that predicted by clinical clustering methods.
Conclusions: Phenotypes derived from the analysis of clinical characteristics using the new clustering method help to identify and stratify the risk of diabetes and related complications.

Disclosure
L. Guo: Consultant; Abbott, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Eli Lilly and Company, Hengrui (USA) Ltd., Dreisamtech, Dongbao, Gan & Lee, Hansoh. W. Wang: None.

Funding
This work was supported by National High Level Hospital Clinical Research Funding, National Natural Science Foundation of China (82170848 and 82370835), Natural Science Foundation of Beijing (7244403), Capital's Funds for Health Improvement and Research (2022-1-4051), Beijing Municipal Science & Technology Commission (No Z221100007422007) and National Key R&D Program of China (2022YFB3203700).
1332-P: Young-Onset Type 2 Diabetes—UK Prospective Diabetes Trial (UKPDS) 30-Year Follow-up
Authors: LIN BERYL , COLEMAN RUTH L. , BRAGG FIONA , MADDALONI ERNESTO , HOLMAN RURY R. , ADLER AMANDA I. 
Published: June 2024

Introduction: Young-onset type 2 diabetes (T2D) is associated with premature complications and death.
Aim: To assess whether long-term complications and mortality rates differed with younger age at T2D diagnosis over UKPDS 30-year follow-up.
Methods: Using 1977-2007 data from UKPDS participants with newly-diagnosed T2D without diabetes autoantibodies, we analysed standardised mortality ratios (SMR) using UK general population data and incidence rates of pre-specified aggregate outcomes in young and later onset T2D (&lt;40 years vs &gt;40 years), and by 10-year age intervals at diagnosis.
Results: Of 4550 participants (59% male, HbA1c 9.1%), 429 (9.4%) had young-onset T2D. The SMR was higher in young-onset T2D (3.72, 95% CI 2.98-4.64; median follow-up: 18.0 years) than in later-onset T2D (1.54, 1.47-1.61; 17.4 years). At any given age, the incidence of any diabetes-related endpoint, all-cause mortality, microvascular disease, and myocardial infarction was higher with younger age at diagnosis (Figure). Annual mean HbA1c was higher in the first 20 years of follow-up in those with younger compared with later-onset T2D.
Conclusion: The risk of dying relative to the general population is even greater for people diagnosed with T2D at younger ages. The greater risk of complications and poorer glycaemic control in young-onset T2D suggests a need to develop services to identify and support these individuals over their lifetimes.

Disclosure
B. Lin: None. R.L. Coleman: None. F. Bragg: None. E. Maddaloni: Advisory Panel; Novo Nordisk, Merck Sharp & Dohme Corp. Speaker's Bureau; Abbott, Eli Lilly and Company. Consultant; PikDare. Speaker's Bureau; MTD. R.R. Holman: Advisory Panel; Anji Pharmaceuticals, AstraZeneca, Novartis AG. A.I. Adler: None.
1342-P: A Predictive Model for Five-Year Early Diabetic Kidney Disease
Authors: HOU XUHONG , YE XIAOQI , JIA WEIPING 
Published: June 2024

Introduction & Objectives: Early identification of individuals at elevated risk of developing diabetic kidney disease (DKD) could improve clinical care and prognosis through enhanced cost-effective surveillance and better management of underlying health conditions. The aim of this study was to develop an effective and practical model for predicting early DKD risk in a community-based prospective cohort.
Methods: A prospective community-based cohort study was undertaken from 2013 to 2018. We analyzed data from 1545 people with diabetes and normal kidney function at baseline. The least absolute shrinkage and selection operator regression with cross-validation was used to identify potential predictive variables. A less complex DKD prediction model was derived from logistic regression and presented as a nomogram. The performance of the novel DKD prediction model was compared with that of the existing prediction model by assessing model discrimination.
Results: Six predictors of DKD were identified: diabetes duration, family history of diabetes, systolic blood pressure, urine albumin-to-creatinine ratio, estimated glomerular filtration rate, and glycated albumin (GA). The new DKD predictive model demonstrated good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.797 and was internally validated with a corrected AUC of 0.786. There were no significant deviations between observed probability and predicted probability. The predictive performance of the existing DKD risk prediction model was significantly lower than our new DKD risk prediction model (AUC: 0.681 vs. 0.797, P &lt;0.001). In addition, the predictive value of GA was higher than that of Hemoglobin A1c and fasting plasma glucose.
Conclusions: The 5-year early DKD predictive model, derived from a community-based cohort, demonstrates good performance. Additionally, GA holds more significant importance than other glucose indicators in predicting DKD.

Disclosure
X. Hou: None. X. Ye: None. W. Jia: None.