bluuebunny/crossref_metadata_2025_split huggingface dataset:
631-P: Development of Noninvasive Diabetes Management Method Using Glycated Albumin in Tears
Authors: AIHARA MASAKAZU , KUBOTA NAOTO , YAMAUCHI TOSHIMASA 
Published: June 2023

Aims/Background: Several clinical trials have demonstrated that strict glycemic control is important to minimize the risk of diabetic complications. Although frequent measurement of blood glucose levels by the invasive finger prick method is useful to achieve strict glycemic control, this method is invasive and burdensome to the patients. Glycated albumin (GA) is a biomarker which reflects the glycemic control status over the previous 2 weeks. We demonstrated GA levels in tears correlated those in blood. We hypothesized that regular GA tests in tears caused behavior change and improved glycemic control.
Methods: Participants with type 2 diabetes were recruited and randomly divided to two groups. One group (intervention group) was performed tear GA tests every 2 weeks and reported the results, while the other group (control group) was not. After 8 weeks of intervention, the two groups were compared. GA levels in tears were measured by Liquid Chromatography / Mass Spectrometry.
Results: We enrolled 56 participants to the study. Compared with the control group, the intervention group showed improvement in fasting blood glucose, HbA1c, GA, non-HDL cholesterol.
Conclusions: Levels of GA, as a diabetes-related biomarker, in tears can be measured noninvasively. Regular measurement of the GA levels in tears could allow smoother management of diabetes mellitus and reduce the risk of complications noninvasively.

Disclosure
M.Aihara: None. N.Kubota: None. T.Yamauchi: Other Relationship; Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited, Novo Nordisk, Astellas Pharma Inc., AstraZeneca, Ono Pharmaceutical Co., Ltd., Nippon Boehringer Ingelheim, Kyowa Kirin Co., Ltd., Kowa Company, Ltd., Merck & Co., Inc., Sanofi, Sanwa Kagaku Kenkyusho, Shionogi & Co., Ltd., Daiichi Sankyo, Taiho Pharmaceutical Co. Ltd., Tosoh Corporation, Eli Lilly Japan K.K., Kissei Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., NTT Docomo Inc., Aero Switch, Asahi Mutual Life Insurance Company, NIPRO Medical Corporation, Abbott Japan Co., Ltd., Bayer Inc., Kyorin Pharmaceutical Company, Limited.
641-P: Diabetes Distress and Blood Glucose in the Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D) Study—Which Comes First, the Chicken or the Egg?
Authors: GONZALEZ JEFFREY S. , HERNANDEZ RAYMOND , SPRUIJT-METZ DONNA , HOOGENDOORN CLAIRE J. , CRESPO-RAMOS GLADYS , AGARWAL SHIVANI , CRANDALL JILL P. , PETERS ANNE L. , PHAM LOREE T. , LEE PEY-JIUAN , SCHNEIDER STEFAN , PYATAK ELIZABETH 
Published: June 2023

Introduction: Diabetes Distress (DD) has been consistently linked with suboptimal blood glucose in T1D. However, prior studies have rarely used methods that can adequately evaluate the directionality of this relationship. This study paired ecological momentary assessment (EMA) and continuous glucose monitoring (CGM) to examine the relative strength of lagged effects of blood glucose (BG) on DD and vice versa.
Methods: FEEL-T1D participants (N=182, 40±14 yrs, 54% women, 41% Latino, 29% White, 15% Black) wore blinded CGM for 10-14 days and completed 5-6 smartphone EMA surveys per day. Using multilevel cross-lagged panel modeling, we evaluated within-person lagged effects from momentary ratings of DD (scale: 0-100) to various BG metrics (BG average, Time in Range [TIR, 70-180 mg/dL], % time 181-250 mg/dL, % time &gt; 250 mg/dL, % time 54-69 mg/dL, % time &lt;54 mg/dL, and coefficient of variation [CV]) over the subsequent 3 hours and between 3 hours of BG metrics and subsequent DD ratings.
Results: Unstandardized within-person parameter estimates and 95% confidence intervals for lagged effects of BG on subsequent DD ratings were significant for average BG (0.01; 0.01, 0.02), TIR (−0.01; −0.02, −0.004), % time 181-250 mg/dL (0.01; 0.001, 0.02), and % time &gt; 250 mg/dL (0.02; 0.01, 0.04), but not for CV or % time in low BG; as expected, higher BG predicted subsequently higher DD. Lagged effects of DD ratings on subsequent 3-hour BG metrics were only significant for % time 54-69 mg/dL (−0.02; −0.04, −0.002); unexpectedly, DD was predictive of less % time with low BG.
Conclusion: These novel findings reveal that the experience of DD is significantly influenced by preceding suboptimal BG levels, particularly high BG, even when individuals are blinded to their BG values. Results suggest that interventions that improve BG levels may reduce DD but do not support the hypothesis that reductions in DD will conversely lead to improvements in BG.

Disclosure
J.S.Gonzalez: Consultant; Virta Health Corp. P.Lee: None. S.Schneider: None. E.Pyatak: Research Support; Abbott Diabetes. R.Hernandez: None. D.Spruijt-metz: None. C.J.Hoogendoorn: None. G.Crespo-ramos: None. S.Agarwal: Advisory Panel; Medtronic, Consultant; Beta Bionics, Inc., Research Support; Abbott Diabetes, Dexcom, Inc. J.P.Crandall: Research Support; Abbott Diabetes. A.L.Peters: Advisory Panel; Abbott Diabetes, Medscape, Novo Nordisk, Vertex Pharmaceuticals Incorporated, Zealand Pharma A/S, Research Support; Abbott Diabetes, Dexcom, Inc., Insulet Corporation, Stock/Shareholder; Omada Health, Inc., Livongo. L.T.Pham: None.

Funding
National Institutes of Health (R01DK121298, P30DK111022)
642-P: Discovering Nonadherence to Diabetes Medications—Which Questions Are Most Effective?
Authors: PILLA SCOTT J. , BUGAYONG MARIELLE T. , LONG JUDITH A. , GORDON HOWARD S. , BATES JEFFREY T. , WASHINGTON DONNA , BOKHOUR BARBARA G. , TUEPKER ANAIS , CATHERINE BEACH MARY , MARUTHUR NISA M. , SAHA SOMNATH 
Published: June 2023

Half of patients with diabetes have difficulty taking medications as directed, creating a major barrier to glycemic control. In studies outside of diabetes, specific, negatively-framed questions (e.g. “Are you missing doses?”) were most effective in eliciting patient nonadherence disclosure. Therefore, we performed the first study examining how primary care providers (PCPs) evaluate nonadherence to diabetes medications. We analyzed audio-recorded PCP visits for 341 adults with diabetes from 4 geographically diverse Veterans Affairs medical centers from 2017-2020. This analysis focused on patients who reported substantial nonadherence on a post-visit questionnaire, defined as taking their diabetes medications “some of the time,” “hardly ever,” or “never.” Using an established framework, two coders independently classified PCP’s medication-related questions as broad (e.g. “How are you doing with your medications?”), clarifying of dose/regimen (e.g. “Is insulin still 30 units?”), positively-framed (e.g. “Are you taking your medications every day?”) or negatively-framed. We analyzed associations between question type and nonadherence disclosure using Fisher’s Exact tests. Results: there were 41 patients with substantial nonadherence who were seen by 25 PCPs. Fewer than half of these patients (19/41; 46%) disclosed nonadherence to their PCP. PCPs asked 42 medication-related questions: most were clarifying (37/42; 88%), 2 were broad, 2 positively-framed and 1 negatively-framed. Patients disclosed nonadherence more often after specific positively- or negatively-framed questions (100% disclosed) vs. other question types (18% disclosed), p=0.008. In conclusion, over half of patients with substantial nonadherence to diabetes medications did not disclose this to their PCP. While PCPs often reviewed patients’ medications and dosing, this rarely uncovered nonadherence. Asking specific questions about nonadherence was infrequent, yet is likely a more effective strategy.

Disclosure
S.J.Pilla: None. N.M.Maruthur: Other Relationship; Johns Hopkins HealthCare Solutions. S.Saha: None. M.T.Bugayong: None. J.A.Long: None. H.S.Gordon: None. J.T.Bates: None. D.Washington: None. B.G.Bokhour: None. A.Tuepker: None. M.Beach: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK128572); U.S. Department of Veterans Affairs (IIR 14-007)
655-P: Diabetes Distress and Associated Factors among Low-Income Chinese Immigrants with Type 2 Diabetes
Authors: HU LU , SHI YUN , WANG CHAN , LI HUILIN , BAO HAN , XU XINYI , JIANG YULIN , ANN SEVICK MARY , ISLAM NADIA 
Published: June 2023

Purpose: To describe diabetes distress and its associated factors among Chinese immigrants with type 2 diabetes (T2D) in NYC.
Methods: Cross-sectional data were derived from three research studies conducted among Chinese immigrants with T2D in NYC. Diabetes Distress Scale (DDS) was used to measure diabetes distress, which includes 4 subscales: emotional, regimen, interpersonal and physician-related distress. A total or subscale score ≥ 2 indicates a moderate or higher distress level and is considered clinically important. Patient Health Questionnaire-2 was used to measure depressive symptoms. Participants’ sociodemographic data were collected. Descriptive statistics and stepwise logistic regression were used.
Results: Most participants (n=178) were currently married (76%), limited English proficient (93%), high school graduates or less (66%), and had an annual household income of less than $25K (62%). The mean age was 63.6 (SD=13.6) years old. About 26% of them reported moderate or higher overall distress levels. The most common sources of distress were emotional burden (30%), followed by regimen (29%), interpersonal (19%), and physician-related distress (14%). Participants who were younger, female, and had elevated depressive symptoms were more likely to have higher diabetes distress.
Conclusions: Diabetes distress is prevalent in Chinese immigrants with T2D, especially emotional distress and regimen-related distress. Given the known negative impact of diabetes distress, it is critical to consider screening for diabetes distress and incorporating psychological counseling in diabetes care in this underserved population.

Disclosure
L.Hu: None. Y.Shi: None. C.Wang: None. H.Li: None. H.Bao: None. X.Xu: None. Y.Jiang: None. M.Sevick: None. N.Islam: None.

Funding
National Institutes of Health (R00MD012811, P30DK111022, U54MD000538-15)
660-P: Association between Livable Wage and Quality of Life in Adults with Diabetes
Authors: CAMPBELL JENNIFER A. , EGEDE LEONARD E. 
Published: June 2023

Background: Livable wage, compared to federal minimum wage, is income required to cover basic needs without outside assistance. There is limited data on the relationship between livable wage and health outcomes in adults with diabetes. This study tested the relationship between livable wage and quality of life in adults with diabetes.
Methods: MEPS data from 2011-2020 were used. Federal minimum wage was based on the federal 2022 level of $7.25. Livable wage was based on the MIT living wage calculator level of $24.16. Both were multiplied by 280 to account for 40 hours per week for 52 weeks. Outcomes were physical component score (PCS) and mental component score (MCS) of the SF-12. Dependent variable was livable wage categorized as: 1) &lt;federal minimum=“” wage=“” (&lt;$15,080);=“” 2)=“” &lt;livable=“” (=livable wage (≥$50,252). Covariates included: demographics, region, education, insurance, and comorbidities. Multiple linear regression was used to test the relationship between living wage and PCS/MCS adjusting for covariates.
Results: Study sample was 20,327, representing 244,622,755 US adults with diabetes. By livable wage category, 64.1% reported wages &lt;federal minimum=“” wage,=“” 22.6%=“” reported=“” wages=“” =livable wage. In unadjusted models, PCS and MCS were 37.5 and 48.5 for &lt; minimum wage; 45.9 and 51.9 for =livable wage. In adjusted models, PCS and MCS were 39.3 and 48.7 for &lt; minimum wage; 43.7 and 52.2 for =livable wage. Differences between groups were statistically significant for PCS and MCS in unadjusted models and only for PCS in fully adjusted models.
Conclusions: These findings show that livable wage is associated with significantly improved physical and mental health, yet 86% of the population are not receiving a livable wage. As the field moves forward to address structural inequalities, emphasis on economic stability via livable wage is critical to optimize patient outcomes.

Disclosure
J.A.Campbell: None. L.E.Egede: None.

Funding
National Institutes of Health (K24DK093699, R01DK118038, R01DK120861, K01DK131319, R01MD013826)
682-P: Intersectionality among Health-Related Social Needs Predicts Poor Mental Health among Youth and Young Adults with Diabetes
Authors: BROWN ANDREA D. , FRONGILLO EDWARD A. , FLORY KATE , LOHMAN MATTHEW , WEI JINGKAI , MENDOZA JASON A. , REBOUSSIN BETH A. , JENSEN ELIZABETH T. , DOLAN LAWRENCE M. , BELLATORRE ANNA , MALIK FAISAL , LIESE ANGELA D. 
Published: June 2023

Little is known about how multiple health-related social needs may overlap to contribute to increased risk for poor mental health outcomes among youth and young adults (YYA) with diabetes. This study aims to understand how household food insecurity (HFI) intersects with other health-related social needs to influence poor mental health among YYA with type 1 diabetes (T1D). Analyses included a total of 829 YYA with T1D from the SEARCH Food Security Cohort study. Classification tree analysis was used to identify patterns among 11 health-related social needs, demographic, and socioeconomic characteristics that distinguish between moderate-to-severe and minimal-to-mild depressive symptoms. Health-related social needs included HFI, housing insecurity, need for reliable transportation, and experiences of discrimination. HFI was measured using the USDA Household Food Security Survey Module and experiences of discrimination were measured using the Everyday Discrimination Scale. The outcome of depressive symptoms was assessed using the Center for Epidemiological Studies-Depression (CES-D) scale. Overall, 35.6% reported moderate-to-severe depressive symptoms and 27.6% of YYA with T1D had anxiety symptoms; however, in the food insecure group, 73% and 56% were affected, respectively. Discrimination intersected with HFI among YYA with T1D such that 86% of YYA experiencing greater discrimination and HFI reported moderate-to-severe depressive symptoms (compared to 47% among the food secure group). In those reporting less discrimination, this corresponded to 56% and 17%, respectively. Adding discrimination to the model that included HFI, demographic, and socioeconomic measures improved the prediction accuracy (AUC= 0.71 versus AUC= 0.64). Study findings have implications for interventions to address multiple health-related social needs to decrease mental health problems among YYA with T1D.

Disclosure
A.D.Brown: None. A.Bellatorre: None. F.Malik: None. A.D.Liese: None. E.A.Frongillo: None. K.Flory: None. M.Lohman: None. J.Wei: None. J.A.Mendoza: None. B.A.Reboussin: None. E.T.Jensen: Consultant; Regeneron. L.M.Dolan: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK117461-01, 1UC4DK108173); National Institute of General Medical Sciences (T32GM081740)
7-LB: Sodium–Glucose Cotransporter-2 Inhibitors (SGLT2i) Decrease Kidney Oxygen Consumption in Adults with Type 2 Diabetes (T2D)—A Randomized Clinical Trial Using 11C-Acetate Positron Emission Tomography (PET) Imaging
Authors: HESP ANNE , SNEL LARS I.P. , SCHOBER PATRICK , SCHWARTE LOTHAR A. , BOELLAARD RONALD , BJORNSTAD PETTER , VAN RAALTE DANIËL 
Published: June 2023

Kidney hypoxia has been proposed as key pathophysiological mechanism in the development of chronic kidney disease, potentially stemming from a mismatch between oxygen delivery and oxygen consumption. SGLT2i are kidney protective drugs that initially lower glomerular filtration rate (GFR). Accordingly, we hypothesized that SGLT2i lower kidney oxygen consumption by reducing GFR and associated tubular workload. Twenty adults with T2D (sex 80% male, age 68±6 years, BMI 30±4 kg/m2, HbA1c 7.5±0.9%, eGFR 76 ± 11 mL/min/1.73m2) received a 4-week treatment with SGLT2i ertugliflozin (ERTU) and matched placebo (PLB) in a randomized, double-blind cross-over study. Participants were treated with metformin and received maximal tolerable dose of an angiotensin receptor blocker. Whole-kidney oxygen consumption (Kmono) was measured by PET using 11C-acetate. GFR was measured by gold-standard iohexol clearance. Tubular sodium transport (TNa) was calculated by kidney sodium load (([arterial Na]*mGFR) - urinary sodium excretion). Kidney efficiency calculated as TNa/ Kmono. GFR was lower during ERTU (94 ± 14 mL/min) vs. PLB (99 ± 15 mL/min) treatment (p=0.02). Kmono was 0.086 ± 0.006 min-1 during ERTU and 0.091 ± 0.009 min-1 during PLB (p&lt;0.01). Kidney sodium load (12.9 ± 1.90 vs 13.7 ± 2.22 mmol/min) and TNa (12.7 ± 1.87 vs 13.6 ± 2.18 mmol/min) were lower during ERTU (p=0.02 for both), while urinary sodium excretion (p=0.1) and TNa/ Kmono remained unchanged (p=0.7). TNa strongly associated with Kmono (r=0.50; p&lt;0.0001).
In conclusion, SGLT2i lowers mGFR, TNa, and kidney oxygen consumption, potentially decreasing hypoxia risk. SGLT2i treatment did not lower overall kidney efficiency, despite the ATP efficiency of cortical sodium transport. Additional data on cortex and medulla-specific oxygen consumption and multiparametric kidney MRI data will be presented at ADA.

Disclosure
A. Hesp: None. L. I. P. Snel: None. P. Schober: None. L. A. Schwarte: None. R. Boellaard: None. P. Bjornstad: Advisory Panel; AstraZeneca. Consultant; Bayer Inc., Bristol-Myers Squibb Company. Advisory Panel; Novo Nordisk, Lilly, Horizon Therapeutics plc, Boehringer Ingelheim (Canada) Ltd., LG Chem. D. van Raalte: Consultant; Boehringer Ingelheim and Eli Lilly Alliance, AstraZeneca, Merck & Co., Inc. Research Support; Boehringer Ingelheim and Eli Lilly Alliance, AstraZeneca, Merck & Co., Inc.

Funding
MSD
724-P: Baseline Findings from ACT1VATE—A Novel RCT for Diabetes Distress
Authors: SORIANO EMILY C. , FORTMANN ADDIE L. , SANDOVAL HALEY , ANTRIM MCKAYLA G. , GUZMAN SUSAN , POLONSKY WILLIAM H. , SPIERLING BAGSIC SAMANTHA R. , PHILIS-TSIMIKAS ATHENA 
Published: June 2023

Recent interventions for diabetes distress (DD) have achieved dramatic improvements in DD, but not A1c. Further, none have been rigorously tested in the healthcare settings where individuals receive their diabetes care. An in-progress RCT will compare diabetes education (DSME/S) to an Acceptance and Commitment Therapy group program (ACT1VATE) in improving glycemic management in N = 484 adults with type 1 diabetes, A1c ≥ 8, and significant DD. We predict that ACT1VATE will be superior to DSME/S in improving DD and glycemic management given its 1) goal to change one's relationship with difficult diabetes thoughts/emotions driving problematic health behaviors and 2) linkage of diabetes self-care behavior to one's personal values, thus eliciting intrinsic motivation for meaningful, lasting health behavior changes. Thus far, enrolled participants (N = 105) are predominantly female (65%), non-Hispanic (83%), and employed (63.8%), but heterogeneous in terms of education (49.5% completed college, 26.1% high school or less), household income (24% &lt; $50k, 38% &gt; $100k), and age (20 to 83; M = 45.9±16.1 years). Mean baseline A1c = 9.2±1.4 and Diabetes Distress Scale total = 2.8±0.9 (indicating “moderate/severe” distress). The Acceptance and Action Diabetes Questionnaire (AADQ) measured psychological processes targeted in ACT1VATE (psychological inflexibility, experiential avoidance). Consistent with our theoretical framework, at baseline, greater diabetes acceptance/action (higher AADQ) was significantly correlated with lower A1c (r = -.30) and diabetes distress (r = -.63), fewer missed insulin doses (r = -.38), healthier diet (r = .29) and better overall well-being (r = .55), ps &lt; .01. As the first large scale DD RCT integrated in a real-world setting, this study will build on prior well-controlled efficacy trials and provide rich information about implementation. These findings will inform healthcare systems’ attempts to meet ADA recommendations to integrate DD screenings and interventions into routine care.

Disclosure
E.C.Soriano: None. A.L.Fortmann: Employee; Dexcom, Inc. H.Sandoval: None. M.G.Antrim: None. S.Guzman: Consultant; Abbott Diabetes. W.H.Polonsky: Consultant; Abbott Diabetes, Boehringer Ingelheim and Eli Lilly Alliance, Eli Lilly and Company, Insulet Corporation, Intuity Medical, Inc., MannKind Corporation, Provention Bio, Inc., Sanofi-Aventis U.S., Vertex Pharmaceuticals Incorporated. S.R.Spierling bagsic: None. A.Philis-tsimikas: Advisory Panel; Dexcom, Inc., Novo Nordisk A/S, Sanofi, Other Relationship; Medtronic, Research Support; Novo Nordisk A/S, Lilly, Viking Therapeutics, NIH - National Institutes of Health.

Funding
National Institutes of Health (1R01DK127491)
727-P: Improvement in Psychosocial Functioning of Youth with Diabetes and Their Caregivers with Multiple Social Risk Factors
Authors: REED ALISON , NOYA CAROLINA E. , WAGNER DAVID V. , LIM JENNIFER H. , GLOCKER VIVIEN , BAL KAVENPREET S. , GONZALES GRANADOS MARYSOL , STONE ANNEMARIE , MCGRATH MAUREEN T. , HARRIS MICHAEL A. , LODISH MAYA , WONG JENISE C. 
Published: June 2023

Background: Social determinants of health (SDOH) lead to health disparities. Novel Interventions in Children's Healthcare (NICH) is a community-based program for youth with chronic conditions such as diabetes, with a high degree of social risk. We describe changes in depressive symptoms, diabetes distress, and diabetes strengths in youth with diabetes and their caregivers who completed one year in NICH at UCSF.
Methods: NICH participants in this analysis had diabetes and were ≥12 years old. All completed the Patient Health Questionnaire-8 (PHQ-8), Problem Area in Diabetes-Teen (PAID-T), and those ≥14 years completed the Diabetes Strength and Resilience measure for adolescents (DSTAR-Teen) at baseline and one year. Caregivers completed the parent PAID-T (P-PAID-T). Paired t-tests were used to compare scores at baseline and one year when scores for both time points were available.
Results: Participants included 15 youth with type 1 and 1 with type 2 diabetes. Mean age was 15.4 ± 1.6 years, 88% were from historically marginalized racial or ethnic groups, and 94% had public insurance. Families had a mean of 8 ± 4.8 social risk factors at baseline, the most common being educational barriers, mental health needs, and trauma. Mean PHQ-8 scores decreased from 8.4 ± 6.4 at baseline to 4.3 ± 5.4 at one year (p=0.014, n=10). Mean PAID-T scores trended towards decreasing from baseline (70.7 ± 19.8) to one year (58.8 ± 22.9, p=0.24, n=10), and mean P-PAID-T scores significantly decreased from 57.3 ± 17.8 to 45.3 ± 16.8 (p=0.044, n=6). Mean DSTAR-Teen scores increased from 44.6 ± 6.3 to 48.9 ± 8.1 at one year (p=0.065, n=8).
Conclusions: Participation in NICH is associated with fewer depressive symptoms, less caregiver diabetes distress, and a trend towards reduced distress in youth and improved diabetes-specific strengths. Further research on SDOH among underrepresented populations is needed, as interventions mitigating social risk have potential to improve psychosocial outcomes.

Disclosure
A.Reed: None. M.A.Harris: None. M.Lodish: None. J.C.Wong: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. C.E.Noya: None. D.V.Wagner: None. J.H.Lim: None. V.Glocker: None. K.S.Bal: None. M.Gonzales granados: None. A.Stone: None. M.T.Mcgrath: None.

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