bluuebunny/crossref_metadata_2025_split huggingface dataset:
1773-LB: Impact of SSTR2a Treatment in Hypoglycemia in Male (M) and Female (F) Rat Models of Type 2 Diabetes (T2D)
Authors: DSOUZA NINOSCHKA , ALEALI NADIA , SHAKERI DORSA , ATHERLEY SARA C. , HOFFMAN EMILY G. , KARIMI-CHAHARTASH SINA , JAVANBAKHSH SAHEL , CHAN OWEN , LIGGINS RICHARD , RIDDELL MICHAEL C. 
Published: June 2024

Introduction: This study characterized a F rodent model of T2D and examined SSTR2a treatment in hypoglycemia in M and F rats with T2D.
Methods: A high fat fed streptozotocin-treated (35 mg/kg) T2D model (n=8-10/group) with impaired glucagon (GNC) counterregulation to hypoglycemia was characterized in terms of basal hyperglycemia and response to an oral glucose tolerance test (2 g/kg, OGTT). The effect of SSTR2a (3 mg/kg ZT-01) was assessed in F rats with 12 U/kg insulin-induced (aspart) hypoglycemia and compared to previously reported data for M.
Results: F had basal blood glucose 16.8 ± 5.3mmol/L and HbA1c (6.3 ± 0.6%) similar to T2D males. With OGTT, M and F glycemia were similar, but F had higher baseline c-peptide (F: 2.3 ± 0.7 vs M: 0.85 ± 0.5 ng/ml) and lower GNC (F: &lt;5.2 vs M: 36 ± 28 ng/mL). M GNC declined during the OGTT to levels similar to F, which were unchanged throughout. ZT-01 increased GNC response in hypoglycemia which was greater in F than M (Fig).
Conclusion: We observed apparent sex-related differences to the hormonal responses to hyper- and hypoglycemia, and SSTR2a may increase glucagon responses more so in F rats with T2D.

Disclosure
N. DSouza: None. N. Aleali: None. D. Shakeri: None. E.G. Hoffman: None. S. Karimi-Chahartash: None. S. Javanbakhsh: None. O. Chan: None. R. Liggins: Employee; Zucara Therapeutics. Stock/Shareholder; Zucara Therapeutics. M.C. Riddell: Consultant; Eli Lilly and Company. Speaker's Bureau; Novo Nordisk. Advisory Panel; Supersapiens. Consultant; Dexcom, Inc. Speaker's Bureau; Sanofi. Advisory Panel; Zealand Pharma A/S. Speaker's Bureau; Dexcom, Inc. Stock/Shareholder; Zucara Therapeutics.

Funding
GlycoNet Strategic Initiatives (CD-85); Zucara Therapeutics Inc
1774-LB: The Glucagon Stimulating Effect in Hypoglycemia of Somatostatin Receptor 2 Antagonist (SSTR2a) Is Maintained with Repeat Dosing
Authors: DSOUZA NINOSCHKA , ALEALI NADIA , SHAKERI DORSA , ATHERLEY SARA C. , HOFFMAN EMILY G. , KARIMI-CHAHARTASH SINA , JAVANBAKHSH SAHEL , CHAN OWEN , LIGGINS RICHARD , RIDDELL MICHAEL C. 
Published: June 2024

Introduction: A single dose of SSTR2a, ZT-01, reduces hypoglycemia exposure in diabetic rat models. However, the pharmacology of daily dosing in type 2 diabetes (T2D) rats has not been reported. The purpose of this study was to determine the effects of repeat ZT-01 dosing in a rat model of T2D with recurrent hypoglycemia.
Methods: In a high-fat-fed (HFF) low dose streptozotocin (35mg/kg) T2D rat model, ZT-01 was dosed daily (0.3 mg/kg/d) for 14 days (n=10-11/group). Rats underwent 4 insulin-induced (6-12 U/kg insulin aspart) hypoglycemic challenges 2-3 days apart, beginning on dosing day 8, with blood glucose and plasma glucagon and c-peptide measured over 2 hours post-insulin dose.
Results: ZT-01-treated rats showed improved glycemia with lower HbA1c vs controls (4.3 ± 0.9 vs 5.3 ± 0.8%, p&lt;0.05) after 2-weeks of treatment. Glucagon response to hypoglycemia across all challenges was 9.7 ± 3.1 vs 22.6 ± 4.8-fold over baseline, with vehicle and ZT-01, respectively. ZT-01 reduced hypoglycemia exposure only in challenges 1 and 2, perhaps due to conditioning from antecedent hypoglycemia and a lower baseline blood glucose in challenge 4, particularly in the ZT-01-treated group (21.95 ± 5.4 vs 16.2 ± 6.3 mmol/L, p&lt;0.05).
Conclusion: Daily dosing of SSTR2a resulted in a consistent increase in glucagon during repeated hypoglycemic challenges, and reduced hypoglycemia exposure in initial challenges. It may also improve overall glycemia in this T2D rat model of recurrent hypoglycemia.

Disclosure
N. DSouza: None. N. Aleali: None. D. Shakeri: None. E.G. Hoffman: None. S. Karimi-Chahartash: None. S. Javanbakhsh: None. O. Chan: None. R. Liggins: Employee; Zucara Therapeutics. Stock/Shareholder; Zucara Therapeutics. M.C. Riddell: Consultant; Eli Lilly and Company. Speaker's Bureau; Novo Nordisk. Advisory Panel; Supersapiens. Consultant; Dexcom, Inc. Speaker's Bureau; Sanofi. Advisory Panel; Zealand Pharma A/S. Speaker's Bureau; Dexcom, Inc. Stock/Shareholder; Zucara Therapeutics.

Funding
GlycoNet Strategic Initiatives (CD-85) Zucara Therapeutics Inc.
1793-LB: Subclinical Atherosclerosis in Latent Autoimmune Diabetes—Insights from a Multicenter Prospective Interventional Study
Authors: XIANG YUFEI , LI XIA , XIAO YANG , HUANG GAN , ZHOU ZHIGUANG , CHINA STUDY GROUP LADA 
Published: June 2024

Objective: To compare subclinical atherosclerosis (AS) between latent autoimmune diabetes in adults (LADA) and type 2 diabetes mellitus (T2D) and to evaluate the impact of early insulin intervention on AS progression in LADA.
Methods: Sixty-four LADA patients and forty T2D patients, matched for diabetes duration, were enrolled from the LADA China multicenter study. Baseline assessments included ultrasound examination of carotid arteries (common carotid artery [CCA], internal carotid artery [ICA], and femoral carotid artery [FCA]). Additionally, demographic and clinical parameters including body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), glycated hemoglobin (A1c), lipid panel, fasting C-peptide (FCP), and postprandial C-peptide (PCP) levels were measured. Medical history was recorded. LADA diagnosis was confirmed with positive glutamic acid decarboxylase antibodies (GADA). Subclinical AS was defined as an increase in intima-media thickness (IMT) greater than 1.0mm or the presence of plaque. Statistical analysis was performed using SPSS with significance set at p &lt; 0.05.
Results: Regression analysis identified age, obesity, and lipid levels (total cholesterol and free fatty acids [FFA]) as risk factors for subclinical AS. After adjusting for age, LADA patients demonstrated similar IMT thickness compared to T2D patients, but a significantly lower AS diagnosis rate and smaller plaque area. Following a three-year follow-up with insulin or non-insulin interventions in LADA patients, the insulin intervention group exhibited a significantly lower AS progression rate.
Conclusion: Our study challenges previous findings by showing that LADA patients have less AS than T2D patients at baseline. Moreover, early insulin intervention may effectively reduce AS progression in LADA, emphasizing the importance of timely management in this population.

Disclosure
Y. Xiang: None. X. Li: None. Y. Xiao: None. G. Huang: None. Z. Zhou: None.
1821-LB: Differences on Clinical Experiences with Health Care Providers and Disease Perceptions in Early-Onset vs. Later-Onset Koreans with Type 2 Diabetes
Authors: SUNG GOWOON , GWON SO-HYEON , JANG HYESUN , FAULKNER MELISSA S. , CHA EUNSEOK 
Published: June 2024

Objective: To examine clinical experiences with healthcare providers and illness perceptions in Koreans with type 2 diabetes (T2D) categorized by age at diagnosis.
Methods: A cross-sectional research design was employed. Of 315 contacts, 165 participants were recruited, comprising 60% men, mean age 46.9 ±12.3 years (range: 20 to 76 years) and mean HbA1c 7.3 ±1.5 %. Participants were divided into two groups based on their age at diagnosis: early-onset (&lt;40 years) or later-onset ( ≥ 40 years). Clinical experiences with healthcare providers and illness perceptions were assessed using self-reported Patient Assessment of Chronic Illness Care survey (PACIC), rated on a scale of 1 to 5, and the Brief Illness Perception Questionnaire, rated on a scale of 0 to 10, respectively. Statistical analyses were conducted using SAS for Windows (version 9.2). The significance level was set at α = .05 (two-tailed).
Findings: Overall, patients were well-informed about treatment plans and options (mean ±SD: 3.8± 0.8), but there was less counseling on goal setting and action plans by healthcare providers, particularly for the later-onset group (mean± SD: 3.0±.8 vs. 2.7±.9, p = .04). Compared to the later-onset group, early-onset group reported that T2D significantly affected their life (6.1±2.5 vs.4.9±2.7, p=.003), experienced more severe symptoms (4.9±2.6 vs.3.9±2.6, p=.02), and had a greater negative impact of emotional well-being (5.5±2.6 vs.4.5±2.9, p=.02). Conclusions: Substantial evidence supports the effectiveness of behavioral goals in promoting behavior change. Individualized behavioral goal-setting and personalized counseling should be provided in clinical practice, especially for those with early-onset T2D who often require strategies to enhance their self-efficacy, mitigate negative perceptions of their health, and bolster empowerment in diabetes management.

Disclosure
S. Gwon: None. H. Jang: None. M.S. Faulkner: None. E. Cha: None.

Funding
Korea Research Foundation (NRF-2023R1A2C2004541)
1824-LB: A Qualitative Analysis of the DM-BOOST Program—Enhancing Patient Engagement and Experience with Diabetes Self-Management Education and Support
Authors: BOAKYE MICHELLE , SHENETTE LISA L. , GERBER BEN S. , AMANTE DANIEL J. 
Published: June 2024

Introduction and Objectives: Diabetes Self-Management Education and Support (DSMES) is a recommended component of diabetes care. Despite proven benefits, patient engagement with DSMES needs improvement. The DM-BOOST program, based on principles of Self-Determination Theory and Behavioral Economics and co-designed with patients, was developed to increase patient engagement with DSMES. DM-BOOST included peer-written text messages and digital health training to improve patient portal and telehealth use. The purpose of this study is to explore the feasibility of implementing DM-BOOST in an established DSMES program and its impact on engagement and experiences among individuals with type 2 diabetes (T2D).
Methods: A feasibility pilot was conducted from November 2021-November 2022. Upon conclusion, semi-structured phone interviews were conducted with 36 individuals with T2D. The interviews were audio recorded and transcribed verbatim. An inductive thematic analysis was conducted by two independent coders using MAXQDA24 software. The data collection, analysis, and interpretation of findings were guided by the Unified Theory of Acceptance and Use of Technology (UTAUT).
Results: Participants (n=36) were mean (SD) 45.9 (8.9) years old, 61% female, with a mean baseline HbA1c of 10.1% (1.8). The racial/ethnic distribution was 64.9% White, 11.1% Black, 5.6% Asian, 8.3% more than one race and 11.1% preferred not to answer (with 27.8% overall Hispanic/Latino). Four themes emerged: (1) empowering autonomy through accessible and personalized DSMES, (2) perceived transformative impact on self-management competency and health outcomes, (3) empathetic experience with diabetes educators and research team, and (4) timely, additional support that was coordinated with their care providers.
Conclusion: DM-BOOST was found to be feasible to implement and positively impacted patient engagement and experience with DSMES.

Disclosure
M. Boakye: None. L.L. Shenette: None. B.S. Gerber: None. D.J. Amante: None.

Funding
National Institutes of Health (KL2TR001455, K01DK131318)
1840-LB: Referral, Participation, and Reimbursement Patterns of an Integrated Behavioral Health Program for Diabetes
Authors: ESPINOSA DE LOS MONTEROS KARLA , SPIERLING BAGSIC SAMANTHA R. , SORIANO EMILY C. , FORTMANN ADDIE L. , NOUHI NUSHA , PHILIS-TSIMIKAS ATHENA 
Published: June 2024

Introduction: Psychosocial factors are known to impact diabetes outcomes. The Diabetes Behavioral Health Integration Program (BeHIP) offers integrated psychosocial assessment and care for people with diabetes at a large health system in Southern California. Objective: To describe referral, participation, and reimbursement patterns of the BeHIP.
Methods: BeHIP services are provided by licensed clinical psychologists co-located with physicians and CDCESs in the Division of Endocrinology. Patients identified for BeHIP support are referred via warm hand-off or through their EHR and undergo an individualized assessment followed by individual psychotherapy when indicated. Patients with severe mental illness or concerns unrelated to diabetes are referred out to appropriate services. Data was collected and analyzed via an EHR extraction. Comparisons between those who did versus did not complete at least 1 BeHIP visit were tested by unpaired t-test for continuous data or Chi Square test for categorical data.
Results: Of 953 BeHIP referrals placed between 2017 and 2023, 45% participated in the program. Individuals with T2D (48%), T1D (45%), GDM or other diagnoses (7%) were referred, with no associations between diabetes type and participation. Compared to non-participants, participants were older [55.4±17.1 vs 53.2±17.6] * and referred by an endocrinologist [75.6% vs 60%] *. While the majority of BeHIP referrals were women (70%), gender did not impact the participation status of those referred (47% vs 41%, for women and men, respectively) ≠. Finally, 78% of Health and Behavior CPT codes billed for BeHIP services were reimbursed by insurance, with the reimbursement rate varying widely across insurance plans.
Conclusion: This project provides real-world information to guide our understanding of factors that can impact participation and financial viability of clinical programs targeting psychosocial and behavioral needs within routine diabetes care. *p≤.05, ≠p≥.10

Disclosure
E.C. Soriano: None. A.L. Fortmann: None. N. Nouhi: None. A. Philis-Tsimikas: Advisory Panel; Dexcom, Inc., Lilly Diabetes, Novo Nordisk, Sanofi, Medtronic, Bayer Inc.
1859-LB: PG-102, a Novel Bispecific GLP-1R/GLP-2R Fc-Fused Agonist—Data on Safety, Tolerability, and Pharmacokinetics (PK) in Single Ascending Dose Trial in Healthy Subjects and Preliminary Population PK Modeling
Authors: HAN SEUNGHOON , HAN SUNGPIL , SON KYOUNG-HWA , SUNG YOUNGCHUL 
Published: June 2024

PG-102, a novel bi-specific GLP-1R/GLP-2R Fc-fused agonist, exhibits promising therapeutic option for metabolic disorders, particularly obesity and diabetes, showing superior efficacy in preclinical studies.
In this Phase 1a study, we conducted a randomized placebo-controlled, and double-blind study to evaluate the safety, tolerability, pharmacokinetics (PK), and preliminary pharmacodynamics (PD) of single ascending doses of PG-102 in healthy subjects. Additionally, we employed PK/PD modeling to propose preliminary dosing intervals for further clinical studies.
Forty volunteers (33 men, 7 women; mean age 30.1 years, mean BMI 23.8 kg/m2) received PG-102 (5, 15, 30, and 60 mg) or placebo in an 8:2 ratio. PG-102 demonstrated acceptable safety and a favorable PK profile. Treatment-emergent adverse events (TEAEs) were primarily gastrointestinal, including dyspepsia, nausea, and vomiting, consistent with the GLP-1RA drug class. Notably, no nausea or vomiting occurred up to the 30 mg dose and TEAEs were generally mild to moderate in severity. The PK profile demonstrated a prolonged sustenance effect of PG-102, enabling sustained high concentrations in the bloodstream, thereby contributing to its prolonged effectiveness compared to other Fc-fused protein agonist.
Utilizing basic population PK modeling with simulated human PK profiles, we proposed efficacious doses and dosing intervals for PG-102. PK/PD modeling suggests weekly injections of 5 mg and 15 mg, and biweekly or longer interval for 30 mg and 60 mg doses. Additionally, simulated dose of 90 mg* are expected to have monthly intervals. These findings will be further refined and updated with the results from the ongoing multiple ascending dose study.
*50% dose of NOAEL in toxicity study

Disclosure
S. Han: None. S. Han: None. K. Son: Employee; Progen Co., Ltd. Y. Sung: Advisory Panel; Progen Co., Ltd.
187-OR: Pathway between Race, Historic and Contemporary Measures of Structural Racism, and Prevalence of Diabetes in the U.S.
Authors: EGEDE LEONARD E. , WALKER REBEKAH J. , LINDE SEBASTIAN 
Published: June 2024

This study investigated direct and indirect relationships between historic structural racism and a novel measure of contemporary structural racism on prevalence of diabetes, accounting for distribution of race across counties in the US. Structural equation modeling in Stata v17 and an analytic sample of 15,190 census tracts across 157 counties, within 50 states including DC were used. Historic structural racism was defined as Home Owners’ Loan Corporation (HOLC) redlining neighborhood grades. Contemporary structural racism was defined as the structural racism effect index (SREI), a summary score of nine social determinant domains. Mean diabetes prevalence was 11.8%. Historic redlining, SREI, and Black race were directly associated with increased diabetes prevalence. Historic redlining was indirectly associated with increased diabetes prevalence via SREI. Black race was indirectly associated with increased diabetes prevalence through more exposure to historic redlining and higher levels of contemporary structural racism. Both historic and contemporary measures of structural racism are associated with increased diabetes prevalence. Contemporary structural racism is a stronger relationship for the pathway through which Black race is associated with diabetes prevalence and is a pathway through which historic residential redlining influences diabetes prevalence.

Disclosure
L.E. Egede: None. R.J. Walker: None. S. Linde: None.

Funding
National Institutes of Health (R01DK118038, R01DK120861, R01MD013826, R01MD017574, R01MD018012)
189-OR: Food Insecurity and Inability to Obtain Recommended Medications, Diabetes Technology, and Multidisciplinary Services in Youth and Young Adults with Diabetes
Authors: EL KALACH NADINE , JULCEUS EMMANUEL F. , RUDISILL CAROLINE , MALIK FAISAL , FLORY KATE , FRONGILLO EDWARD A. , SAUDER KATHERINE A. , MENDOZA JASON A. , LIESE ANGELA D. 
Published: June 2024

Introduction & Objective: Little evidence exists on how household food insecurity (FI) affects youth and young adults (YYA) obtaining medical care related to diabetes. We assessed if FI is cross-sectionally associated with not obtaining recommended diabetes medications, technology, and multidisciplinary services, and explored the most common reasons for not obtaining recommended treatments in YYA with diabetes.
Methods: Using data from 911 YYA with type 1 diabetes (T1D) and 144 YYA with type 2 diabetes (T2D) in the SEARCH Food Security Cohort Study Follow-up 1 (2018-2021) and logistic regression, we evaluated the association of FI and the inability to obtain recommended treatments and tabulated the reasons reported.
Results: Almost 30% of YYA with T1D and FI and 20% of YYA with T2D and FI did not obtain one or more recommended treatment (15.8% and 14.4% in food secure YYA, respectively). YYA with T1D and FI had higher odds of not obtaining insulin (OR 3.2, 95% CI 1.2-8.4), an insulin pump (OR 2.2, 95% CI 1.2-4.4), a continuous glucose monitor (OR 2.5, 95% CI 1.5-4.4), mental health counseling (OR 3.3, 95% CI 1.3-8.2), and diabetes education (OR 3.6, 95% CI 1.4-9.3), adjusted for demographics, household income, food assistance, and diabetes duration. Among YYA with T2D, FI was related to not obtaining dietician services (OR 8.1, 95% CI 1.2-53.8). YYA with T1D mostly reported financial reasons (e.g., unable to afford, insurance issues) for not obtaining diabetes technology and medications, followed by structural reasons (e.g., lack of time, not allowed time off) for not obtaining services such as diabetes education or mental health counseling.
Conclusion: YYA with diabetes and FI face constraints in obtaining medications, diabetes technology, and multidisciplinary services, largely due to financial and structural reasons. New strategies are needed to bridge the gap between medical care required versus obtained by YYA with diabetes.

Disclosure
N. El Kalach: None. E.F. Julceus: None. C. Rudisill: None. F. Malik: None. K. Flory: None. E.A. Frongillo: None. K.A. Sauder: None. J.A. Mendoza: None. A.D. Liese: None.

Funding
1R01DK1174611R01DK12720811UC4DK108173
1891-LB: Glycemic Control in Patients with Type 2 Diabetes Mellitus with A1C ≥9.0% with Oral Hypoglycemic Agents vs. Insulin plus Oral Agents
Authors: VIOLANTE ORTIZ RAFAEL , FERNANDEZ ORDOÑEZ NORMA , NARVAEZ GALLIFA EMANUEL , GUERRA CÁRDENAS JOSÉ E. , TAVERA TAPIA ALEJANDRA , REYNA-BELTRÁN ELIZABETH , PEREZ PEREZ JESSICA , CASTRO CHONG IRENE , VÁZQUEZ GARCIA VIRIDIANA , BADILLO GRIJALVA IZMENE , BAUTISTA SÁNCHEZ JAIDY , WONG DE LEÓN KARLA , OLVERA ESCOBEDO ANA , RAMOS GOMEZ CHRISTIAN , AVILA SILVA ANETTE 
Published: June 2024

Introduction & Objective: Insulin therapy in patients with type 2 diabetes mellitus (T2DM) with A1c ≥9% as recommended by some guidelines is not always possible due to different psychological and social factors. Our work compares this strategy with the intensified and combined use of oral hypoglycemic agents (OHAs) in patients with uncontrolled T2DM.
Methods: This was a descriptive and longitudinal study with 426 T2DM patients and A1c ≥9% divided in 2 groups: Group A consisted of OHAs-only therapy (n=188) and Group B of insulin plus OHAs (n=238). We considered the glycemic goal of A1c ≤7%. Cohorts at 3, 6 and 12 months were evaluated using the chi-square test with a significance level of p=≤ 0.05.
Results: Initial Group A vs Group B: age 53.1 ±12.3 vs 56.1 ±12.4 (p= 0.695), weight 77.8 ±15.6 vs 74.3 ±18.1 (p= 0.202), BMI 29.7 ±5.5 vs 29.1±6.0 (p= 0.202); years since T2DM diagnosis 8.6 ±7.6 vs 13.5 ±8.8 (p= 0.000); FPG 223.4 ±69.6 vs 253.6 ±82.8 (p= 0.299); A1c 10.8 ±1.5 vs 11.4 ±1.6 (p= 0.128); At 3 months Group A vs Group B: monotherapy 5 (2.7%) vs 19 (8.0%) p=0.018, dual therapy 53 (28.2%) vs 117 (49.2%) p= 0.000, triple therapy 83 (44.1%) vs 77 (32.4%) p=0.013, quadruple therapy 42 (22.3%) vs 9 (3.8%) p= 0.000; at 6 months: monotherapy 4 (4.3%) vs 13 (11.4%) p=0.064, dual therapy 18 (19.4%) vs 61 (53.5%) p= 0.000, triple therapy 43 (46.2%) vs 37 (32.5%) p= 0.043, quadruple therapy 23 (24.7%) vs 3 (2.6%) p= 0.000; at 12 months: monotherapy 1 (6.8%) vs 8 (10.0%) p= 0.054, dual therapy 16 (27.1%) vs 6 (57.5%) p= 0.000, triple therapy 26 (44.1%) vs 26 (32.5%) p= 0.164. A1c glycemic target achievement at 3 months Group A vs Group B; 46.3% vs 25.2% p=0.000; at 6 months 63.4% vs 37.7% p=0.000; at 12 months 74.6% vs 32.5% p=0.000.
Conclusion: The combined use of OHAs was more effective than insulin therapy plus OHAs in T2DM patients with A1c ≥9.0%, this new approach may be an alternative in patients who do not choose to use insulin or doctors without sufficient knowledge of insulinization.

Disclosure
R. Violante Ortiz: None. N. Fernandez Ordoñez: None. A. Tavera Tapia: None. E. Reyna-Beltrán: None. J. Perez Perez: None. I. Castro Chong: None. V. Vázquez Garcia: None. I. Badillo Grijalva: None. J. Bautista Sánchez: None. K. Wong De León: None. A. Olvera Escobedo: None. C. Ramos Gomez: None. A. Avila Silva: None.