bluuebunny/crossref_metadata_2025_split huggingface dataset:
1294-P: A Novel Electronic Medical Record (EMR) Search Method to Identify Atypical Diabetes Patients
Authors: AHMED MAAZ , KUBOTA-MISHRA ELIZABETH A. , SILLER ALEJANDRO F. , DAVIS ANSLEY E. , MIGACZ ILIANA , SISLEY STEPHANIE , FARUQI JORDANA , SAEED ZEB I. , AHMED SARAH , PHILIPSON LOUIS H. , REDONDO MARIA J. , BALASUBRAMANYAM ASHOK , TOSUR MUSTAFA , STUDY GROUP RADIANT 
Published: June 2024

Introduction & Objectives: Efficient automated EMR review methods to identify people with atypical diabetes (DM) for research are lacking. We aimed to develop a novel Python-based Expeditious Program for EMR Review (PEPPER) and assess its efficiency.
Methods: We extracted the list of 1660 youth (&lt;19 yo) with type 2 DM (T2D) seen between 2019-2022 from EMR to identify candidates with A-β+ (autoantibody negative, preserved β-cell function) Ketosis-prone DM (KPD) for enrollment into Rare and Atypical Diabetes Network (RADIANT). We developed PEPPER to identify diabetic ketoacidosis (DKA) occurrence within 6 months (mo) of diagnosis to prioritize individuals for detailed manual chart review for RADIANT eligibility. We also manually reviewed EMR of 100 youth with T2D to identify DKA occurrence within 6 mo of diagnosis without PEPPER for comparison.
Results: PEPPER identified 110 youth with T2D who had DKA within 6 mo of diagnosis. Twenty-one met the RADIANT A-β+ KPD criteria. The time spent to identify those with T2D and DKA was significantly shorter with PEPPER compared to manual review (13.4 ± 3.9 vs. 26.6 ± 9.4 seconds, p&lt;0.001), translating to 6.2 vs. 12.3 hours to review 1660 charts with and without PEPPER. Both methods yielded identical results, confirming PEPPER’s accuracy.
Conclusion: We developed a novel, efficient and reliable EMR review method that could be used on large cohorts to identify research candidates.

Disclosure
M. Ahmed: None. E.A. Kubota-Mishra: None. A.F. Siller: None. A.E. Davis: None. I. Migacz: None. S. Sisley: Speaker's Bureau; Rhythm Pharmaceuticals, Inc. J. Faruqi: None. Z.I. Saeed: None. S. Ahmed: None. L.H. Philipson: Research Support; Novo Nordisk, Novo Nordisk Foundation, Dompé, Vertex Pharmaceuticals Incorporated, Imcyse. M.J. Redondo: None. A. Balasubramanyam: None. M. Tosur: None.

Funding
U54 DK118638 and U54 DK118612 (RADIANT Study Group) and K23-DK129821 (MT)
1298-P: Increased Fasting Glucagon-Like Peptide-1 Level Is Associated with Higher Triglyceride–Glucose Index in Type 2 Diabetes Mellitus Patients with Hypertriglyceridemia
Authors: CHIN CHONG SHIAU , SUKOR NORLELA , ROBERT SARAH A. , FONG NG KIM , KAMARUDDIN NOR A. 
Published: June 2024

Introduction & Objective: Triglyceride-glucose (TyG) index is a reliable and simple surrogate marker of insulin resistance (IR). Limited studies have been conducted to assess the association between fasting glucagon-like peptide-1 (fGLP-1) and IR estimated by TyG index. We aimed to investigate the association between fGLP-1 and TyG index in type 2 diabetes mellitus (T2DM) patients with hypertriglyceridemia and to further explore triglyceride or glucose, as parameters of TyG index, was more closely related to fGLP-1.
Methods: A total of 35 T2DM subjects and 27 subjects diagnosed with T2DM + hypertriglyceridemia were recruited. Hypertriglyceridemia was defined as serum triglyceride ≥ 1.7 mmol/L. Plasma total fGLP-1 concentrations was measured by enzyme-linked immunosorbent assay. The TyG index was determined as ln(fasting triglycerides [mg/dL]×fasting glucose [mg/dL]/2).
Results: Total fGLP-1 level was significantly increased in T2DM + hypertriglyceridemia subjects than T2DM subjects (29.44±12.21 pmol/L vs. 18.24±8.79 pmol/L, p=0.02). FGLP-1 level was positively correlated with TyG index (r=0.375, p=0.001) and fasting triglyceride (r=0.395, p=0.02). There was no significant association between fGLP-1 and fasting plasma glucose. Furthermore, linear regression analysis showed TyG index and triglyceride were independently associated with fGLP-1 (Β=0.328, p=0.02; Β=1.58, p=0.047, respectively).
Conclusion: In T2DM patients with hypertriglyceridemia, increased fGLP-1 was associated with higher IR as measured by TyG index. FGLP-1 was not related to glucose as a parameter of the TyG index, but fGLP-1 was significantly associated with fasting triglyceride. Increased fGLP-1 secretion may play a compensatory role in the pathogenesis of IR induced by hypertriglyceridemia.

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
University Kebangsaan Malaysia (GUP-2017-066); Malaysian Endocrine and Metabolic Society (L12-MEMS6)
1344-P: Socioeconomic Status Patterns in Remote Diabetic Retinopathy Screening Using Teleophthalmology
Authors: JESSICA CRUZ MARIA , CHOKSHI TANVI , NGUYEN LINDSEY , VARGAS-RAMOS TREYSI G. , HANG ABRAHAM , SNYDER BLAKE M. , YIU GLENN 
Published: June 2024

Purpose: Diabetic retinopathy disproportionately affects groups from disadvantaged backgrounds. Although teleophthalmology improves diabetic retinopathy (DR) screening rates, the impact of socioeconomic status on retinal disease severity and remote eye care access is unknown. Here, we investigate whether socioeconomic condition as measured by Area of Deprivation Index (ADI) impacts the prevalence and severity of ocular pathologies and eye care follow-up after remote eye screening.
Methods: We reviewed medical records of patients from University of California, Davis Health who underwent remote diabetic retinopathy screening between 2018-2022 to collect demographic data, medical history, teleophthalmology findings, and in-person eye care follow-up reports. ADI is a composite measure of income, education, employment, and housing, which has been used to inform health policy. Patients with no census neighborhood level data were excluded.
Results: Among 1533 patients who underwent remote DR screening (mean age 61.5, 46.4% female, 11.9% Black, 16.1% Hispanic, mean HbA1c 7.6), most patients had no (78%) or mild DR (11.7%), while some had more than mild non-proliferative DR (2.1% moderate, 0.3% severe, 0.3% proliferative, 1.2% diabetic macular edema). Patients with greater socioeconomic disadvantage was associated with worse DR severity (p&lt;0.001). For those who were referred for in-person eye care evaluation (n = 398), the most socioeconomically deprived individuals were also less likely to follow up within the recommended time frame (23.5% in 5th quintile vs. 65.6% in 1st quintile).
Conclusion: Socioeconomic disadvantage as measured by ADI is independently associated with worse DR severity, and less likely to receive follow-up care within the recommended time frame after remote DR screening using teleophthalmology. Although remote DR screening improves overall screening rate, further investigation is needed to understand methods to best mitigate these disparities.

Disclosure
M. Cruz: None. T. Chokshi: None. L. Nguyen: None. T.G. Vargas-Ramos: None. A. Hang: None. B.M. Snyder: None. G. Yiu: Consultant; 4DMT, AbbVie Inc., Adverum Biotechnologies, Alimera Sciences, Bausch + Lomb, Boehringer-Ingelheim, Clearside, Endogena, Genentech, Inc., Gyroscope, Iridex, Janssen, jCyte, Myrobalan, NGM Bio, Novartis, Ray, RegenXBio, Stealth.
1347-P: Risk of Primary Liver Cancer following New-Onset of Diabetes—A Longitudinal Study in a Chinese Adult Cohort
Authors: QI XIAOLONG , LI YILING , ZHANG SHUAIRAN , LIU CHUAN , WANG SHAN , GAO JINGLI 
Published: June 2024

Introduction & Objective: Primary liver cancer (PLC) is a major global health concern, with diabetes mellitus (DM) identified as a potential risk factor. Our study aimed to evaluate the temporal association between the onset of DM and the risk of developing PLC.
Methods: A retrospective cohort study was conducted, encompassing a sample of 89,243 Chinese adults free from any previous diagnoses of cancer or DM. Incidence rates of new-onset DM and PLC were recorded over a median follow-up of 14.04 years. Data from biennial health assessments between 2006 and 2020 were analyzed using Cox proportional hazards models, adjusting for demographics and lifestyle factors.
Results: Of the participants, 13,225 developed incident DM. Those with new-onset DM exhibited a higher risk of PLC within the first five years post-diagnosis (HR 3.09), which declined over time (Figure). HBsAg-positive individuals with recent-onset DM faced an even higher risk (HR 4.30). Subgroup analysis identified males, non-obese, current drinkers, and smokers as high-risk groups for PLC among those with new-onset DM.
Conclusion: The onset of DM is associated with a heightened risk of PLC, especially within the first five years following diagnosis, particularly for those with concurrent HBsAg positivity. Our findings highlight the need for vigilant PLC screening in newly diagnosed diabetic patients.

Disclosure
X. Qi: None. Y. Li: None. S. Zhang: None. C. Liu: None. S. Wang: None. J. Gao: None.
1349-P: Diabetes in Chronic Pancreatitis Is Characterized by Significant Insulin Deficiency
Authors: KUDVA YOGISH C. , LI YISHENG , WANG FUCHENCHU , YADAV DHIRAJ , ANDERSEN DANA K. , SAEED ZEB I. , BELLIN MELENA , FISHER WILLIAM E. , CUSI KENNETH , PARK WALTER , RAZA RIZVI SHAFAQ , TOLEDO FREDERICO G. , CONSIDINE ROBERT V. , SERRANO JOSE , GOODARZI MARK O. , HART PHIL 
Published: June 2024

Objectives: Chronic pancreatitis (CP) is associated with a high lifetime prevalence of diabetes mellitus (CPDM). However, our understanding of the pathophysiology of CP-DM in contrast to type 2 DM (T2DM) remains incomplete.
Method: We used a mixed meal tolerance test (MMTT 120 min) to assess metabolic alterations in 170 participants with CPDM or with T2DM &lt; 3 years. The DM duration in CP was dichotomized as ≥ or &lt; 3 years. We compared estimates of insulin sensitivity (Matsuda index), insulin secretion (insulinogenic index), and beta cell function (oral disposition index or ODI) between subgroups using Wilcoxon rank-rum tests.
Results: Area under the curve (AUC) for glucose was increased, while measures of insulin secretion were reduced in CPDM vs T2DM (Table 1). Glucagon and GIP did not differ. Insulin sensitivity was increased in CPDM &lt;3 yrs but this cohort differs from T2DM with BMI being lower. Interestingly, CPDM ≤ 3 yrs and CPDM &gt;3 yrs did not show any significant differences in insulinogenic index, Matsuda index and ODI.
Conclusion: The most important difference seen in both CPDM cohorts was a significant reduction in insulin secretion. Future studies are needed to understand how these differences can be used to develop personalized anti-hyperglycemic therapy for this patient population.&lt;u&gt;&lt;/u&gt;

Disclosure
Y.C. Kudva: Research Support; Dexcom, Inc. Other Relationship; Tandem Diabetes Care, Inc., Medtronic. Y. Li: Stock/Shareholder; Agenus, Inc., Mink Therapeutics, Inc. F. Wang: None. D. Yadav: Consultant; Pfizer Inc. Research Support; AbbVie Inc. D.K. Andersen: None. Z.I. Saeed: None. M. Bellin: Research Support; ViaCyte, Inc. Advisory Panel; Vertex Pharmaceuticals Incorporated, Insulet Corporation. Research Support; Dexcom, Inc. W.E. Fisher: Other Relationship; Intuitive Surgical. K. Cusi: Research Support; Echosens, Boehringer-Ingelheim, Quest Diagnostics, Inventiva Pharma, LabCorp, Nordic Bioscience A/S. Consultant; Arrowhead Pharmaceuticals, Inc., AstraZeneca, Boehringer-Ingelheim, Lilly Diabetes, 89bio, Inc., GlaxoSmithKline plc, Novo Nordisk, Siemens Healthcare Diagnostics, Sagimet Biosciences, Terns Pharmaceuticals. W. Park: Research Support; AbbVie Inc. Advisory Panel; Pfizer Inc. Consultant; Arctx Medical. Advisory Panel; Ariel Medicine. Consultant; Capsovision, Olympus. Advisory Panel; Horizon Therapeutics plc, Nestlé Health Science. S. Rizvi: None. F.G. Toledo: Advisory Panel; Sanofi. Research Support; Dompé. R.V. Considine: Research Support; Eli Lilly and Company, Adipo Therapeutics. J. Serrano: None. M.O. Goodarzi: Advisory Panel; Nestlé Health Science, Organon. P. Hart: None.

Funding
NIDDK (U01DK108327)
1356-P: Factors Associated with Liver Fibrosis in Type 2 Diabetes Mellitus
Authors: PULZ GEORGIA T.C. , DE ALMEIDA PAULA , MULLER GUILHERME R. , JUNG MAITHÊ K. , COPATTI VITÓRIA , FRIEDRICH MARIANGELA G. , FACCIN CARLO S. , DE FRAGA RAQUEL S. , LEITAO CRISTIANE B. 
Published: June 2024

Introduction & Objective: risk factors for liver fibrosis in metabolic associated steatotic liver disease are not clear in T2DM patients. We aimed to assess clinical, laboratory and body composition factors associated with liver stiffness in T2DM.
Methods: individuals &gt;18 years attending the T2DM outpatient clinic were included in a cross-sectional study. Clinical, biochemical, anthropometric and body composition data were collected. Liver steatosis and stiffness were evaluated (ultrasound and elastography). Data were analyzed by x², t test and logistic regression.
Results: from 664 medical records reviewed, 204 met inclusion criteria and were included. So far, 87 patients were evaluated. Forty-one (47%) patients had mild, 13 (15%) moderate and 2 (2%) severe liver steatosis. In elastography, 54 (65%) patients had no liver stiffness (≤5 kPa), while 28 had some degree (5 - 9 kPa n = 19; &gt;9 kPa n = 9). Variables associated with liver stiffness are depicted in Table 1. In multivariate analysis, ALT and BMI remained associated with higher liver stiffness. Similar results were observed when BMI was switched for total fat mass, trunk fat or limbs fat mass. NFS was the only score associated with liver stiffness.
Conclusion: ALT and parameters of fat mass were independently associated with higher liver stiffness. Notably, NFS performed better than FIB-4 score. Global fat mass, rather than fat in a specific body segment, is associated with higher risk for liver stiffness.

Disclosure
G.T.C. Pulz: None. P. de Almeida: None. G.R. Muller: None. M.K. Jung: None. V. Copatti: None. M.G. Friedrich: None. C.S. Faccin: None. R.S. De Fraga: None. C.B. Leitao: None.
1360-P: Racial Disparities in Selected Complications and Comorbidities among People with Type 2 Diabetes
Authors: HACKL CAITLIN M. , LEE WEI-CHEN , SALLAM HANAA , SERAG HANI 
Published: June 2024

Introduction & Objective: T2DM is a growing public health concern differentially impacting racial and ethnic minorities. To achieve the Centers for Disease Control and Prevention’s Division of Diabetes Translation goal to reduce disparities in diabetes outcomes, assessing disparities is the first step in designing plans to address them.
Methods: We analyzed data from patients (18 years+) diagnosed with T2DM between 01/01/2012 and 03/31/2017 using electronic records of a single health system. We employed Chi-Square to compare selected micro and macro-vascular complication age-standardized rates, associated obesity, and insulin dependence among racial and ethnic groups.
Results: Our sample included 20,680 patients who made 394,106 visits (9,922 non-Hispanic Whites, 4,698 non-Hispanic Blacks, and 6,060 Hispanics). Our results suggest a higher risk of acquiring selected macrovascular (hypertension, ischemic disease, and stroke) and microvascular (renal, ophthalmic, and neurological) complications in Blacks compared to non-Hispanic Whites and Hispanics (p&lt;0.0001). Rates of stage I or II obesity were 62.6% in Blacks, 59.7% in Whites, and 60.0% in Hispanics (p&lt;0.0007 and p=0.0051 for Blacks vs. Whites and Blacks vs. Hispanics; respectively). Rates of insulin use rather than oral hypoglycemics were 52.9% in Blacks, 48.6% in Whites, and 49.7% in Hispanics (p&lt;0.0001 and p=0.0012 for Blacks vs. Whites and Blacks vs. Hispanics; respectively).
Conclusion: Our study suggests a higher susceptibility to complications among Black patients. These disparities are possibly linked to the socioeconomic disadvantages of this patient population leading to poorer management. Prevention strategies are warranted to reduce the incidence of T2DM complications in racial minorities.

Disclosure
C.M. Hackl: None. W. Lee: None. H. Sallam: None. H. Serag: None.
1373-P: Longitudinal Associations of Dietary Exposures and Hypothalamic Gliosis in the Framingham Heart Study
Authors: YEUM DABIN , LO JUSTIN , MELHORN SUSAN J. , OLERICH KELSEY , HUANG ALYSSA , KEE SARAH , DECARLI CHARLES , BEISER ALEXA , SESHADRI SUDHA , SCHUR ELLEN A. 
Published: June 2024

Introduction: Hypothalamic gliosis is linked to obesity and is known to be induced by dietary factors in rodent models including high-fat, fructose-rich, and sucrose-enriched diet. This longitudinal analysis evaluated whether dietary exposures are associated with the degree of hypothalamic gliosis as assessed at MRI examinations obtained 5-8 years later.
Methods: Dietary exposures and brain MRI images were collected from 867 adults. Self-reported food frequency questionnaires were obtained and daily consumption of % total fat, % total carbohydrates, % total protein, % saturated fat, % fructose, and % sucrose of total energy intake were calculated and used as dietary exposures. To calculate the primary outcome, MRI T2 signal intensities were extracted to calculate a ratio of mediobasal hypothalamus (MBH)/amygdala (AMY), a greater ratio suggesting evidence of gliosis; a positive control ratio of MBH/putamen (PUT); and a negative control ratio of PUT/AMY. Linear regression evaluated the association between each dietary exposure and the outcomes of T2 signal ratios adjusting for age, sex, and BMI.
Results: The average age was 54.9±8.8 y (54.9% female). There were no statistically significant associations between % total fat, % saturated fat, % fructose, % sucrose, % total carbohydrates, and % total protein with the degree of MBH gliosis (MBH/AMY) as assessed at MRI examinations obtained 5-8y later (P = 0.89, 0.79, 0.42, 0.90, 0.71, 0.63, respectively). No associations were found between the dietary exposures and the positive or negative control ratio.
Conclusion: We did not find evidence of prospective associations between self-reported diet and MRI evidence of MBH gliosis. However, further research is warranted given the limitations of self-reported diet data and the extended time interval between the dietary exposure and MRI measurements.

Disclosure
D. Yeum: None. J. Lo: None. S.J. Melhorn: None. K. Olerich: None. A. Huang: None. S. Kee: None. C. DeCarli: None. A. Beiser: None. S. Seshadri: None. E.A. Schur: Consultant; Amgen Inc.

Funding
National Institute of Health (5K24HL144917)
1379-P: Detection of Type 2 Diabetes—Evidence from a Pilot Screening Study in Denmark
Authors: CAYUELAS MATEU NURIA , ROSSING PETER , NEERGAARD KIRSTEN P. , THYBO TANJA 
Published: June 2024

Introduction & Objective: Early detection of type 2 diabetes mellitus (T2DM) increases the quality of life and the life expectancy of individuals with T2DM and reduces societal health care costs. The aim of the study is to evaluate the efficiency of targeted and free screening using at-home self-sampling A1c tests for early detection of T2DM.
Methods: In October 2022 to June 2023, the Danish Diabetes Association mailed free capillary at-home self-sampling A1c tests to 8,000 randomly selected individuals aged 50 to 75 years, who had not had their A1c measured within the past two years. The Clinical Laboratory Information Register, including all laboratory measurements covering hospitals and GPs, was used to identify the population.
Results: 3,040 individuals, 38%, returned a blood sample. This is in line with screening studies for other diseases in Denmark. The participation rate was 3.8 %-points higher for women than for men and approximately U-shaped across age for both sexes with the highest participation rate among the 50-year-olds. The age-adjusted share of participants with A1c of 42-47 mmol/mol was 11%, equivalent to the estimated share of individuals with unknown prediabetes in the Danish population aged 50-75 years. The age-adjusted share of the participants with A1c ≥48 mmol/mol was 1.2% for women and 2.5% for men. It is slightly lower than the estimated shares of individuals with unknown T2DM, 1.6% for women and 2.7% for men. Further, individuals between 50-59 years of age constituted 51% of the participants with A1c ≥48 mmol/mol compared to 40% of the population, when diagnosed by the Danish Health Care System (DHCS). Similarly, the median A1c was 52 mmol/mol among the participants with A1c ≥48 mmol/mol compared to a median A1c of 60 mmol/mol in the population, when diagnosed with T2DM by the DHCS.
Conclusion: The pilot screening study for at-home self-sampling prove highly efficient in detecting individuals with A1c ≥48 mmol/mol earlier compared to individuals in the same age group diagnosed by the DHCS.

Disclosure
N. Cayuelas Mateu: Research Support; Novo Nordisk A/S, Bayer Inc., Boehringer-Ingelheim, Sanofi, AstraZeneca, Abbott, Abbott Diagnostics. P. Rossing: Other Relationship; AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Gilead Sciences, Inc., Novo Nordisk, Eli Lilly and Company, Novartis AG, Abbott Diagnostics. K.P. Neergaard: None. T. Thybo: Research Support; Novo Nordisk A/S, Bayer Inc., Boehringer-Ingelheim, Sanofi, AstraZeneca, Abbott, Abbott Diagnostics.
1382-P: Pilot Study of the Healthy Immigrant Effect in Africans Living in America
Authors: HUEFNER ELIZA A. , WORTHY CHARLITA , SAYED MARIAM , HURSTON JAMAIICA , DUBOSE CHRISTOPHER , MABUNDO LILIAN , HORLYCK-ROMANOVSKY MARGRETHE F. , SUMNER ANNE E. 
Published: June 2024

Since the mid-20th century, the Healthy Immigrant Effect (HIE) has been used to describe better cardiometabolic health in African immigrants than African Americans (AA). However, with heart disease and diabetes (DM) rapidly increasing in Africa, it is unknown whether African immigrants who entered the United States (US) in the 21st century have better cardiometabolic health than AA. Therefore, we undertook a pilot study of 17 African immigrants and 17 AA who were matched by sex, age, and BMI (Male: 35% (12/34), Age: 42±16, (mean±SD), range 20-67y, BMI: 30.2±5.8, range 20.2-41.9 kg/m2). Africans entered the US from 2000 to 2022 and were 18y or older at immigration. Biological Age was determined by the Phenotypic Age equation. The Framingham Risk Score (FRS) was used to estimate the 10y risk of a cardiac event. To detect DM, OGTT were performed. Biological Age tended to be lower in African immigrants than AA (38±16 vs 41±16y, P=0.06). Yet, there was no difference by group in FRS (4.4±5.5 vs 4.5±5.2, P=0.95) or DM prevalence (12% (2/17) vs 12% (2/17), P=0.99). African immigrants had a lower rate of health insurance coverage (59% (10/17) vs 88% (15/17), P=0.05) and a higher rate of low income (&lt;45k)(47% (8/17) vs 29% (5/17), P=0.29) than AA. Yet, African immigrants had better diet, activity, sleep, smoking and alcohol habits than AA (Table). Overall, based on lower Biological Age, the HIE may be valid in the 21st century and explained by health behaviors.

Disclosure
E.A. Huefner: None. C. Worthy: None. M. Sayed: None. J. Hurston: None. C. DuBose: None. L. Mabundo: None. M.F. Horlyck-Romanovsky: None. A.E. Sumner: None.