bluuebunny/crossref_metadata_2025_split huggingface dataset:
FRI648 GLP-1RA And SGLT2i Treatments May Show Improved Depression Metrics In Diabetes Treatment
Authors: Jain Arad , Esper Layal , Powell Joseph , Meyer Kristin , Sen Sabyasachi 
Published: October 2023

Abstract
Disclosure: A. Jain: None. L. Esper: None. J. Powell: None. K. Meyer: None. S. Sen: None.
Background: Depression is a widespread condition that develops due to a multitude of etiologies. Type 2 Diabetes (T2DM) is associated with several comorbidities, including depression. A class of T2DM medication, Glucagon-Like-peptide-1 receptor agonists (GLP1RA), acts on the hypothalamus, pancreas, and other systems to reduce weight and control blood sugar. GLP1RAs may play a positive role in improving depression by improving satiety and acting on brain centers responsible for anxiety and depression. We hypothesized that patients on GLP1RA would have lower depression scores than those on insulin/metformin standard regimen, or on SGLT2 inhibitors ( which serves as an active comparator) due to localized effects of SGLT2i in the renal cortex. This research will add to ongoing studies in our lab that examine different classes of diabetes medication in treating patients with increased cardiovascular or renal risk, with the goal of increasing the specificity by which endocrinologists prescribe particular classes of glycemic control medications. Methods: We conducted a retrospective observational chart analysis at the Washington DC VA Medical Center and compared the PHQ-9 scores of 50 T2DM patients selected at random over 6 weeks maintaining a consistent diabetes care regimen for 6 months. We observed n=9 GLP1RA, n=7 SGLT2i, and n=31 control subject records. 3 subjects on both medications were excluded from this analysis. We noted the PHQ-9 scores of subjects on active psychotropics, but those were not excluded from the study at this time. Results: Our cohort had a mean age of 61.8±12.5 years and mean A1C of 8.04±2.13%. These factors were evenly distributed between analysis groups. Our analysis showed that T2DM subjects on GLP1RA had PHQ-9 scores of 5.00±1.51. This wasn’t significantly lower than the control cohort (6.21±1.22, p=0.53), or SGLT2i cohort (3.85±1.24, p=0.57). Conclusion: Our preliminary analysis in a real-life clinical setting shows a trend indicating subjects on neither GLP1RA nor SGLT2i have higher depression scores than those on either one. However, we plan to continue reviewing records to see if this trend or differences between classes is significant. With a larger sample size, we also plan to include correlations between depression scores and efficacy of treatment. Continuing this research, particularly in a VAMC cohort at higher risk of depression, may provide insight into clinical decision making in T2DM patients with history or high risk for depression and related disorders.
Presentation: Friday, June 16, 2023
FRI658 Diabetic Ketoacidosis Masked By Cannabis In Type 2 Diabetes Mellitus
Authors: Bosques-Lorenzo Jaymilitte , Velazquez-Acevedo Sharolyn , Baez-Torres Joedali , Colon-Castellano Janet 
Published: October 2023

Abstract
Disclosure: J. Bosques-Lorenzo: None. S. Velazquez-Acevedo: None. J. Baez-Torres: None. J. Colon-Castellano: None.
Background: With the legalization of cannabis in many states, cannabis-related emergency visits have doubled. In recent years, hyperglycemic ketosis and altered glycemic control have been more frequently described in diabetic patients who are also cannabis users. Physicians mostly rely on pH and bicarbonate to diagnose and classify diabetic ketoacidosis (DKA). However, diabetic-cannabis users with typical DKA symptoms may present with alkalosis rather than acidosis. Clinical Case: We present the case of a 71-year-old male patient with a history of insulin-dependent type 2 diabetes mellitus, hypertension, and hyperlipidemia who came to the ED with a chief complaint of increased tiredness, fatigue, polyuria, polydipsia, and a home blood glucose measurement of greater than 500 mg/dl. Labs were remarkable for central blood glucose of 528 mg/dl, b-hydroxybutyrate of 42.1 mg/dl, and anion gap of 18.5mEq/L. Urine was also positive for glucose and ketones. However, arterial blood gasses showed a pH of 7.438 and bicarbonate of 25.5 mmol/l which did not meet the criteria for typical DKA. Upon record review, the patient had prior toxicology tests which were positive for cannabinoids. This admission wasn’t the exception. Studies have suggested that diabetic cannabis users tend to present with metabolic alkalosis despite high anion gap ketosis. Therefore, the patient was managed as per DKA protocol with adequate response and improvement of symptoms. Conclusion: The diagnosis of DKA in cannabis users may be frequently missed due to its differing and conflicting acid-base profile compared with non-cannabis users. Gastric delay and frequent vomiting have been suggested as the likely cause of alkalosis in these patients. Our patient did not present with severe vomiting; therefore, this case suggests that an alternate mechanism for alkalosis is possible and that relying only on pH and bicarbonate can be misleading. This case highlights the importance of screening urine toxicology for cannabis in patients who do not meet the typical criteria for DKA (pH &gt;7.4 and bicarbonate &gt;15 mmol/L) to provide the most effective treatment.
Presentation: Friday, June 16, 2023
SAT050 Liver Androgen Receptor Knockout Delayed The Onset Of High Fructose Diet-induced Dysglycemia In Female Mice
Authors: Falzarano Claire , Oliver Trinitee , Osei-Ntansah Adjoa , Lofton Taylor , Andrisse Stanley 
Published: October 2023

Abstract
Disclosure: C. Falzarano: None. T. Oliver: None. A. Osei-Ntansah: None. T. Lofton: None. S. Andrisse: None.
Introduction: Previous research has indicated that a lipid-independent pathogenic mechanism plays a role in androgen-induced hepatic insulin resistance where liver androgen receptors may play a role in modulating disease. Consequently, this study aims to investigate the pathophysiology of high fructose diet (HFrD) induced dysglycemia in male and female liver androgen receptor knockout (LivARKO) mice. Andrisse et al 2021 showed that deleting the liver androgen receptor prevented female mice from developing hyperandrogenemia (HA)-induced insulin resistance. From this, we asked the question, does LivARKO prevent HFrD induced dysglycemia? Hypothesis: It was hypothesized that HFrD LivARKO female mice would display impaired whole body glucose metabolism in comparison to the Control diet fed LivARKO female mice, suggesting that AR does not play a significant role in regulating HFrD-induced dysglycemia. Methods: We performed insulin tolerance tests (ITT), glucose tolerance tests (GTT), pyruvate tolerance tests (PTT), and glucose stimulated insulin secretion (GSIS) tests on LivARKO female mice fed a high fat diet (HFD) or a control diet (CD) (from Research Diets Inc) during months 1 or 2 after starting the diet. Results: After 1-month, LivARKO female mice fed a Control diet had impaired glucose tolerance compared to LivARKO-HFrD female mice; however, after 2-months, the LivARKO-HFrD female mice displayed impaired glucose tolerance above that of the Control diet LivARKO female mice. LivARKO female mice fed a high fructose diet (HFrD) did not display increased fasting insulin levels compared to LivARKO female mice on a control diet. HFrD LivARKO mice did not display any increase in GSIS at 15-min or 30-min. Conclusion: These findings suggest that LivARKO delayed the onset of HFrD-Induced dysglycemia in female mice. Further research may consist of molecular data to elucidate the mechanistic pathways involved in these whole body phenotypes observed.
Presentation: Saturday, June 17, 2023
SAT078 A Case Of MODY Due To A Rare Activating Variant In The ABCC8 Gene
Authors: Milosavljevic Jovan , Greally John M , Milman Sofiya 
Published: October 2023

Abstract
Disclosure: J. Milosavljevic: None. J.M. Greally: None. S. Milman: None.
Background: ATP-binding cassette transporter subfamily C member 8 (ABCC8) gene encodes the sulfonylurea receptor 1 (SUR1) regulatory subunit of the beta cell ATP-sensitive K+ channel (KATP). Activating mutations in the ABCC8 cause both neonatal and maturity-onset diabetes of the young (MODY). The majority of patients (85%) with diabetes due to ABCC8 gene mutations could be successfully treated with oral sulfonylureas. A substitution c.2473C&gt;T in the ABCC8 gene results in R825W change in the nucleotide-binding domain 1 of SUR1 and in activation of the KATP channel. We report a case of MODY with an activating mutation of ABCC8 gene (R825W). Clinical Case: A 23-year old woman with a history of ventricular septal defect was diagnosed with diabetes mellitus after she presented with a 2-month history of polyuria and polydipsia. At the time of diagnosis, random serum glucose level was 242 mg/dL, Hemoglobin A1c 7.6%, and BMI was 18 kg/m2. There was absence of acanthosis nigricans on exam or a family history of diabetes, although paternal medical history was unknown. A history of low birth weight was reported, but no developmental delays, neonatal diabetes or history of hypoglycemia. A history of seizure during childhood was also noted but was not associated with hypoglycemia. Additional work-up revealed absence of glutamic acid decarboxylase, islet cell, and insulin autoantibodies. C-peptide level was 2.0 ng/mL with blood glucose 113 mg/dL. The patient did not experience microvascular complications of diabetes. Genetic testing was negative for known mutations in HNF1A, HNF1B, HNF4A, GCK, and PPX1 genes. The patient was initially treated with metformin, but never achieved adequate glycemic control and experienced side effects. She was subsequently treated with sitagliptin and ertugliflozin, however, glycemic control remained inadequate (HbA1C 8.1%). At the age of 33 she was referred for clinical exome sequencing. This detected heterozygous ABCC8 variant c.2473 C&gt;T; p.(R825W). Glucose control improved once therapy was switched to glipizide, resulting in the most recent HbA1C of 6.0%. Conclusion: Activating mutations of ABCC8 gene are infrequent genetic causes of diabetes in adults. Sequencing of the ABCC8 gene should be considered in select adult patients, as diagnosis can guide management decisions.
Presentation: Saturday, June 17, 2023
SAT088 Poor Sleep Quality And Insufficient Sleep Duration Are Common In Maturity Onset Diabetes Of The Young
Authors: Arosemena Marilyn A , Wroblewski Kristen , Tasali Esra , Philipson Louis H 
Published: October 2023

Abstract
Disclosure: M.A. Arosemena: None. K. Wroblewski: None. E. Tasali: None. L. Philipson: Research Investigator; Self; Novo Nordisk, Novartis Pharmaceuticals.
Background: Poor sleep quality and insufficient sleep duration are highly common in type 1 and type 2 diabetes. Maturity Onset Diabetes of the Young (MODY) is a unique form of diabetes that is usually characterized by patients being lean, not using insulin, or using diabetes-related technology. This subpopulation has not been studied in regards to their sleep patterns. Objective: To evaluate objective and subjective sleep patterns and their association with glycemic variability in adults with MODY. Methods: Adults with MODY were recruited from the Monogenic Diabetes Registry at the University of Chicago. Subjective sleep quality was measured by a validated survey, the Pittsburgh Sleep Quality Index (PSQI), and sleep patterns were objectively assessed at home by wrist-worn accelerometry (Fitbit Inspire 2) for two consecutive weeks. Glycemic variability was assessed by 2 weeks of continuous glucose monitoring (CGM). Results: To date, a total of 51 patients completed the study. Participants (age:46 ± 12.4 years; BMI:24.6 ± 3.5 kg/m2, diabetes duration: 22.6 ± 13.5, HbA1c: 6.3 ±0.6%) were mostly white (84%), premenopausal (68%), and female (74%). Pathogenic variants included 51% GCK-MODY, 25% HNF1A-MODY, 16% HNF4A-MODY, and 8% HNF1B-MODY. Most participants (71%) reported engaging in regular exercise ( i.e., exercising more than twice and accumulating at least 90 min of moderate or 40 min of vigorous activity in an average week), 45% were only on diet and exercise as their diabetes therapy and 20% were on insulin. Only 27% were on diabetes-related technology (insulin pump and/or CGM) and 88% had no diabetes-related complications. Based on accelerometry (630 nights of analyzed Fitbit data; n=45) 39% of patients had a sleep duration of &lt;7 hours, below the healthy adult recommendations, 90% had a wake after sleep onset (WASO) &gt;40 minutes (normative criteria ≤40 minutes) and, 14% had a sleep efficiency &lt;85% (normative criteria ≥85%)Most patients (69%) reported poor sleep quality with a PSQI mean score of 7.2±3.3 (a score of &gt;5 reflecting poor sleep quality). The data analyses on the association between sleep and glycemic patterns (from CGM) are ongoing. Conclusion: Poor subjective and objective sleep quality and insufficient objective sleep duration are common among MODY patients despite most of them being lean, not on insulin or using diabetes-related technology. Further research should investigate sleep-glycemia relationship in this unique diabetes population.
Presentation: Saturday, June 17, 2023
SAT109 Diabetic Ketoacidosis Due To Non-medical Switching
Authors: Can Ahmet Selçuk , Zhang Zhiwei , Yeakley Forrest 
Published: October 2023

Abstract
Disclosure: A.S. Can: None. Z. Zhang: None. F. Yeakley: None.
Background/Objective: Non-medical switching is a change in treatment regimen for reasons other than efficacy, side effects, or adherence. Non-medical switching aims to decrease health care costs and is initiated by patient’s health insurance company. Case Report: A 20-year-old female with type 1 diabetes mellitus presented with diabetic ketoacidosis (DKA). She was having issues between her health insurance and pharmacy in filling her prescriptions. Both her standing prescription for long-acting (Basaglar, Eli Lilly and Company, Indianapolis, IN, USA) and rapid-acting (Admelog, sanofi-aventis U.S. LLC, Bridgewater, NJ, USA) insulin were no longer covered. The insulin treatment was switched as requested by her health insurance and Semglee (Mylan Pharmaceuticals Inc., a Viatris Company, Morgantown, WV, USA) as long-acting and Humalog (Eli Lilly and Company, Indianapolis, IN, USA) as rapid-acting insulin prescriptions were transmitted to the pharmacy electronically. The patient was confused on what she should be taking. This led to her thinking that her new long-acting insulin (Semglee) was her rapid-acting due to a name that she did not recognize from her past diabetes self-management education. The patient endorsed taking long-acting insulin Semglee three times daily before meals in place of rapid-acting insulin along with previously prescribed long-acting insulin Basaglar twice daily before breakfast and at bedtime. To make things worse, she could not fill her prescription for Semglee due to a Semglee shortage in the preceding three weeks before her admission. Patients with similar health plan were switched to the same insulin at the same time, causing a shortage in our service area. Even if Admelog was prescribed, she was under the impression that she was getting her rapid-acting insulin needs from Semglee. She did not fill her prescription for Admelog. After her discharge, her insurance covered her original regimen (Basaglar and Admelog) that she was on before her non-medical switching. Around the time of admission, wholesale acquisition cost of 5-pack of 3 ml (1500 Units) of Basaglar was $326.36 and unbranded Semglee $147.98 allowing a saving of $0.12 for one unit of insulin. Our patient takes 40 units of long-acting insulin daily, totaling 14600 units per year. Non-medical switching would achieve $1736 savings per year. But inpatient bill for this DKA was $17078. Discussion: In our case, non-medical switching defeated its purpose and increased health care spending. With the switches, patient became confused about her medical regimen. Non-medical switching did not only place additional financial burden but jeopardized patient safety by significantly contributing to an acute complication of diabetes. Further studies that compare health care utilization, not just drug prices are needed to find out if non-medical switching really saves money and is cost-effective.
Presentation: Saturday, June 17, 2023
SAT118 The "Intelligent" Chatbot: Can It Answer Questions About Health And Health Disparities?
Authors: Wu Gloria , Zhao Weichen , Cheng Emily , Wong Adrial , Gim Heidi , Zhang Youcheng , Dorado Perla , Mansubi Nikki 
Published: October 2023

Abstract
Disclosure: G. Wu: None. W. Zhao: None. E. Cheng: None. A. Wong: None. H. Gim: None. Y. Zhang: None. P. Dorado: None. N. Mansubi: None.
Introduction: In 2022, &gt;130 million adults have diabetes or prediabetes and ∼122 million have a form of heart disease. Of those with diabetes; non-Hispanic blacks 12.1%, Hispanics 11.8%, Native Americans 14.5%, Asian Americans 9.5%, and non-Hispanic whites 7.4%. ChatGPT, launched on 11/30/2022, has the newest Artificial Intelligence (AI) software for answering questions in natural language. Purpose: Can ChatGPT answer questions about diabetes, other comorbidities, and health disparities? Methods: ChatGPT was given 5 questions: 1) I am African American, I have diabetes and heart disease. What are my risks of dying? 2) I am South Asian, my cholesterol is 250 mg, my triglycerides are 300 mg, and I am pre-diabetic. What is my risk of dying? 3) I am Native American, I have diabetes and heart disease, drink alcohol, and I smoke. What are my chances of dying versus my blonde American wife? 4) I am Chinese American, and my hemoglobin/A1C is 9. My fasting blood sugar is 200. I cannot read my newspaper anymore. Why? 5) I am Mexican American and my fasting blood glucose is 300, and I was just diagnosed with diabetes but for the past 6 months, I cannot feel my toes. Why? The questions were evaluated with the keywords below: (each keyword was given one point, maximum of 11 pts per question) healthcare team, stroke, heart attack, ADA/Endocrine Society, ACC/AHA, high blood sugar, high blood pressure, complications (eye, kidney, neuropathy, feet), statistics relating to ethnicity, metabolic syndrome.
Keyword Scores: Qn1=4/11; Qn2=5/11; Qn3=1/11; Qn4=3/11; Qn5=3/11 Results: All answers mention “healthcare team,” 4/5 mention heart disease, 4/5 mention high blood sugar, 2/5 mention stroke, 1/5 mention diabetic retinopathy, and 1/5 mention neuropathy. None of the responses list ADA/Endocrine Society, ACC/AHA, statistics, or metabolic syndrome. None of the answers mention eye MD/ophthalmologist, endocrinologist, nephrologist, or podiatrist. None mention health disparities. Qn 1 answers: stroke, heart attack, high blood sugar, and health care team. Qn 2 answers: increased cholesterol as a risk factor and the same answers as Qn1. The answer to Qn 3, involving Native Americans, does not mention “stroke” in the setting of diabetes, heart disease, smoking, and alcohol consumption. Despite the words of "South Asian" and "Chinese American", Qn 2 and 4, respectively, do not mention metabolic syndrome. Qn 4 does not mention the risks of kidney disease and stroke. Only two answers (Qn 1, 2) mention stroke as a risk factor. Conclusions: ChatGPT is not perfect but it provides baseline information for diabetic patients and is a great start to furthering health education for the public.
Presentation: Saturday, June 17, 2023
The autotaxin-LPA axis promotes membrane trafficking and secretion in yolk sac visceral endoderm cells
Authors: Koike Seiichi , Keino-Masu Kazuko , Tanimoto Yoko , Takahashi Satoru , Masu Masayuki 
Published: October 2023

ABSTRACT
Autotaxin, encoded by the Enpp2 gene, is an exoenzyme that produces lysophosphatidic acid, thereby regulating many biologic functions. We previously reported that Enpp2 mRNA was abundantly expressed in yolk sac visceral endoderm (VE) cells and that Enpp2−/− mice were lethal at embryonic day 9.5 owing to angiogenic defects in the yolk sac. Enpp2−/− mice showed lysosome fragmentation in VE cells and embryonic abnormalities including allantois malformation, neural tube defects, no axial turning, and head cavity formation. However, whether the defects in endocytic vesicle formation affect membrane trafficking in VE cells remained to be directly examined. In this study, we found that pinocytosis, transcytosis, and secretion of angiogenic factors such as vascular endothelial growth factor and transforming growth factor β1 were impaired in Enpp2−/− VE cells. Moreover, pharmacologic inhibition of membrane trafficking phenocopied the defects of Enpp2−/− mice. These findings demonstrate that Enpp2 promotes endocytosis and secretion of angiogenic factors in VE cells, thereby regulating angiogenesis/vasculogenesis and embryonic development.
Selective Self-assembly of Gold Nanocrystals Using Complementary Leucine Zipper Peptides
Authors: Nakao Issei , Sumida Kento , Kitamatsu Mizuki , Soejima Tetsuro 
Published: October 2023

Abstract
A heterodimeric leucine zipper (Lz)–based peptide hybrid was utilized as a molecular adhesive to bind two types of gold nanocrystals with different shapes. An acidic leucine zipper (LzE) and a basic leucine zipper (LzK) peptides with terminal cysteine are respectively adsorbed to the surface of spherical gold nanoparticles (LzE–Au NPs) and gold nanocubes (LzK–Au NCs). Transmission electron microscope (TEM) observation and visible (Vis) absorption spectroscopy revealed that LzE–Au NPs and LzK–Au NCs are selectively self-assembled in water. The dynamic self-assembly behavior is also confirmed by in-situ fluorescence resonance energy transfer between fluorescence dyes connected to LzE and LzK peptides and other control experiments.
Comparative evaluation of gestosis score vs uterine artery pulsatility index in predicting gestational hypertension: A study protocol
Authors: Dahiphale Swati , Potdar Jyotsna , Acharya Neema , Garapati Jyotsna 
Published: October 2023

Background: Gestational hypertension and its consequences such as preeclampsia, eclampsia is a leading cause of maternal mortality in India. Multiple risk factors are already known to cause hypertension in pregnancy and with newer advances in the field of medicine, newer risk factors are also being detected which contribute to gestational hypertension. There is need to detect these risk factors so that women who are susceptible to developing hypertension in their pregnancy can be identified at the earliest and monitored and managed accordingly. This study includes two methods, gestosis score which is a newer method, and uterine artery Doppler pulsatility index which is commonly utilized in usually urban centers where ultrasonography facilities are available to look for these risk factors. Objective: The study intends to compare the results of both prediction approaches, the Gestosis score and the Uterine Artery Pulsatility Index in identifying women at risk for gestational hypertension so that these women can be monitored vigilantly for the development of hypertension during their pregnancies and contribute to better management and healthy outcomes of pregnancy. Methods: This study will include 140 pregnant women with gestational ages between 13 to 20 weeks. The gestosis score and mean uterine artery pulsatility index will be calculated. Women with a gestosis score of three or more are deemed at risk for gestational hypertension. Women with mean pulsatility index of 95th percentile or higher are labeled at risk of gestational hypertension. The outcomes of these two methods will be compared to assess which is more effective in predicting developing gestational hypertension. Expected outcome: The study aims to provide insights into the effectiveness of both the Gestosis Score and the Uterine Artery Pulsatility Index in predicting gestational hypertension. The results will contribute to employing better risk assessment in clinical practice and the management of high-risk pregnancies.