bluuebunny/crossref_metadata_2025_split huggingface dataset:
1169-P: Pediatric Type 1 Diabetes (T1D) Care Approaches Compared across International Clinics with Mean HbA1c &lt;7% and ≥7%
Authors: CRISTELLO SARTEAU ANGELICA , GOPISETTY NIKHITA R. , SOURIS KATHERINE J. , BOWLBY DEBORAH , JAIN NINA , KING BRUCE R. , LIU WEI , MALIK FAISAL , PIHOKER CATHERINE , SMART CARMEL E. , TANDON NIKHIL , MAYER-DAVIS ELIZABETH J. 
Published: June 2024

Introduction & Objective: Clinic-level factors that may influence HbA1c among youth with T1D have not been explored in-depth. We qualitatively investigated differences in practices between diabetes centers reporting mean clinic HbA1c &lt;7% and ≥7%.
Methods: Semi-structured interviews based on the Donabedian model were conducted with endocrinologists, educators, dieticians, social workers, and psychologists at pediatric T1D centers selected from an existing international collaborative to represent diversity in practice. We used the rapid analysis matrix method for deductive consensus coding and thematic analysis.
Results: Thirty-one interviews were conducted at 7 T1D clinics across Australia (n=1), China (n=1), India (n=1), Sweden (n=1) and the United States (n=3) (2019-2023). Key clinic-and provider-level drivers of differences in youth HbA1c were the 1) extent to which education timelines and messaging were standardized and personalized 2) existence of protocols for care coordination and escalation 3) availability of patient and clinic-level data to inform decision-making (Figure 1).
Conclusion: Our exploratory study generates useful hypotheses about clinic-and-provider-level messaging, protocols and resources that may shape youth HbA1c. Further research should evaluate how much these factors influence health and the potential for translation across clinics.

Disclosure
A. Cristello Sarteau: None. N.R. Gopisetty: None. K.J. Souris: None. D. Bowlby: None. N. Jain: None. B.R. King: None. W. Liu: None. F. Malik: None. C. Pihoker: None. C.E. Smart: None. N. Tandon: None. E.J. Mayer-Davis: None.
1181-P: Differences in Hemoglobin A1c and CGM-Derived Glucose Management Indicator (GMI) in Youth with Type 1 Diabetes
Authors: SILLER ALEJANDRO F. , SICKLER JAMES K. , VILLEGAS CAROLINA , HUANG XIAOFAN C. , MINARD CHARLES G. , REDONDO MARIA J. , DESALVO DANIEL 
Published: June 2024

Introduction: The relationship of A1c vs. GMI across race/ethnicity has significant differences between Non-Hispanic White (NHW) vs. Non-Hispanic Black (NHB) adults; however, data in ethnically diverse children are lacking. We assessed the correlation of A1c vs. GMI in a large, diverse pediatric population with T1D.
Methods: T1D youth with ≥70% CGM use over the prior 14 days at the time of A1c were included. Delta (defined as GMI minus A1c) was categorized as ≤-0.5%, &gt;-0.5 to &lt;0.5%, ≥0.5% with absolute value of ≥0.5% considered clinically significant. Proportional odds regression was used to evaluate if race/ethnicity was associated with larger difference category.
Results: In 969 youth (age 11.6 ± 3.8y; 53% female; T1D duration 4.4 ± 3.4y), mean A1c was 7.71% and mean GMI was 7.98%. Delta overall and across race/ethnicity are presented in Table 1. Hispanic (OR 2.17; 95% CI 1.44-3.26; p&lt;0.001) and NHW (OR 2.22; 95% CI 1.53-3.22; p&lt;0.001) youth had significantly higher likelihood of having Delta (GMI - A1c) of ≥0.5% compared to NHB youth.
Conclusion: In this diverse pediatric population with T1D, NHW and Hispanic youth were more likely to have a clinically significant discrepancy in which GMI is greater than A1c as compared to NHB youth. Clinical relevance of the A1c vs. GMI relationship, including which best predicts risk of micro- and macrovascular complications, warrants further study.

Disclosure
A.F. Siller: None. J.K. Sickler: None. C. Villegas: None. X.C. Huang: None. C.G. Minard: None. M.J. Redondo: None. D. DeSalvo: Advisory Panel; Insulet Corporation. Consultant; Dexcom, Inc.
1187-P: Increased C4B Gene Copy Number Is Associated with Increased Inflammation in Adolescent Type 1 Diabetes
Authors: DAMILANO CECILIA P. , ZHOU DANLEI , YU CHACK-YUNG , HOFFMAN ROBERT P. 
Published: June 2024

Introduction: Cardiovascular disease will be the primary cause of future death for adolescents with type 1 diabetes (T1D). Increased systemic inflammation is likely to play a role in this. The complement system is part of the innate immune system regulating inflammation. C4 total gene copy number (GCN) and C4 subtype (C4A, C4B, C4Long, and C4Short) CGN have been associated with various aspects of the metabolic syndrome.
Objective: To determine if C4 GCN is associated with fasting and/or post-prandial inflammation in adolescents with T1D.
Methodology: 12 non-obese children and adolescents, 10-18 years old, with T1D were recruited from the Diabetes Clinic of Nationwide Children's Hospital. A randomized cross-over design for two subsequent visits was used. Fasting baseline blood samples were taken to measure glucose, TNFα, IL6, C3 and C4 protein levels and total C4, C4A, and C4B GCN. Rapid acting insulin was given to cover meal carbohydrate without glucose correction. Blood samples were repeated at 30, 60, 90, and 120 minutes. Visits 1 and 2 were identical except for GI of the meal. Visits were rescheduled if fasting glucose was &gt; 200 mg/dl. Spearman’s correlation was used.
Results: Total C4 GCN C4A and C4 Long GCN did not correlate with TNFα, IL6, C3, or C4 levels pre or post prandially for either meal. C4 short CGN positively correlated with baseline TNFα for the high glycemic index meal (rs=0.80, p&lt;0.001) but not the low glycemic index meal. C4B GCN positively correlated with baseline TNFα (rs=0.64; rs=0.68 p&lt;0.02) and IL6 (rs=0.79, p&lt;0.01; rs=0.67 p&lt;0.02) levels and 30 min TNFα (rs=0.80; rs=0.70, p&lt;0.01) for both the high and low glycemic index meals, respectively. C4B GCN also correlated with 60 min C4 levels for both meals (rs=0.80; rs=0.70 p&lt;0.01).
Conclusions: High C4B GCN is associated with increased inflammatory markers (TNFα and IL6) in adolescent T1D. This association may indicate that individuals with high C4B GCN are at increased future risk for diabetes related cardiovascular disease.

Disclosure
C.P. Damilano: None. D. Zhou: None. C. Yu: None. R.P. Hoffman: Research Support; Pfizer Inc.
1196-P: CGM Metrics in Teens with Type 1 Diabetes and Diabetes Distress in the Promoting Resilience in Stress Management (PRISM) Trial
Authors: FERM MICHAEL L. , DESALVO DANIEL , ZHOU CHUAN , BRADFORD MIRANDA , MALIK FAISAL , O'DONNELL MAEVE B. , PIHOKER CATHERINE , ROSENBERG ABBY , YI-FRAZIER JOYCE P. , HILLIARD MARISA E. 
Published: June 2024

Introduction & Objective: Many adolescents with T1D experience diabetes distress, which is related to suboptimal glycemic outcomes. PRISM is a skills-based psychosocial intervention that benefitted psychosocial and behavioral outcomes in youth with T1D but did not improve HbA1c. We explored whether PRISM impacted CGM metrics, given the greater glycemic specificity than HbA1c.
Methods: A 2-site, 1:1 RCT of PRISM vs. Usual Care (UC) included youth with T1D aged 13-18y with elevated diabetes distress (Problem Areas in Diabetes - Teen screener score ≥30). In an exploratory analysis of teens using CGM for routine T1D management (n = 114, 66% of total sample had ample CGM data), we used Wilcoxon rank sum exact tests to compare CGM values above, in, and below target range between PRISM vs. UC at baseline, 6, and 12 months.
Results: Table 1 summarizes CGM metrics at each time point. The difference reached statistical significance only for Level 1 Hypoglycemia at 6 months. There were no other significant group differences in CGM metrics.
Conclusion: The reduction in hypoglycemia suggests potential for psychosocial intervention to have glycemic benefit in youth with diabetes distress, though additional strategies are needed to sustain long-term improvement. Larger intervention studies with teens using CGM are needed to evaluate potential for improving CGM-derived glycemic outcomes.

Disclosure
M.L. Ferm: None. D. DeSalvo: Advisory Panel; Insulet Corporation. Consultant; Dexcom, Inc. C. Zhou: None. M. Bradford: None. F. Malik: None. M.B. O'Donnell: None. C. Pihoker: None. A. Rosenberg: None. J.P. Yi-Frazier: None. M.E. Hilliard: None.

Funding
National Institutes of Health (R01DK121224); National Institute of Diabetes and Digestive and Kidney Disease (K26DK138332)
123-OR: MiR103 as a Potential Inhibitor for Dyslipidemia through Modulation of ANGPTL8 Level
Authors: ABUBAKER JEHAD , CHERIAN PREETHI T. , AL-KHAIRI IRINA , ABU-FARHA MOHAMED 
Published: June 2024

There is increasing interest in the role of epigenetic factors in obesity and its impact on diabetes and dyslipidemia. Earlier report found that miR-103 suppresses de novo lipogenesis (DNL) and dampens the development of obesity/diet-induced fatty liver through targeting at Fasn and Scd1 genes in mouse liver. On the other hand, lipid regulating hormone angiopoietin-like 8 (ANGPTL8) is a known regulator of triglycerides through its inhibition of the lipoprotein lipase activity through its interaction with ANGPTL3. We aimed to study the miR-103 expression in the blood and adipose tissue in a cohort of obese and non-obese people and confirm its binding and regulation to ANGPTL8. miR-103 expression levels were investigated using RT-PCR in 144 participants, 82 who were non-obese (body mass index [BMI] &lt;30) and 62 who were obese (BMI &gt;30). Overexpression and luciferase assays were used to confirm the binding between miR-103 and ANGPTL8. The plasma levels of ANGPTL8 were also measured by ELISA. The miR-103 levels were significantly lower in obese than in non-obese individuals (P = 0.002). In vitro analysis confirmed miR-103 binding to and repression of the ANGPTL8 transcript and protein. Obesity leads to alterations in miR-103 expression. Its downregulation in obese humans was inversely correlated with ANGPTL8, a protein involved in lipid metabolism. Further, miR-103 plasma levels were inversely correlated with TG levels (P = 0.011), and ANGPTL8 levels were positively correlated with TG levels. miR-103 can be used as an inhibitor of ANGPTL8 to reduce the TG plasma level and mitigate dyslipidemia.

Disclosure
J. Abubaker: None. P.T. Cherian: None. I. Al-khairi: None. M. Abu-farha: None.
1246-P: Maternal Proinflammatory Markers Associate with Obesity and Glycemic Measures in Pregnancy
Authors: VAZQUEZ LAURA , VAZQUEZ ARREOLA ELSA , LOOKER HELEN C. , HANSON ROBERT L. , WASAK DOROTA , CABALLERO RACHEL , SINHA MADHUMITA 
Published: June 2024

Introduction & Objective: Both maternal adiposity and dysglycemia induce low-grade inflammation that impacts the fetal intrauterine milieu. We examined the association between maternal proinflammatory markers with gestational glycemia, and pregestational BMI.
Methods: From the Early Tracking of Childhood Health Determinants (ETCHED) longitudinal observational study, data on 66 pregnant Hispanic (73%) and American Indian women were available (May 2022-Sep 2023); 33% had diabetes. We analyzed baseline glycemic measures (fasting glucose, insulin, C-peptide, HbA1c), proinflammatory biomarkers (IL-6, hsCRP), and maternal leptin.
Results: Mean age was 29.9 years (SD ±6.3), mean pregestational BMI was 33.1 kg/m2 (SD±9.4). Table 1 shows significant positive Spearman correlations between maternal serum IL-6 and hsCRP with pregestational BMI, insulin, HbA1c, C-peptide, and leptin. There was no significant correlation between pregestational BMI and offspring birth weight. In a subset (n=40) of matched samples maternal IL-6 was correlated with cord-blood leptin (r=0.34, p=0.03) and TNF-α (r=0.31, p=0.04).
Conclusion: Gestational maternal proinflammatory cytokines were elevated in women with excess adiposity and hyperglycemia. Maternal IL-6 associated with fetal adipocytokines, however, additional data are needed to explore this relationship and its impact on fetal growth and development.

Disclosure
L. Vazquez: None. E. Vazquez Arreola: None. H.C. Looker: None. R.L. Hanson: None. D. Wasak: None. R. Caballero: None. M. Sinha: None.
125-OR: New Lipid Biomarkers for Worsening Glucose Tolerance in Nondiabetic Relatives of People with Type 2 Diabetes
Authors: SYED ISMAIL , SLUIS KENNETH , ARYAL PRATIK , SOLOMON ZACHARY , PATEL RUCHA , KONDURI SRIHARI , SIEGEL DIONICIO , SMITH ULF , KAHN BARBARA B. 
Published: June 2024

There is a growing need for early biomarkers for Type 2 diabetes (T2D). Fatty Acid esters of Hydroxy Fatty Acids (FAHFAs) are bioactive lipids with &gt;580 regioisomers in human tissues. Some FAHFAs such as Palmitic Acid Hydroxy Stearic Acids (PAHSAs) have anti-diabetic and anti-inflammatory effects. PAHSA levels are lower in serum and adipose tissue of insulin-resistant versus insulin-sensitive humans and strongly correlate with insulin sensitivity. Since PAHSAs and palmitic acid esters of hydroxy oleic acids (PAHOAs) are among the most abundant FAHFAs in human serum, we aimed to determine whether these FAHFAs predict worsening glucose tolerance in people with an increased T2D risk, i.e. first-degree relatives of people with T2D. All participants had normal glucose tolerance (NGT) at baseline. Throughout a rolling enrollment period, 27 participants remained NGT (NGT-NGT) and 21 developed impaired glucose tolerance (NGT-IGT). In the group that remained NGT, followup serum PAHSA regioisomers and total PAHSA levels were similar to baseline. In contrast, total serum PAHSA and most regioisomers concentrations decreased in participants who developed IGT. The change in total PAHSAs (R=-0.476; p=0.0006), 5-PAHSA (R=-0.506; p=0.0002), and 9-PAHSA (R=-0.356; p=0.013) correlated tightly with worsening glucose tolerance. Multivariate analysis showed the decrease in PAHSAs predicted worsening glucose tolerance independent of BMI and age. The levels of total PAHOAs and most PAHOA isomers were similar at enrollment and follow-up in the NGT-NGT group. In NGT-IGT, initial and followup PAHOA levels were higher than in participants who remained NGT. Initial total PAHOA levels were: NGT-NGT (15.63±0.79) vs NGT-IGT (28.19±2.27) p&lt;4.48E-07. Followup total PAHOA levels NGT-NGT (14.70±0.62) vs NGT-IGT (31.07±2.73) p&lt;2.88E-08.
Conclusion: A fall in PAHSA levels serves as a biomarker for worsening glucose tolerance while high PAHOA levels predict worsening glucose tolerance and IGT.

Disclosure
I. Syed: None. K. Sluis: None. P. Aryal: Employee; Cellarity. Z. Solomon: None. R. Patel: Employee; Novo Nordisk. S. Konduri: None. D. Siegel: None. U. Smith: None. B.B. Kahn: Advisory Panel; Janssen Pharmaceuticals, Inc. Consultant; Vida Ventures Advisors, Arrowhead Pharmaceuticals, Inc.

Funding
NIH K01 DK118041 (IS).Joslin Pilot & Feasibility Grant P30 DK046200 (IS).NIH R01 DK106210 (BBK).JPB Foundation (BBK).
130-OR: Mediterranean Diet and Gestational Diabetes—What Is the Role of Exposure to Persistent Organic Pollutants
Authors: YU GUOQI , WEI PANG WEI , YANG JIAXI , ZHANG CUILIN 
Published: June 2024

Background: Healthy diet, such as greater adherence to Mediterranean diet (aMED), has been associated with a lower risk of gestational diabetes mellitus (GDM). However, foods characterizing aMED, such as fish and vegetables, are high in certain persistent organic pollutants (POPs) that are known to increase GDM risk. As such, it is critical to examine the joint associations of healthy dietary patterns and POPs exposure with GDM risk.
Methods: The study is based on a prospective multi-racial pregnant cohort in the U.S., the NICHD Fetal Growth Study (N=2,802). aMED in peri-conception/early pregnancy was derived using validated food frequency questionnaire. In total, 76 POPs of different classes were measured using blood samples collected at 8-13 gestational weeks. Pregnant individuals were categorized into four mixed groups based on the median values of aMED and POP concentrations. Binary logistic regression models were utilized to evaluate the joint associations of aMED and POPs with GDM.
Results: aMED and POPs exposure are jointly associated with GDM risk, with the lowest risk among women of high aMED score and low POP levels. For instance, the risk of developing GDM was ~80% lower among women with a high aMED score and low Polychlorinated Biphenyls (PCBs) levels as compared to those with a lower aMED score and high PCB levels [OR (95% CI): 0.18 (0.04, 0.86) (p-interaction=0.041)]. Further, high POP levels appeared to diminish the beneficial role of aMED on lowering GDM risk: women with a higher aMED score and high PCBs did not have a reduced GDM risk compared to those with a higher aMED score and low PCBs.
Conclusions: This study is one of the first to examine the association of healthy diet in early pregnancy with GDM while considering POP levels, and results suggest that future endeavours for promoting a healthy diet for the prevention of GDM may consider optimizing environmental contaminants such as POPs simultaneously.

Disclosure
G. Yu: None. W. Pang: None. J. Yang: None. C. Zhang: None.
1331-P: High Pancreatic Steatosis Prevalence in Type 2 Diabetes Mellitus—What Are the Potential Associated Factors?
Authors: DE ALMEIDA PAULA , PULZ GEORGIA T. , JUNG MAITHÊ K. , COPATTI VITÓRIA , MULLER GUILHERME R. , FRIEDRICH MARIANGELA G. , DE FRAGA RAQUEL S. , FACCIN CARLO S. , LEITAO CRISTIANE B. 
Published: June 2024

Introduction and Objectives: T2DM is linked to ectopic fat storage. Data on pancreatic steatosis (PS) and its associated factors in T2DM are scarce. This study aims to determine PS prevalence in T2DM population and to assess clinical, laboratory or body composition associated factors.
Methods: Adults over 18 years attending the outpatient T2DM clinic were included in this cross-sectional study. Clinical, biochemical, anthropometric and body composition data were collected. PS and stiffness were evaluated by ultrasound and elastography (shear wave 2D). Data were analyzed with x2 and student t test.
Results: Out of 664 reviewed medical records, 204 individuals met the inclusion criteria and consented to participate. So far, 86 individuals have been evaluated and PS evaluation was possible in 83 (96%), being present in 78 [94%; mild n = 33 (38%); moderate n = 43 (50%) and severe n = 2 (2%)]. As the majority exhibited some PS degree, we compared subjects with no/mild vs. moderate/severe PS (Table 1). Waist circumference (WC) was the only variable associated with greater PS. Pancreatic stiffness evaluation was possible in 44 (53%) participants (median = 7 kPa), being similar in both groups.
Conclusion: PS evaluation by ultrasound is feasible and highly prevalent in the T2DM population. WC was the only variable associated with PS. Pancreatic stiffness evaluation was possible in half of the sample and was not associated with PS.

Disclosure
P. de Almeida: None. G.T. Pulz: None. M.K. Jung: None. V. Copatti: None. G.R. Muller: None. M.G. Friedrich: None. R.S. De Fraga: None. C.S. Faccin: None. C.B. Leitao: None.
1348-P: Trends and Independent Correlates of Cardioprotective Antihyperglycemic Agent Use in U.S. Adults with Cardiovascular-Kidney-Metabolic Syndrome
Authors: OZIEH MUKOSO N. , THORGERSON ABIGAIL , EGEDE LEONARD E. 
Published: June 2024

Cardiovascular-kidney-metabolic syndrome (CKMS) includes those at risk for and those with CVD. Cardioprotective antihyperglycemic agents (CAA) have beneficial effects on CKMS. The goal of this study is to examine trends and correlates of CAA use among US adults with CKMS. Data from the Medical Expenditure Panel Survey (2008-2021) representing a weighted population of 30,583,033 US adults aged &gt;=18 years with CKMS were used for this analysis. CKMS was defined as individuals diagnosed with type 2 diabetes, CKD, or CHF. The dependent variable was CAA use defined as GLP-1RAs or SGLT2i use (yes/no). Proportion of CAA use over time was examined overall and by demographic characteristics (age, sex, race/ethnicity, poverty, and insurance) controlling for time. Logistic regression models were used to examine the association between CAA use adjusting for relevant covariates. Analyses were conducted using R v 4.3.1 and significance was p-value&lt;0.05. The prevalence of CAA use in 2008 was 6% (n=2,811) in this population. Use of CAA significantly increased overall from 6 to 61% from 2008 to 2021 (p&lt;0.01). After controlling for time, there were significant differences in CAA use by age (p=0.03), sex (p=0.03), race/ethnicity (p=0.01), poverty (p&lt;0.01), and insurance (p=0.04). In fully adjusted model, independent correlates of CAA use were age 45-64years [OR 1.58 (1.24, 2.02)], non-Hispanic Black [OR 0.71 (0.59, 0.89)], college education [OR 1.62 (1.32, 1.99)], unmarried status [OR 0.83 (0.72, 0.96)], unemployment [OR 0.83 (0.72, 0.96)], low poverty [OR 0.76 (0.62, 0.92)], uninsured [OR 0.46 (0.30, 0.69)] or publicly insured [OR 0.79 (0.69, 0.92)], and survey year. CAA use has increased over time however utilization remains suboptimal among US adults with CKMS. Targeted multilevel interventions including policy-level, health system-level, provider-level, and patient-level focusing on individuals most at risk who have CKMS are critical.

Disclosure
M.N. Ozieh: None. A. Thorgerson: None. L.E. Egede: None.

Funding
National Institute of Diabetes and Digestive Kidney Disease (R21DK131356, PI: Ozieh; R01DK118038 and R01DK120861 PI: Egede) and the National Institute for Minority Health and Health Disparities (K23MD016448, PI: Ozieh; R01MD013826, PI: Egede/Walker; R01MD018012 and R01MD017574, PI: Egede/Linde)
1351-P: Relationship between Body Mass Index (BMI) or Waist Circumference (WC) and Risk of Severe Diabetic Complications in Patients with Diabetes (DM)
Authors: YAGUCHI YUTA , FUJIHARA KAZUYA , YAMADA MAYUKO H. , MATSUBAYASHI YASUHIRO , YAMADA TAKAHO , KITAZAWA MASARU , YAMAMOTO MASAHIKO , KODAMA SATORU , SONE HIROHITO 
Published: June 2024

Although weight management plays a central role in diabetes treatment, the associations between two major anthropometric obesity indicators (i.e., BMI and WC) and severe diabetic complications have not been fully elucidated. Thus, we investigated the relationship between BMI or WC and the risk of severe diabetic complications in patients with DM. Analyzed were 113,336 patients with DM (mean age 52 y, HbA1c 7.2%) without prior treatment-requiring diabetic eye disease (TRDED), dialysis, coronary artery disease (CAD), cerebrovascular disease (CVD), heart failure (HF) or amputation. Patients were divided into 6 categories according to BMI or WC (Table). Risk of diabetic complications was analyzed by a multivariate Cox regression model. High BMI was associated with an increased risk of HF but decreased risk of TRDED and initiation of dialysis. Conversely, low BMI was associated with a reduced risk of CAD but increased risks of initiation of dialysis, CVD and HF. A U-shaped relationship between HF and BMI was observed. Risk of amputation was not significantly associated with BMI and initiation of dialysis. Results for WC were similar to those for BMI. The relationship between BMI or WC and the risk of diabetic complications differed greatly among complications, suggesting that the target weight should be individualized according to complications most likely to occur.

Disclosure
Y. Yaguchi: None. K. Fujihara: None. M.H. Yamada: None. Y. Matsubayashi: None. T. Yamada: None. M. Kitazawa: None. M. Yamamoto: 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.