bluuebunny/crossref_metadata_2025_split huggingface dataset:
1831-LB: Digital Chronic Condition Management Personalized Newsletter Pilot Powered by Predictive Modeling Increased Coaching Utilization
Authors: KAPOOR KARAN , VISWANATH RAMASUBRAMANIAM AADITHYA , JIANG YUZE , BORASTON SARA , ROACH MERCEDES , EISELT ANNE-KATHRIN , LAWTON SHANNON , KOMPALA TEJASWI , YEDAPADI RAJARAM GOWTHAM 
Published: June 2024

Introduction & Objective: Digital chronic condition programs (DCCP) offer education, coaching, and self-management tools to improve health behaviors. Engagement is key for behavior change and improved outcomes, and personalized recommendations have shown to increase engagement. This study examined 1:1 coaching utilization with certified diabetes care and education specialists (CDCES) between DCCP members who received a personalized ‘next best action’ e-newsletter powered by predictive modeling.
Methods: Members with type 2 diabetes and no reported insulin use were included in a weekly e-newsletter pilot from 11/20/2023 - 1/29/2024 to evaluate predictive models that recommend next best action from member’s past engagement. Control and treatment groups were block randomized by age, gender, time in program, A1c, and historical email engagement rates. Control 1 (C1) received original design and content. C2 received new design and original content. Treatment 1 (T1) received new design and personalized activity graphic. T2 received new design and next best action. T3 received new design, activity graphic, and next best action. First time utilization of coaching compared between groups was measured by any coaching completed after first newsletter open date. Standard two sample independent proportions test was used to measure utilization differences. Results: Average age was 55.6 years old (SD 10.6) with each group 50% female. All treatment groups with next best action had increased utilization of coaching in members with no coaching engagement prior to pilot (N = 137,283) (C1 0.14%, C2 0.12%, T1 0.14%, T2 0.17%, T3 0.21%). Statistically significant increases were shown for T3 compared to both C1 (p=0.02) and C2 (p=0.007).
Conclusion: Use of predictive modeling to recommend next best action from past engagement in a DCCP was shown to be effective in increasing short-term coaching engagement that has been associated with improved glycemic control.

Disclosure
K. Kapoor: Employee; Teladoc Health. A. Ramasubramaniam: Employee; Teladoc Health. Y. Jiang: Employee; Teladoc Health. S. Boraston: Employee; Teladoc Health. M. Roach: Employee; Teladoc Health. A. Eiselt: Employee; Teladoc Health. Stock/Shareholder; Teladoc Health. Research Support; Teladoc Health. S. Lawton: None. T. Kompala: None. G. Yedapadi Rajaram: Employee; Teladoc Health.
1832-LB: Exercise Training and Cold Exposure Trigger Distinct Molecular Adaptations to Inguinal White Adipose Tissue
Authors: VAMVINI MARIA , NIGRO PASQUALE , STANFORD KRISTIN I. , HIRSHMAN MICHAEL F. , MIDDELBEEK ROELAND J. , GOODYEAR LAURIE 
Published: June 2024

Exercise training and cold exposure are physiological stimuli that both improve systemic glucose metabolism, but the mechanisms are not well understood. Here, we tested the hypothesis that adaptations to inguinal white adipose tissue (iWAT) are critical for the beneficial effects of exercise-trained and cold-exposed iWAT on metabolism. First, we utilized an iWAT transplantation model. Male donor mice were sedentary, exercise trained by voluntary wheel running, or cold exposed (5°C) for 11 days (n=5/group). Transplanting iWAT from exercised into sedentary mice enhanced glucose tolerance, yet cold-exposed iWAT had no effect, suggesting unique adaptations to trained iWAT that confer beneficial effects on glucose homeostasis. To determine exercise-specific effects on iWAT, quantitative proteomic profiling (QPP) of iWAT was done from sedentary, trained, and cold-exposed mice. Cold down-regulated &gt;2,000 proteins in iWAT, but also resulted in a protein signature of enhanced mitochondrial biogenesis, energy production, and fatty acid metabolism. Training also regulated protein expression, but interestingly only training-specific proteins (&gt;50 proteins), and not cold proteins, were inversely correlated with fasting glucose. This suggests that training results in fundamental changes in iWAT that mediate systemic glucose homeostasis, consistent with the transplantation glucose tolerance data. Training also upregulated iWAT extracellular space and vesicle transport proteins. Consistent with this finding, isolation of adipocyte-derived EVs from sedentary and trained mice revealed a significant increase in EV release from trained adipocytes. In sum, exercise training facilitates the release of iWAT-derived molecules, fostering inter-tissue communication. We define the unique exercise training- and cold exposure-induced iWAT proteomes, revealing distinct mechanisms for the beneficial effects of these interventions on metabolic health.

Disclosure
M. Vamvini: None. P. Nigro: None. K.I. Stanford: None. M.F. Hirshman: None. R.J. Middelbeek: Research Support; Novo Nordisk. L. Goodyear: None.

Funding
This work was supported by NIH grant (R01DK099511, R01DK101043 (to L.J.G.)), (T32DK00726042, F32DK12643201) and Joslin DRC (P30 DK36836) Pilot and Feasibility Program award (to M.V.), K23DK114550 (to R.J.W.M), and the Joslin Diabetes Center DRC (P30 DK36836).
1838-LB: Effects of VLCDs on Weight Loss and Glycemic Control among Kuwaiti Adults with Type 2 Diabetes
Authors: ALSUMAITI DURRA , ALLAHOU BADREYA , ALMATROOK REEM 
Published: June 2024

Introduction: Kuwait faces significant health challenges with high rates of obesity and T2D. Although very low-calorie diet plans (VLCDs) have proven effective for weight loss and glycemic control, their impact has not yet been assessed among Kuwaiti adults. This study aimed to evaluate the effectiveness of two VLCDs on weight loss and glycemic control in Kuwaiti adults with T2D.
Methods: We analyzed data from 32 adults with T2D who were not on weight loss medications at the Dasman Diabetes Institute between 2021 and 2023. Adults chose between two diet plans: TDR providing 800 kcal/day liquid formula, or a VLCD providing 900 kcal/day food-based regimen. Weight and HbA1c were measured at baseline and 3-month. Within-group changes were analyzed using paired t-tests and Wilcoxon ranked tests.
Results: Groups were comparable at baseline, with no significant differences in age or sex distribution (TDR: 52.4 ± 10.7 years and 88.9% male; VLCD: 57.6 ± 10.7 years and 78.3% male; P &gt;0.05). The TDR group achieved a mean weight loss of 10.0 ± 3.5 kg (10.2% of initial weight) and a median HbA1c reduction of 1.0 (IQR= 0.80), whereas the VLCD group achieved a mean weight loss of 7.2 ± 3.9 kg (7.7% of initial weight) and a median HbA1c reduction of 0.9 (IQR= 0.60). Adherence differed significantly, with one-third completing the TDR (n= 9 out of 26) compared to two-thirds in the VLCD group (n= 23 out of 33, P= 0.03).
Conclusion: VLCDs demonstrated potential in reducing weight and HbA1c in Kuwaiti adults with T2D over three months. However, adherence to the TDR proved more challenging. Further research with larger samples and longer duration is warranted.

Disclosure
D. Alsumaiti: None. B. Allahou: None. R. Almatrook: None.
184-OR: Association between Composite Dietary Antioxidant Index and Stroke among U.S. Adults with Diabetes—Insights from NHANES
Authors: ZHANG HONGQIANG , SHI JIE , YUE TONG , WENG JIAHAO , WANG XULIN , ZHENG XUEYING , LUO SIHUI , DING YU , WANG CHAOFAN 
Published: June 2024

Introduction & Objective: While previous research suggests a negative correlation between the Composite Dietary Antioxidant Index (CDAI) and stroke prevalence, particularly in pre-diabetes, data on this relationship in diabetic individuals remain limited. This study aims to assess the association between CDAI and stroke risk in individuals with diabetes.
Methods: This cross-sectional study analyzed data from the NHANES from 2003 to 2018, including 6735 participants aged ≥20 with diabetes. Stroke status was determined based on self-report. The CDAI was calculated using dietary intake data of six antioxidants (vitamins A, C, E, carotenoids, selenium, zinc) obtained from 24-hour dietary recall interviews. The association between CDAI and stroke risk was assessed using multivariate logistic regression and restricted cubic spline analysis.
Results: The mean age of participants was 59.6 ± 13.6 years, 51.5% were male, with 611 (9.1%) reporting a stroke. Higher CDAI levels were associated with a lower risk of stroke after adjusting confounding factors (OR = 0.96; 95% CI 0.92-0.99, P&lt;0.001). Specifically, participants in the highest CDAI quintile had a 43% lower stroke prevalence compared to those in the lowest quintile (OR = 0.57, 95%CI 0.40-0.83, P = 0.003). Restricted cubic spline showed that there was a negative linear association between CDAI and stroke.
Conclusion: This study found a negative relationship between CDAI and stroke risk in US diabetic adults, highlighting the potential role of antioxidant-rich diets in stroke prevention.

Disclosure
H. Zhang: None. J. Shi: None. T. Yue: None. J. Weng: None. X. Wang: None. X. Zheng: None. S. Luo: None. Y. Ding: None. C. Wang: None.

Funding
Clinical Medical Research Transformation Project of Anhui Province (Grant No. 202204295107020026)
1846-LB: Developing Best Practices for Preventing "Diabulimia"—Focusing on Health Care Professionals' Knowledge of Insulin Omission/Restriction
Authors: BORDNER CANDACE , STUCKEY-PEYROT HEATHER L. , LAFFEL LORI M. , PROKOP AMIE , TOSCHI ELENA , GOEBEL-FABBRI ANN E. 
Published: June 2024

Introduction: Disordered eating behaviors (DEB) are common in type 1 diabetes (T1D), occurring in ~25% of young adults. DEBs are often characterized by insulin restriction and chronic hyperglycemia, increasing risk for future microvascular complications. This study focused on identification, prevention, and treatment of this high-risk condition by investigating healthcare professional (HCP) perceptions of the problem.
Methods: A semi-structured interview guide was developed to address topics such as: general eating disorder knowledge, knowledge of “diabulimia”, and resources needed to identify, prevent, and treat “diabulimia.” T1D HCPs identified by study team members underwent screening for eligibility based upon experience caring for patients with T1D prior to interviewing. Codes were developed inductively, with coding performed by two researchers attaining a kappa &gt;0.70 (MAXQDA).
Results: Individual interviews (n=11) were conducted with T1D HCPs (2 MD/DO; 1 BSN/CDCES; 4 RD/CDCES; 3 NP/MSN; 1 NP/CDCES). Themes included a lack of: (a) information on DEBs, especially “diabulimia”, as these are not addressed in formal medical education; (b) knowledge about how best to initiate conversations and communicate with patients about DEBs; and (c) lack of diabetes mental health professionals available for referral. Suggested educational interventions included quick reference guides on communication techniques to use in the clinic; live training sessions to practice with standardized patients; and available referral networks for mental health professionals through the ADA and APA.
Conclusions: T1D HCPs identified need for more resources and education to help identify, discuss, and manage DEBs in people with T1D. Notably, a lack of mental health professionals remains a major hindrance. Future interviews with people with T1D in recovery from DEB can help guide HCPs in best practices to help manage DEBs.

Disclosure
C. Bordner: None. H.L. Stuckey-Peyrot: None. L.M. Laffel: Consultant; Dexcom, Inc. Advisory Panel; Medscape, Medtronic, Vertex Pharmaceuticals Incorporated. Consultant; Novo Nordisk. Advisory Panel; Lilly Diabetes, Provention Bio, Inc., Sanofi-Aventis U.S., Janssen Pharmaceuticals, Inc., MannKind Corporation. A. Prokop: None. E. Toschi: Consultant; Vertex Pharmaceuticals Incorporated, Sanofi. A.E. Goebel-Fabbri: None.

Funding
Juvenile Diabetes Research Foundation International (3-SRA-2024-1457-M-B)
1850-LB: Role of Cardiovascular Risk Communication in Motivating Self-Management of Young-Onset Type 2 Diabetes (YOD)—A Mixed-Methods Study
Authors: ABRAHA MOSANA , SENGA JOYEUSE , YU CATHERINE H. , SHAH BAIJU R. , KE CALVIN 
Published: June 2024

Introduction & Objective: Optimal self-management may help mitigate the high cardiovascular risk of YOD (defined as age at type 2 diabetes diagnosis &lt;40 years). However, perceptions of cardiovascular risk communication have never been studied in YOD. We determined the accessibility, emotional impact, and perceived role of various formats of cardiovascular risk communication in influencing YOD self-management behaviors.
Methods: We depicted cardiovascular risk predictions using 6 different visual formats for this mixed-methods study. Participants rated each format using validated scales (accessibility, emotional responses). Semi-structured interviews were conducted and thematically analyzed to understand perceptions using the Behavior Change Wheel framework.
Results: We recruited 18 participants (52.6% women, mean age 41.0 years, 7 ethnic groups). Accessibility and emotional response ratings varied (Table). Lifetime risk formats were perceived as the most clear, accessible, urgent, and motivating to change self-management behavior, while 5-year risk predictions were perceived as reassuringly low and unmotivating. Cardiovascular age was perceived as confusing and unclear.
Conclusion: Cardiovascular risk communication, especially using lifetime risk predictions, may play an important role in interventions to motivate YOD self-management.

Disclosure
M. Abraha: None. J. Senga: None. C.H. Yu: None. B.R. Shah: None. C. Ke: Advisory Panel; Sanofi. Speaker's Bureau; AstraZeneca.

Funding
Novo Nordisk Network for Healthy Populations, Sunnybrook Program to Access Research Knowledge (SPARK) for Black and Indigenous Students
1851-LB: “You feel isolated. You’re kind of in over your head”—Experiences of Caregivers of Aging People with Diabetes
Authors: MOORE KELLY , STUCKEY-PEYROT HEATHER L. , HUGHES ALLYSON S. 
Published: June 2024

Type 1 diabetes (T1D) is becoming more prevalent in the aging U.S. population due to treatment advancements resulting in people with T1D living longer and more people being diagnosed with T1D as adults. Unfortunately, resources to care for aging people with T1D are sparse. This dearth of information may further exacerbate age related health disparities. In this study, we characterized the impact of caring for aging people with diabetes from the caregiver’s perspective. This qualitative study included 12 participants who were family members or professional caregivers who support aging people with T1D. Using an interview guide, semi-structured interviews were conducted. Interviews were transcribed and a codebook was developed to guide thematic analysis. Two coders independently coded the transcripts and then met to compare codes and confirm consensus. Three themes emerged from the data: 1. Lack of training and education for the aging T1D population, 2. Caregiver frustration, worry, and burden, and 3. Lack of community amongst aging people with T1D and their caregiver. Participants wished they knew more about how to provide effective diabetes care. Each caregiver described feeling frustrated towards the unpredictable nature of T1D or described feeling worried about hypoglycemic episodes. While participants were not outright in stating they felt burdened, each caregiver made some form of physical or emotional sacrifice which made an impact on their life. They reported caregiving difficulties and successes as well as the impact caregiving has had on work life, mental health, and physical health. Participants also expressed an interest in creating a community of caregivers to discuss the challenges of caring for an aging person with T1D similar to those for parents of children with T1D. This data provides insight into the challenges caregivers face when caring for aging people with T1D. More support and resources are needed specifically for caregivers of aging people with diabetes.

Disclosure
K. Moore: Consultant; Biocomposites LLC. H.L. Stuckey-Peyrot: None. A.S. Hughes: None.
1857-LB: Improvement of Liver Steatosis by Mazdutide in Chinese Participants with Overweight or Obesity—An Exploratory Analysis of GLORY-1
Authors: JI LINONG , JIANG HONGWEI , ZHANG YAWEI , LV LINGCHUN , GU JIEYU , LIU ZIHAN , WANG YANQI , DENG HUAN , QIAN LEI 
Published: June 2024

Introduction & Objective: To explore the effect of mazdutide, a once-weekly GLP-1 and glucagon receptor dual agonist, on liver steatosis.
Methods: In the GLORY-1 phase 3 trial (NCT05607680), 610 Chinese adults with a BMI of 28 kg/m2 or more, or 24 kg/m2 or more and at least one weight-related comorbidity were randomly assigned 1:1:1 to receive once-weekly, subcutaneous mazdutide 4 mg, mazdutide 6 mg or placebo for 48 weeks. A subpopulation of participants had MRI scan and liver fat content (LFC) measurement by MRI-proton density fat fraction (MRI-PDFF). Change from baseline at week 48 in LFC was an exploratory endpoint of the study.
Results: In participants with baseline LFC of 5% or more and 10% or more, treatment with mazdutide 4 mg or 6 mg for 48 weeks led to marked and dose-dependent reductions in LFC. Of note, a mean relative reduction of 80.2% was achieved with mazdutide 6 mg among participant with baseline LFC of 10% or more. In participants with baseline LFC of 5% or more, compared with placebo, substantially more participants with mazdutide 4 mg and 6 mg achieved ≥30% relative reduction in LFC, ≥50% relative reduction in LFC and normalization of LFC (&lt;5%) at week 48 (Figure).
Conclusion: In Chinese adults with overweight or obesity and liver steatosis, mazdutide 4 mg and 6 mg provides robust reductions in LFC.

Disclosure
L. Ji: None. H. Jiang: None. Y. Zhang: None. L. Lv: None. J. Gu: None. Z. Liu: Employee; Innovent Biologics. Y. Wang: Employee; Innoventbio. H. Deng: Employee; Innovent. L. Qian: Employee; Innoventbio.
186-OR: Longitudinal Effect of Diabetes Fatalism on Clinical Outcomes and QOL in AA with Type 2 Diabetes Mellitus
Authors: IREGBU SANDRA C. , WALKER REBEKAH J. , EGEDE LEONARD E. 
Published: June 2024

High diabetes fatalism scores (DFS) strongly correlate with poor glycemic control in individuals with type 2 diabetes (T2D). Although relationships between diabetes fatalism (DF) and outcomes have been established in cross-sectional data, gaps remain regarding its longitudinal effect on clinical outcomes and quality of life (QOL). This study used results from an RCT to examine the longitudinal impact of DF on clinical outcomes and QOL in African Americans (AA) with T2D. Data were collected from AA adults (n=200) with poorly controlled T2D (HbA1c ≥8%) randomly assigned to one of two groups and received 12 sessions of telephone-delivered diabetes knowledge/skills training or usual care. HbA1c, systolic blood pressure, diastolic blood pressure, physical health-related (PCS), and mental health-related (MCS) QOL were measured at baseline, 3-, 6-, 9-, and 12 months. DF was also measured at all time points with a validated 12-item DFS. DF was investigated using validated scoring of the entire scale and the emotional distress subscale. Longitudinal mixed models with random effects were run for each of the five outcomes, adjusting for treatment, time, treatment-by-time interaction, and baseline scores of the outcome of interest. Participants were primarily female and unemployed. A statistically significant negative relationship was found between the total DFS and MCS over time (β= -0.01, 95% CI -0.17, -0.03). There was also a significant longitudinal relationship between the emotional subscale of the DFS and HbA1c (β=0.02, 95% CI 0.004, 0.04); PCS (β= -0.16, 95% CI -0.27, -0,06), and MCS (β= -0.23, 95% CI -0.34, -0.11). Higher diabetes fatalism is associated with lower MCS over time. Higher scores on the emotional distress subscale of DFS are associated with higher HbA1c, lower PCS, and lower MCS over time. This study establishes that the effect of diabetes fatalism on diabetes outcomes is persistent over time, and the emotional distress component is particularly detrimental to diabetes outcomes over time.

Disclosure
S.C. Iregbu: None. R.J. Walker: None. L.E. Egede: None.
1872-LB: Therapeutic Potential of HM15275, a Novel Long-Acting GLP-1/GIP/GCG Triple Agonist, in Animal Models of Heart Failure
Authors: YE BYEONGJIN , KIM WONKI , MYEONG LEE SEON , KIM JEONG A. , KIM EUNSEON , BAE SUNGMIN , HYUN LEE SANG , YOUNG CHOI IN 
Published: June 2024

Introduction & Objective: Obesity significantly increases the risk of cardiovascular death and is a leading cause of heart failure with preserved ejection fraction (HFpEF). Considering these outcomes, the purpose of this study is to evaluate whether HM15275, a novel long-acting GLP-1/GIP/GCG triple agonist, could alleviate heart failure (HF)-related symptoms in various animal models of HF.
Methods: To investigate therapeutic effects of HM15275 in HF animal models, we used the monocrotaline (MCT)-induced HF rat model to induce HF caused by pulmonary arterial hypertension (PAH), which is one of the major contributing factors to HF. Second, isoproterenol (ISO)-induced HF mouse model was used to induce HF with cardiac dilation and ventricular dysfunction through the increase in cardiac hypercontractility. Finally, we used a high fat diet (HFD) + nitrol-arginine methyl ester (L-NAME) mouse model of HFpEF, induced by obesity and hypertension. HM15275 was administrated for 2 to 5 weeks after model induction. Semaglutide (SMG) and tirzepatide (TZP) were used as comparative control.
Results: In three HF animal models, HM15275 significantly improved cardiac hypertrophy (-66.5% in MCT-induced HF model, -12.6% in ISO-induced HF model, -28.8% in HFD + L-NAME model) compared to other incretin drugs, SMG and TZP. Interestingly, HM15275 significantly improved exercise capacity (+313.9%) and arterial oxygen saturation (+13.8%) and reduced myocardial fibrosis and cardiomyocytes size compared to SMG and TZP in MCT-induced HF rat model. Also, in HFD + L-NAME mouse model, HM15275 remarkably changed multiple biomarkers of cardiovascular risk, including body weight, blood glucose, levels of lipids, and physical limitations.
Conclusion: HM15275 significantly improved exercise intolerance, cardiac hypertrophy, and fibrosis in HF murine models, compared to SMG and TZP, supporting that it could be a novel therapeutic option for HF patients.

Disclosure
B. Ye: None. W. Kim: None. S. Lee: None. J.A. Kim: None. E. Kim: None. S. Bae: None. S. Lee: None. I. Choi: None.