bluuebunny/crossref_metadata_2025_split huggingface dataset:
694-P: Engaging Family and Health Care Provider Stakeholders to Refine a Type 1 Diabetes Peer Mentoring Program for Equitable CGM Use
Authors: ENLOW PAUL , THOMAS COURTNEY , COLLINS D A. , LESTER MARIA , SIMPSON KEVIN L. , MAYSONET ABIGAIL , MAYSONET ASHLEY , LIPMAN TERRI H. , GANNON ANTHONY , ALDERFER MELISSA A. 
Published: June 2024

Introduction & Objective: Racial disparities in the use of CGM are persistent and contribute to racial disparities in health outcomes among youth with type 1 diabetes (T1D). Here we describe the process and outcomes of partnering with families of youth of color with T1D and healthcare providers to refine Type 1 Together, an intervention combining peer mentoring, educational resources, community health worker access to promote equitable use of CGM.
Methods: Monthly meetings were held with 5 Black and 5 Hispanic caregiver-youth dyads and 4 diabetes care providers via a video-conferencing platform. We also sent post-meeting summaries outlining plans to address issues identified during meetings. The quality of stakeholder engagement was assessed by meeting attendance rates and stakeholder ratings on the synergy subscale of the Community Engagement Survey (range 1-6, higher scores indicate better engagement).
Results: We achieved attendance rates of 99% and 95% for family and healthcare provider stakeholders, respectively. Community Engagement Survey responses revealed high levels of engagement for family (M=5.3, SD=0.8) and healthcare provider (M=5.5, SD = 0.7) stakeholders. Family stakeholders renamed the program and outlined processes for discussing and addressing social determinants of health. Feedback from family and healthcare provider stakeholders was incorporated into the measurement strategy and peer mentor training curriculum. Healthcare provider stakeholders refined mentor recruitment strategies and clinical processes to facilitate communication between the study community health worker and other members of the diabetes care team.
Conclusion: Partnering with family and healthcare provider stakeholders helped refine Type 1 Together. Lessons learned when co-developing health equity interventions and utilizing evidence-based community engagement practices to enhance the quality of these partnerships will be discussed.

Disclosure
P. Enlow: None. C. Thomas: None. D.A. Collins: None. M. Lester: None. K.L. Simpson: None. A. Maysonet: None. A. Maysonet: None. T.H. Lipman: None. A. Gannon: None. M.A. Alderfer: None.

Funding
National Institute of General Medical Sciences (P20GM144270-01)
703-P: The Association of Environmental Mastery and Diabetes Distress among Young Adults with Type 1 Diabetes
Authors: NAGEL KATHRYN , DEARTH-WESLEY TRACY , HERMAN ALLISON N. , WHITAKER ROBERT C. 
Published: June 2024

Objective: Although diabetes distress (DD) is common among young adults with type 1 diabetes (T1D), little is known about how to prevent DD. We determined whether greater environmental mastery is associated with a lower prevalence of DD.
Methods: In 2017, an online survey was completed by 423 of 743 (56.9%) young adults (19-31 years) with T1D receiving care at a specialty clinic in New York City. The prevalence of DD (score &lt;u&gt;&gt;&lt;/u&gt;3) was measured with the 17-item Diabetes Distress Scale, and environmental mastery scores were measured with the 7-item subscale from Ryff’s Psychological Well-Being Scale. Logistic regression was used to adjust for sociodemographic and clinical covariates.
Results: Of the 416 respondents with complete DD and environmental mastery data, 59.1% were female, 62.7% used an insulin pump, and 47.6% used continuous glucose monitoring. Mean (SD) HbA1c was 8.0 (1.7)%, and 24.3% had DD. The covariate-adjusted prevalence (95% CI) of DD decreased across tertiles (sample-defined) of increasing environmental mastery: 49.6% (41.2%, 58.0%), 19.1% (12.8%, 25.3%), 6.5% (2.5%, 10.6%). This graded association was present across levels of HbA1c (Figure).
Conclusion: Greater environmental mastery was associated with lower DD and may protect young adults with T1D from developing DD.

Disclosure
K. Nagel: None. T. Dearth-Wesley: None. A.N. Herman: None. R.C. Whitaker: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health (T32DK007028)
707-P: Advanced Glycation End Products and Executive Functions in Elderly People with Type 2 Diabetes
Authors: ALVES ANNE 
Published: June 2024

Advanced glycation end products (AGE) is one of the major pathways involved in the progression of diabetic complications. Also, diabetes increases risk for cognitive impairment and dementia. The aim of this study was to correlate AGE with executive functions in elderly people with type 2 diabetes (DM2). The sample consisted of 34 elderly DM2. A questionnaire was used to evaluate the AGE consumption score, AGE reader was used to measure skin autofluorescence and two tasks from the Brief Neuropsychological Assessment (NEUPSILIN) to assess executive functions. The Spearman and Mann-Whitney tests were used (mean+SD). AGE consumption (7.77+ 3.48) was considered adequate and the skin autofluorescence value was higher for age (3.03+0.67). There was no relationship between AGE measures and executive functions (p=0.253; p=0.481). It was observed that the better the performance in verbal fluency, the lower the medication amount (p&lt;0.001; r=-0.555) used by the elderly and the higher the income (p=0.033; r=0.366). Women (-0.025+1.03) had a higher problem-solving Z score than men ( -0.93+1.03; p=0.011). Elderly non-smokers (1.01+2.12) obtained a higher Z score on this same task than elderly smokers (-0.17+1.36; p=0.034).
In conclusion, an adequate consumption of AGE was noted, but elderly DM2 had higher skin autofluorescence. AGE measures were not predictors of executive functions, but gender, smoking, income and polymarcy influenced this performance.

Disclosure
A. Alves: None.

Funding
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.
717-P: National DPP—Best Practices for Program Implementation and Participant Retention in a Primarily Hispanic Population
Authors: WALLACE CHARLENE , MANCILLAS ELI , SHATTUCK TERESA D. 
Published: June 2024

To date, 585,000+ at-risk US adults have taken part in the National Diabetes Prevention Program (National DPP). While the National DPP is effective, challenges exist for building successful programs that support participant retention, particularly for high-risk populations such as Hispanic/Latino (H/L). The aim of this evaluation was to identify factors that influence successful Lifestyle Change Program (LCP) implementation to facilitate participant retention.
Utilizing an implementation research model, researchers analyzed surveys, focus groups and program delivery data from 8 LCPs (4 in predominately Hispanic communities) serving 5226 participants (74% Hispanic). Retention analysis focused on program completion (attended 8+ classes over a 9-month period).
Non-H/L v. H/L (p&lt;.001; 40.5% v 32.4%), and Whites v. Non-Whites (p&lt;.001; 31.6% v 22.3%) were more likely to complete an LCP. Additionally, participants attending through in- person/online or in-person/distance learning were more likely to complete (p&lt;.001; 70.4% and 69.4%, respectively). Themes emerged regarding successful program implementation: 1) address sustainability initially and allow time for the LCP to develop; 2) organizational leadership support and appropriate staffing plans are critical; 3) be prepared to adapt to challenges that may arise and the needs of participants (i.e., adapting schedules, delivery modes, personalization). LCPs attributed retention success to providing optional virtual sessions, flexible scheduling, innovative retention strategies, and frequent communication. Participants attributed retention success to coaches creating a nurturing environment; finding common ground; group sharing; staff follow up; accountability; and experiencing improved health.
This project provided a unique opportunity to identify important and practical considerations for National DPP LCPs across the US in developing programs to support participant retention.

Disclosure
C. Wallace: Employee; American Diabetes Association. E. Mancillas: None. T.D. Shattuck: None.

Funding
Centers for Disease Control and Prevention (NU58DP006364-03-00)
727-P: A New HbA1c Test Based on a Cellular Stiffness Measurement of Red Blood Cells
Authors: PARK EUNYOUNG , KANG SEUNGJIN , KO UNGHYEON 
Published: June 2024

Objective: Diabetic red blood cells (RBCs) exhibit increased stiffness compared to their healthy counterparts. In our prior work, we successfully developed a microfluidic device for measuring cellular stiffness at the single-cell level. This study investigates the potential of utilizing RBC stiffness measurements to predict HbA1c levels.
Methods: The study adhered to the approved protocol of the Public Institutional Review Board designated by the Ministry of Health and Welfare of Korea. Blood samples were collected from fingertip punctures and diluted in Dulbecco's Phosphate Buffered Saline solution. All experiments were completed within 30 minutes of blood collection. Individual RBCs traversed a micro-sized fluidic channel, with their transit times serving as a representation of cellular stiffness.
Results: Stiffness analysis was conducted on over 500 RBCs from each participant. Histogram analysis revealed a diverse stiffness distribution with a wide range. Notably, the stiffness distribution of RBCs varied between HbA1c groups, with the higher HbA1c group exhibiting a greater proportion of stiffer RBCs compared to the group with lower HbA1c levels.
Conclusion: Our result is the first to report the proportionality between HbA1c level and cellular stiffness of RBCs. We believe that cellular stiffness measurements would be a groundbreaking metric for A1c testing, free from conventional protein quantification.

Disclosure
E. Park: None. S. Kang: None. U. Ko: None.
735-P: Association between Glucagon-Like Peptide 1 Receptor Agonists and Risk of Depression in U.S. Older Adults with Type 2 Diabetes—A Population-Based Cohort Study
Authors: LU YING , TANG HUILIN , DONAHOO WILLIAM T. , BIAN JIANG , GUO JINGCHUAN 
Published: June 2024

Background: Literature evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may have anti-depressant effects. However, population studies assessing the association between GLP-1RAs and depression risk are limited and have yielded mixed results.
Methods: Older adults with type 2 diabetes (T2D) who were newly prescribed either a GLP-1RA or a dipeptidyl peptidase 4 inhibitor (DPP4i) were identified from 2016-2020 national Medicare Claims data. We employed 1:1 propensity score matching to control for potential confounding at baseline and a Cox proportional hazards regression to estimate hazard ratio (HR) and 95% confidence intervals (CI) for incident depression.
Results: We included 25,824 Medicare beneficiaries with T2D. Figure 1 presents the Kaplan-Meier plots showing the cumulative incidence of depression over time between matched groups. The incidence rate of depression among GLP-1RA users was lower than that among DPP4i users (46.3 cases vs. 57.1 cases per 1,000 person-years). In the Cox model, GLP-1RAs were significantly associated with a decreased risk of incident depression compared to DPP4i (HR, 0.81; 95%CI, 0.71-0.85).
Conclusion: Among older people with T2D, GLP-1RAs were associated with a significant decrease in the risk of depression compared to DPP4i.

Disclosure
Y. Lu: None. H. Tang: None. W.T. Donahoo: None. J. Bian: None. J. Guo: None.
741-P: Circulating Follistatin Predicts Tirzepatide Treatment Outcomes on Type 2 Diabetes
Authors: ZOU QI , ENGSTRÖM GUNNAR , PAN JINGXUE , ZHANG JIALIN , PERISHO ESTHER J. , LIN YANZHU , WIESE RUSSELL , WILSON JONATHAN M. , PAVO IMRE , GAO RUI , DUFFIN KEVIN L. , DE MARINIS YANG 
Published: June 2024

Elevated circulating hepatokine follistatin (FST) is associated with increased risk of type 2 diabetes (T2D) by inducing adipose tissue insulin resistance and adipocyte lipolysis. In this post-hoc analysis, we explored effects of the GIP/GLP-1 receptor agonist tirzepatide (TZP 5, 10, and 15 mg) and insulin glargine on plasma FST levels at weeks 24 and 52 in adults with T2D and high cardiovascular risk (SURPASS-4, n=1624). At baseline, higher concentration of FST was correlated with higher HbA1c and reduced HOMA-B. The adjusted hazard ratio (HR) for achieving HbA1c&lt;5.7% by 15 mg TZP in the highest quartile of baseline plasma FST (Q4) vs. the lowest quartile (Q1) was 2.39 (CI: 1.14-5.03, p&lt;0.05) in 24 weeks and 2.03 (CI: 1.12-3.70, p&lt;0.05) in 52 weeks. TZP dose dependently reduced FST at 52 weeks (4.69; 4.49; 4.11 ng/ml for 5, 10, 15 mg TZP, p&lt;0.001); and 15 mg TZP reduced FST at 24 and 52 weeks (baseline 5.14; 24 week 4.03; 52 week 4.11 ng/ml, p&lt;0.001). Change from baseline FST correlated with HbA1c and BMI reduction and HOMA-B increase, with stronger associations on higher TZP dose. These post-hoc data show that TZP treatment reduces plasma FST, and TZP is more effective for reaching HbA1c&lt;5.7% in T2D individuals with higher baseline FST levels. Further understanding of link between TZP outcomes and FST, including related role of FST in β-cell, hepatocyte and/or adipocyte function associated with TZP treatment, remain to be elucidated.

Disclosure
Q. Zou: None. G. Engström: Stock/Shareholder; AstraZeneca. J. Pan: None. J. Zhang: None. E.J. Perisho: Research Support; Eli Lilly and Company. Y. Lin: Stock/Shareholder; Eli Lilly and Company, Pfizer Inc., AstraZeneca. R. Wiese: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. J.M. Wilson: Employee; Eli Lilly and Company. I. Pavo: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. R. Gao: None. K.L. Duffin: Employee; Eli Lilly and Company. Y. De Marinis: None.

Funding
Crafoord Foundation (Crafoordska stiftelsen) grant to Y.D.M.
746-P: GLP-1 RA and Risk of Malignancy in Patients with Type 2 Diabetes
Authors: ISHOLA FAIDAT A. , WILLIAM PIKE C. , KIM SUN H. 
Published: June 2024

Introduction and Objective: Glucagon-like peptide 1 receptor agonists (GLP-1 RA) have been associated with both increased (Bezin 2023) and decreased risk (Wang 2023) of certain cancers in patients with type 2 diabetes (T2DM). We investigated the risk of developing 13 obesity-associated malignancies in patients with T2DM who received GLP-1RA compared with other anti-hyperglycemic agents except insulin.
Methods: We conducted a real-world retrospective cohort study on 130 million US adults using deidentified electronic health records from Eversana Life Sciences. The study included patients with new diagnosis of T2DM and no history of malignancy who were prescribed GLP-1RA (n=30,196) within 12 months of T2DM diagnosis and propensity matched to patients on other anti-hyperglycemic agents (n=30,196) between 2010 to 2023. Outcome was incidence of 13 obesity-associated malignancies. Time-varying Cox proportional hazard model was used to compare time to event rates.
Results: In patients with T2DM (56 years, 53% female, 53% White), there was a total of 1219 malignancies after a mean follow up of 2.9 years. Most common cancers were breast (388), prostate (328), and colorectal (148). GLP-1RA users had higher risk for prostate cancer (HR 1.28, 95% CI 1.03, 1.6) compared with those on other anti-hyperglycemic agents. However, E-value was small (1.2), indicating unmeasured confounders affecting outcomes. There was no increased rate of other or overall malignancies (HR 1.04, 95% CI 0.93, 1.17).
Conclusion: Despite a noted increased risk for prostate cancer with GLP-1RA use, non-visible confounders limit the results. Other cancers showed no significant association with GLP-1RA use.

Disclosure
F.A. Ishola: None. C. Pike: None. S.H. Kim: Consultant; ALIGOS Therapeutics. Advisory Panel; GI Dynamics. Research Support; Fractyl Health, Inc. Consultant; Nutrisense.
747-P: Insulin Therapy Deintensification with iGlarLixi (IDEAL) Randomized Controlled Trial—CGM-Related Outcomes
Authors: NOVODVORSKY PETER , THIEME LENKA , LANKOVA IVANA , VESELÁ ALICA , ZAHUMENSKY EMIL , EDELSBERGER TOMAS , LÖBLOVÁ MARIE , HRUBÝ FILIP , MRAZ MILOS , HALUZIK MARTIN 
Published: June 2024

Introduction: The IDEAL RCT examined the efficacy and safety of MDI de-intensification into once-daily administered iGlarLixi in people with type 2 diabetes (PwT2D) and showed that it provides comparable glycemic control with the benefits of reduction of body weight, total daily insulin dose and number of insulin injections. Here we report CGM outcomes from the trial.
Methods: IDEAL was a 5-centre, open-label, parallel-group, phase 4 RCT with a 24-week active treatment period. Participants were randomized in a 1:1 fashion into iGlarLixi or continuation with MDI and were applied professional CGM (Freestyle Libre Pro iQ) before the onset (BL) and for the last 2 weeks of the treatment period (W24). Participants in whom ≥ 72 hours of CGM data were available were included in the analysis.
Results: Altogether 73/91 (80.2%) of IDEAL participants were analyzed. Median (IQR) %TIR increased in the iGlarLixi group (70 [57 - 88] at BL vs 80 [61 - 92] at W24, p = 0.039), but remained unchanged in the MDI group (78 [67 - 89] vs 82 [64 - 89], p = 0.728). In the iGlarLixi group reductions in %TAR (26 [11 - 44] vs 13 [6 - 35], p = 0.04), % of time in level 2 hyperglycemia (2 [1 - 9] vs 1 [0 - 4], p = 0.019), mean glucose (8.6 [7.4 - 10.1] vs 7.7 [6.9 - 9.2] mmol/L, p = 0.012) and glycemia risk index (GRI) (26 [10 - 46] vs 19 [8 - 35], p = 0.036) were detected. Median (IQR) %TBR (&lt; 3.9 mmol/L) remained unchanged in iGlarLixi group (0 [0 - 1] vs 1 [0 - 2], p = 0.337) and MDI group (0.5 [0 - 2] vs 1 [0 - 3.75], p = 0.147). Statistically significant differences between the changes (BL - W24) in the following CGM metrics (iGlarLixi vs MDI) were observed: %CV (-0.8 [-3.4 - 0.75] vs 1.4 [-1.2 - 3.3], p = 0.016) and GRI (-3.2 [-22.4 - 2.4] vs 1.6 [-6.25 - 10.6], p = 0.045).
Conclusion: Insulin therapy de-intensification from MDI into iGlarLixi in PwT2D showed an improvement in CGM outcomes vs baseline (TIR, TAR, level 2 hyperglycemia, mean glucose and GRI) and vs continuation with MDI (glycemic variability and GRI) without increase of time spent in hypoglycemia.

Disclosure
P. Novodvorsky: Speaker's Bureau; Sanofi, Boehringer-Ingelheim. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Novo Nordisk A/S. Research Support; Sanofi. Speaker's Bureau; Abbott, Medtronic, Berlin-Chemie AG, Viatris Inc., Novartis AG. L. Thieme: None. I. Lankova: None. A. Veselá: None. E. Zahumensky: None. T. Edelsberger: None. M. Löblová: None. F. Hrubý: None. M. Mraz: None. M. Haluzik: Advisory Panel; Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Johnson & Johnson Medical Devices Companies. Consultant; Merck & Co., Inc., Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Johnson & Johnson Medical Devices Companies, Novatin. Research Support; Sanofi. Speaker's Bureau; Sanofi, Novo Nordisk.

Funding
Sanofi
778-P: Changes in HbA1c with GLP-1 Use in People with Type 1 Diabetes—Data from the T1D Exchange QI Initiative
Authors: LEVY CAROL J. , GILLIS MARGARET , PAT GALLAGHER MARY , BASINA MARINA , SHAH VIRAL N. , OSPELT EMMA L. , ROMPICHERLA SAKETH , BREIDBART EMILY , ZUPA MARGARET , EBEKOZIEN OSAGIE , COLLABORATIVE T1DX-QI 
Published: June 2024

Background: Glucagon-like peptide 1 receptor agonists (GLP-1RA) are currently not approved for use in people with T1D (PwT1D). At present there is limited safety and efficacy data using these agents in PwT1D. We analyzed the association of GLP-1RA on HbA1c levels and weight in PwT1D.
Methods: Electronic medical record data from T1D Exchange Quality Improvement Collaborative, including 13 endocrinology clinics across the United States was subcategorized by age, race/ethnicity, gender, insurance type use as well as type of GLP-1RA prescribed. Analysis included PwT1D, 20 years of age or older with at least two prescriptions of the same GLP-1RA. BMI and HbA1c prior to GLP-1RA use and 6-12 months after the initiation of GLP-1RA were analyzed using t and chi square tests as appropriate (Table 1).
Results: The population consisted of 481 PwT1D using GLP1RA. Of these individuals, 53% were non-Hispanic White, 70% were female, and 90% were prescribed long acting GLP-1RA. There was a reduction in the mean HbA1c level from 7.5 to 7.3 (p=0.04). No significant differences were found in BMI or DKA events.
Conclusions: HbA1c levels decreased after 6-12 months on a GLP-1RA. Prospective research should further clarify use, optimal dosing, and potential benefits, including cardiovascular risk reduction, of GLP1-RA medication for PwT1D.

Disclosure
C.J. Levy: Research Support; Dexcom, Inc. Consultant; Dexcom, Inc. Research Support; MannKind Corporation, T1D Exchange, Tandem Diabetes Care, Inc., Abbott, Insulet Corporation. M. Gillis: None. M. Gallagher: None. M. Basina: None. V.N. Shah: Consultant; Dexcom, Inc., Insulet Corporation. Research Support; Insulet Corporation. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Sanofi, Medscape. Consultant; embecta, Tandem Diabetes Care, Inc. E.L. Ospelt: None. S. Rompicherla: None. E. Breidbart: None. M. Zupa: None. O. Ebekozien: Advisory Panel; Sanofi, Medtronic. Research Support; Vertex Pharmaceuticals Incorporated. Speaker's Bureau; Vertex Pharmaceuticals Incorporated. Research Support; Medtronic, Lilly Diabetes, Abbott, Dexcom, Inc.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust