bluuebunny/crossref_metadata_2025_split huggingface dataset:
561-P: Family Matters—The Need for a Holistic Approach toward Recruitment and Retention of Culturally Diverse Adults
Authors: GAILLARD TRUDY R. , SHAMBLEY-EBRON DONNA , VACCARO JOAN A. , SWAGGER PHILDRA , NEFF DONNA F. , MORTON CYNTHIA , WEBB FERN 
Published: June 2023

Introduction: Participation in diabetes research is essential to lower health disparities; however, recruitment and retention of culturally diverse populations (African American, Caribbean, Hispanic/Latino) remains lower than the general population. The aim of this study was to identify the beliefs in this diverse population concerning types and characteristics of health research that they would consider participation.
Methods: The following study was part of a larger study aimed to explore the impact of intergenerational influence (IGI) and perceptions regarding research recruitment and retention of culturally diverse adults. Participants were recruited via flyer, word of mouth, and our statewide Community Advisory Board. Listening sessions were conducted in dyads of older adults (&gt;65 years) and younger adults (25-64 years). The Theory of Reasoned Action and IGI was the framework used to guide the study. All transcripts were transcribed verbatim. NVivo software© was used for data management.
Results: There were 361 adults who participated (N=181 (&gt;65 years) and N=180 (25-64 years). The most cited health concerns were Alzheimer’s disease, diabetes, and hypertension. Most participants cited personal experiences with diabetes, and the need for research in this area “especially in black and brown neighborhoods.” Solutions to increase research participation were, grass roots approaches with community leaders, churches, civic organizations, and schools. Both groups stated interventions should involve the family, focus on prevention, and lifestyle education.
Conclusions: Studies are needed to evaluate the success of recruitment methods that involve community leaders for outreach, include multiple generations, and focus on education and prevention. Thus, continued outreach to culturally diverse groups incorporating multiple holistic approaches warrants future exploration.

Disclosure
T.R.Gaillard: None. D.Shambley-ebron: None. J.A.Vaccaro: None. P.Swagger: None. D.F.Neff: None. C.Morton: None. F.Webb: None.

Funding
National Institute on Aging (R24AG067951)
575-P: Do Overnight Dips Exist following Afternoon Exercise? Factors Associated with Nocturnal Hypoglycemia in the Type 1 Diabetes Exercise Initiative Pediatric (T1DexiP) Study
Authors: SHERR JENNIFER , BERGFORD SIMON , PATTON SUSANA R. , CLEMENTS MARK A. , CALHOUN PETER , GAL ROBIN L. , RIDDELL MICHAEL 
Published: June 2023

Some controlled studies have associated afternoon exercise with a biphasic pattern of hypoglycemia (hypo) risk: during exercise and 7-11hrs later. We explored factors relating to nocturnal hypo following afternoon exercise (12PM-6PM) among youth in the observational T1DexiP study. Youth with T1D (n=203; [mean±SD] age14±2 yrs; HbA1c=7.0± 1.2%; 42% female; T1D duration 5.4±3.9yrs; 12% on MDI and 58% on AID) wore a continuous glucose monitor, an activity monitor and logged activity using the Bant app for 10 days. Repeated measures logistic regression adjusted for bedtime glucose and % time below range (TBR &lt; 70mg/dL) in the prior 24hrs. Of the 833 afternoon exercise sessions, 14% led to nocturnal hypo (≥15 consecutive minutes &lt;70 mg/dL). Median TBR was higher in the 24hrs before exercise in youth who developed nocturnal hypo vs those who did not (3% vs 1%), while pre-exercise glucose level, heart rate, and insulin on board were similar. Nocturnal hypo risk was higher among teens who exercised more often during the study (Table). A trend for lower risk was noted with AID use. Our model revealed that participants who exercised &gt;90 min/day had increased risk of nocturnal hypoglycemia, while AID use may reduce risk. This suggests algorithmically modulated insulin delivery may help to mitigate the impact of afternoon exercise on nocturnal glycemia.

Disclosure
J.Sherr: Advisory Panel; Bigfoot Biomedical, Inc., Insulet Corporation, Medtronic, Vertex Pharmaceuticals Incorporated, Cecelia Health, StartUp Health T1D Moonshot, Consultant; Bigfoot Biomedical, Inc., Insulet Corporation, Medtronic, Lilly, Research Support; Insulet Corporation, Medtronic, NIH - National Institutes of Health, Juvenile Diabetes Research Foundation (JDRF), Speaker's Bureau; Insulet Corporation, Zealand Pharma A/S, Lilly, Medtronic. S.Bergford: None. S.R.Patton: None. M.A.Clements: Consultant; Glooko, Inc., Research Support; Dexcom, Inc., Abbott Diabetes. P.Calhoun: None. R.L.Gal: None. M.Riddell: Advisory Panel; Zealand Pharma A/S, Zucara Therapeutics, Indigo Diabetes, Consultant; Lilly Diabetes, Eli Lilly and Company, Jaeb Center for Health Research, Speaker's Bureau; Dexcom, Inc., Novo Nordisk, Sanofi, Stock/Shareholder; Supersapiens, Zucara Therapeutics. T1dexip study group: n/a.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust; Dexcom, Inc.
590-P: Assessment of a Comprehensive Physical Fitness Index to Predict Future Diabetes Mellitus (DM) and Metabolic Syndrome (MetS)
Authors: SATO TAKAAKI , FUJIHARA KAZUYA , YAMADA MAYUKO H. , YAGUCHI YUTA , YAMAMOTO MASAHIKO , KITAZAWA MASARU , ISHIGURO HAJIME , OSAWA TAEKO , YAMADA TAKAHO , KATO KIMINORI , SONE HIROHITO 
Published: June 2023

Impaired muscle strength, balance, and flexibility have been associated with the development of type 2 diabetes and atherosclerosis. A physical score (PS), which integrates these physical fitness indices, could be expected to better predict future metabolic diseases. We investigated the longitudinal relationship between the baseline PS and changes in PS and future DM and MetS. Analyzed were 5,718 persons (4,068 men) aged 30 to 69 y without DM who underwent physical fitness tests. Principal component analysis was performed on the correlation matrix of the physical fitness test results according to age and sex. The PS was defined as the first principal component score. Associations between PSs at the start of observation (year −2), change in the PS two years later (year 0) and the incidence of DM at the end of observation (until year 3) were examined by logistic regression analysis. The same analysis was performed for 5,304 persons (3,729 men) without MetS at baseline. Although no significant difference was found in the incidence of DM, a significant difference was found in the incidence of MetS; odds ratio was 1.39 (1.20, 1.61) for each decrease of 1 in the PS in year −2 and 1.51 (1.18, 1.92) for each decrease of 1 in the change in PS from year -2 to year 0. = Results showed that the PS was a simple and non-invasive predictor of MetS.

Disclosure
T.Sato: None. K.Kato: None. H.Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kyowa Kirin Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Ono Pharmaceutical Co., Ltd., Eisai Co., Ltd., Takeda Pharmaceutical Co., Ltd. K.Fujihara: None. M.H.Yamada: None. Y.Yaguchi: None. M.Yamamoto: None. M.Kitazawa: None. H.Ishiguro: None. T.Osawa: None. T.Yamada: None.

Funding
Japan Society for the Promotion of Science; Japan Ministry of Health, Labour and Welfare (21K11569)
648-P: Perceptions of Diabetes and Stigma—A Quasi-Experimental, Cross-Sectional Evaluation of Australian Diabetes Campaign Videos
Authors: HOLMES-TRUSCOTT ELIZABETH , HATELEY-BROWNE JESSICA , CHARALAMBAKIS ELIZABETH M. , VENTURA ADRIANA D. , GLENISTER ANNETTE G. , SCIBILIA RENZA , SPEIGHT JANE 
Published: June 2023

Aim: To examine the potential negative and positive impacts of, and reaction to, eight Australian National Diabetes Week campaign videos (originally broadcast between 2005 and 2015) among adults with and without diabetes.
Method: Cross-sectional, quasi-experimental, 10-arm online study. A general population sample (n=1023, aged 41±14 years, 60% women) and a diabetes population sample (n=510, aged 52±12 years, 49% women, 78% type 2 diabetes) were recruited via an Australian research panel. Participants were randomly exposed to one of eight diabetes campaign videos (intervention) or allocated to one of two control groups (active or passive). Post-exposure, study-specific scales measured diabetes Misconceptions and Seriousness, General and Diabetes Risk-Reduction Motivation and Self-efficacy, and perceptions of video Stigmatization of diabetes. Scores were compared by condition (intervention vs. control), and by campaign Stigma (high vs. low), separately by cohort (general and diabetes).
Results: Exposure to diabetes campaigns had no significant impact on diabetes perceptions, relative to control, with one exception: a modest effect on General Self-efficacy among the general cohort only (p=0.015; d=-0.19). Those perceiving high campaign Stigma (15%), relative to low Stigma (60%), reported significantly greater diabetes Misconceptions (general: d=1.5; diabetes: d=-1.9) and lower Seriousness (d=0.5; d=0.3), as well as lower General Motivation (d=0.2) but higher Diabetes Risk Reduction Motivation (d=0.3) for the general cohort only.
Conclusion: Single exposure to diabetes campaign videos had seemingly little positive impact on public perceptions. The minority, who perceive them as stigmatising, have greater misconceptions about diabetes, and perceive diabetes as less serious. This novel study has implications for the design and evaluation of future diabetes campaign videos globally.

Disclosure
E.Holmes-truscott: Research Support; Sanofi, AstraZeneca. J.Hateley-browne: None. E.M.Charalambakis: None. A.D.Ventura: None. A.G.Glenister: None. R.Scibilia: Advisory Panel; Ascensia Diabetes Care, Eli Lilly and Company, Roche Diagnostics, Employee; Diabetes Australia, Speaker's Bureau; diaTribe. J.Speight: Research Support; Sanofi, Medtronic, Abbott Diabetes, Lilly, Novo Nordisk A/S, Speaker's Bureau; Sanofi.

Funding
Diabetes Victoria
658-P: Evaluating Financial Incentives as a Tool to Increase Medication Adherence—A Systematic Review and Meta-analysis
Authors: WINBERG DEBRA , TANG TIANGE , RAMSEY ZACHARY , BAZZANO ALESSANDRA N. , LI JIAN , LIN YILU , NAUMAN ELIZABETH , SHI LIZHENG 
Published: June 2023

Background: Costs are a barrier to medication adherence in patients living with Type 2 Diabetes (PLWD). Financial incentives may lower costs and increase adherence.
Methods: PubMed, Scopus, and Embase were searched for articles published before March 2022 assessing the impact of financial incentives on medication adherence in PLWD. Search terms included “medication adherence,” “T2D,” “financial incentive,” incentive types, and associated Medical Subject Headings. Two pooled analyses - the mean difference in proportion days covered (PDC) or mean possession ratio (MPR) and the mean difference in percent adherent (PDC/MPR ≥80%) - were conducted. Coehn's d Treatment Effect was calculated for each study using mean difference and standard errors. The overall treatment effect for each pooled analysis was calculated using Bayesian meta-analysis.
Results: The review included 25 studies. Medication adherence always improved in 21 studies, three indicated they increased adherence only in some populations, and incentives had no effect in one study. Figure 1 illustrates the meta-analysis results for studies with appropriate outcome data. Both pooled analyses demonstrate a small but statistically significant increase in adherence due to financial incentives (d=0.02, p&lt;0.01).
Conclusion: Financial incentives have the potential to increase medication adherence to antidiabetic drugs.

Disclosure
D.Winberg: Employee; Janssen Scientific Affairs, LLC. T.Tang: None. Z.Ramsey: None. A.N.Bazzano: None. J.Li: None. Y.Lin: None. E.Nauman: None. L.Shi: None.

Funding
Centers for Disease Control and Prevention (U18DP006523)
676-P: Diabetes Distress, Medical Education, and Gamification in a Pediatric/Young Adult Diabetes Center
Authors: IMAI TAYLOR , NGUYEN TANGELA , STANIC TAMARA S. , DIAZ DOREEN , LOPEZ DANIEL , KINMAN RENEE 
Published: June 2023

Purpose: It is well known that children, adolescents, and young adults with diabetes face numerous obstacles to adherence. Diabetes distress can lead to diabetes burnout, which worsens diabetes nonadherence. We initiated diabetes distress screening to determine the impact of diabetes distress on our patients and developed games and animated videos in an attempt to assess diabetes knowledge and decrease visit stress.
Methods: Diabetes patients aged 10 and older were given the two-question diabetes distress screening scale (DDS2) during their routine follow-up visits. Two games were created to play at the beginning of each appointment and two animated medical education videos were created on how to recognize and manage diabetes distress.
Results: A total of 207 patients received DDS2 screening questionnaires. The mean DDS2 score was 5.6 (Type 1, n=178) and 5.5 (Type 2, n=29) out of 12 possible points. Only a weak correlation was found between the DDS2 score and hemoglobin A1C (Type 1:R2=0.34, Type 2:R2=0.18) with essentially no correlation noted between diabetes duration and DDS2 score (Type 1:R2=0.001; Type 2:R2=0.01). Ninety-seven percent of patients liked the “pin the bone on your A1C” game, while 93% enjoyed the medical education quiz game, 80% felt they learned something from it, and 89% felt that it made them more relaxed for their visit.
Conclusions: Diabetes distress can lead to diabetes burnout, thus it is important to identify when present. Our data suggest that distress may sometimes be hidden, hence we should specifically screen for diabetes distress in all our pediatric patients that are tweens and older as no significant correlation was found between DDS2 score, hemoglobin A1C, and duration of diabetes. Therapy can be then directed to ameliorating the stress and burnout associated with living with diabetes while the use of easily created educational games and animated videos can be helpful adjuncts to assess patient knowledge while simultaneously lessening appointment stress.

Disclosure
T.Imai: None. T.Nguyen: None. T.S.Stanic: None. D.Diaz: None. D.Lopez: None. R.Kinman: None.
68-LB: Early Pharmacological Intervention (EPIC) to Preserve Beta-Cell Function in Prediabetes (PreDM)
Authors: CHAVEZ ALBERTO , MEROVCI AURORA , NEPPALA SIVARAM , CRUZ MORENO LUIS A. , BASKOY GOZDE , ACOSTA FRANCISCA M. , HANSIS-DIARTE ANDREA A. , PUCKETT CURTISS L. , ADAMS JOHN M. , ABDUL-GHANI MUHAMMAD , TRIPLITT CURTIS L. , CERSOSIMO EUGENIO , DEFRONZO RALPH A. 
Published: June 2023

Beta cell failure is the key pathophysiologic determinant in progression from PreDM to type 2 diabetes (T2D). Lifestyle modifications frequently are insufficient to prevent T2D onset and drugs that modify disease progression by targeting pathophysiologic defects in PreDM may be required.
Methods: EPIC seeks to answer whether a specific drug provides greater benefit to prevent PreDM progression and to assess the effect of two years of treatment with antidiabetic drugs in 200 individuals with IFG and/or IGT on insulin sensitivity (IS) and beta cell function (BCF). At baseline, participants received 2h-OGTT and two-step hyperglycemic clamp (HC) (+125 and +400 mg/dl) with GLP-1RA infusion. Subjects then were randomized to metformin (MET), pioglitazone (PIO), saxagliptin (SAXA) or dapagliflozin (DAPA). 55 participants have completed the intervention (35F/20M; age = 51 ± 3 ys) Matsuda Index of IS was quantitated from OGTT. Beta Cell Function (BCF) was quantitated: (i) from OGTT as (ΔC-Pep/ΔG) x (Matsuda) and (ii) from HC as ΔC-Pep (First Phase, AIR x Matsuda; ΔC-Pep (Second Phase, +400 mg/dL x Matsuda; and (Second Phase + Exenatide) x Matsuda.
Results: A1c did not change significantly in any group, while FPG (106 ±4 to 100 ± 3 mg/dl) and 2h PG (150 ±8 to 141 ± 11) decreased significantly in all groups (p&lt;0.05 for PIO &gt; SAXA). Matsuda Index increased in all groups (p&lt;0.01 for PIO vs all other groups). Weight increased significantly in PIO (+2.5kg p&lt;0.05), did not change with SAXA, decreased with DAPA and MET (both p = NS). BCF during OGTT tended to increase in all groups (p&lt;0.10 for trend). No significant changes in AIR, second phase (+400 mg/dl), and second phase (+400) + Exenatide were seen for MET, SAXA, DAPA, but significantly increased with PIO (AIR 7.1 to 22.8; 2ND STEP 10 to 45.4; 2nd STEP + Exenatide 19 to 79 (all p &lt;0.01).
Conclusion: Early drug intervention in prediabetes with pioglitazone preserves beta cell function and improves insulin sensitivity better than MET, SAXA, and DAPA.

Disclosure
A. Chavez: None. A. Merovci: None. S. Neppala: None. L. A. Cruz Moreno: None. G. Baskoy: None. F. M. Acosta: None. A. A. Hansis-Diarte: None. C. L. Puckett: None. J. M. Adams: None. M. Abdul-Ghani: None. C. L. Triplitt: Speaker's Bureau; Novo Nordisk. E. Cersosimo: None. R. A. DeFronzo: Speaker's Bureau; AstraZeneca. Advisory Panel; AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Novo Nordisk. Research Support; AstraZeneca, Boehringer-Ingelheim, Merck & Co., Inc.

Funding
National Institutes of Health (R01DK024092-3AZ, ISSDAPA0002)
696-P: Evaluating REACHOUT—A Mobile App That Delivers Peer-Led Mental Health Support to Adults with Type 1 Diabetes
Authors: TANG TRICIA S. , KLEIN GERRI , GÖRGES MATTHIAS , FISHER LAWRENCE , POLONSKY WILLIAM H. , HESSLER DANIELLE M. , TAYLOR DEANNE 
Published: June 2023

Introduction: Recent years have witnessed a dramatic shift toward digital health technologies for mental health care delivery. While research investigating digital interventions involving peer support for children and adolescents with type 1 diabetes (T1D) has been growing, few, if any studies, have examined peer support mental health interventions for adults with T1D.
Methods: We recruited 46 adults with T1D (M age= 43.9, females=71.7%) living in rural and remote communities in British Columbia to participate in REACHOUT, a 6-month intervention utilizing a mobile app to deliver three modalities of support: one-on-one with a peer supporter, group-based text messaging, and video group sessions. Participants were invited to select their own peer supporter and encouraged to access any or all of the three modalities as frequently as desired. Assessments were conducted at baseline and six months and measured diabetes distress (and seven distress subscales), depressive symptomatology, and perceived support from family/friends, peers, and the health care team. Independent mixed-effects regression models were run to examine pre-post intervention changes.
Results: Thirty-eight participants completed the intervention (attrition = 17%). At six months, reductions were observed for overall distress (p=0.007) and four subscales: powerlessness (p=0.009), management distress (p=0.001), negative social perceptions (p=0.023), and eating distress (p=0.032). For secondary outcomes, depressive symptoms decreased (p=0.009) while perceived support from family/friends (p=0.023) and peers (p&lt;0.001) increased.
Conclusions: Participation in REACHOUT was associated with improvements in diabetes distress as well as other psychosocial outcomes. By offering different modalities of support delivery over a digital platform, participants, especially those living in more geographically marginalized communities, can customize support to meet their own unique needs.

Disclosure
T.S.Tang: Research Support; Juvenile Diabetes Research Foundation (JDRF), Speaker's Bureau; Abbott Diabetes, Insulet Corporation. G.Klein: None. M.Görges: Research Support; Careteam Technologies, IDENTOS, Smile CDR Inc., SecureKey Technologies Inc., Thrive Health, Excelar Technologies. L.Fisher: Consultant; Abbott Diabetes, Eli Lilly and Company, Research Support; Ascensia Diabetes Care. 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. D.M.Hessler: Consultant; Lilly. D.Taylor: None.

Funding
JDRF (2-SRA-2020-986-S-B)
699-P: Neighborhood Disadvantage and Psychosocial Health for Parents of Teens with Type 1 Diabetes (T1D)
Authors: O'DONNELL MAEVE B. , SCOTT SAMANTHA R. , ELLISOR BRITNEY M. , GARCIA PEREZ SAMANTHA , ROJAS YULIANA , MALIK FAISAL , HILLIARD MARISA E. , YI-FRAZIER JOYCE P. 
Published: June 2023

Background: The psychosocial health of parents is important to the mental and physical health of teens with T1D, yet living in an area of high neighborhood disadvantage may risk parental psychosocial health due, in part, to increased exposure to stressors and less available support. We explored associations among neighborhood disadvantage and parents’ self-reported psychosocial outcomes among racially, ethnically, and socioeconomically diverse parents of teens with T1D.
Methods: At baseline of a 2-site psychosocial intervention trial, 130 parents of teens aged 13-18 with T1D reported on demographic information and their diabetes distress, family conflict, diabetes-related quality of life, and resilience. We retrieved area deprivation index (ADI) scores for home addresses; this measure of neighborhood disadvantage summarizes neighborhood-level income, education, employment, and housing quality via a state-relative decile score ranging from 1-10 (higher scores indicate more disadvantage). Regression analyses were used to examine associations among ADI and psychosocial measures.
Results: 130 parents (2% American Indian/Alaska Native, 2% Asian, 8% Black/African American, 10% Latino/Mexican/South or Central American, 81% White; 87% mothers; 73% employed full-time; 78% private Insurance; 59% college graduate or higher) completed surveys. Mean ADI was 3.8±2.7 (range 1-10). Higher neighborhood disadvantage was associated with significantly higher diabetes distress [F(1,127)=13.99, p&lt;.001] and family conflict [F(1,126)=19.42, p&lt;.001] and lower resilience [F(1,127)=4.30, p=.04] and diabetes-related quality of life [F(1,125)=10.42, p=.002].
Conclusions: Consistently poorer psychosocial health among parents in areas with higher neighborhood disadvantage highlights the centrality of social determinants of health to families of teens with T1D. Targeted support for parents in these areas may benefit family T1D management and, ultimately, youth outcomes.

Disclosure
M.B.O'donnell: None. S.R.Scott: None. B.M.Ellisor: None. S.Garcia perez: None. Y.Rojas: None. F.Malik: None. M.E.Hilliard: None. J.P.Yi-frazier: None.

Funding
National Institutes of Health (R01DK121224)
712-P: Social Support, eHealth Literacy, and mHealth Use in Older Adults with Diabetes—Moderated Mediating Effect of Perceived Importance of App Design
Authors: KIM MINJIN , KIM BEOMSOO , PARK SUNHEE 
Published: June 2023

Mobile healthcare (mHealth) for older adults with diabetes could benefit diabetes self-management. However, limited research is available regarding the factors influencing mHealth use. This descriptive study aimed to identify the factors that influence mHealth use. Participants aged 65 years or older with diabetes living in South Korea were recruited online and offline to complete a structured self-report questionnaire. With 252 valid responses, the moderated mediating effect of eHealth literacy and the perceived importance of app design in the relationship between social support and mHealth use were tested using SPSS PROCESS Macro 4.0. The results show that social support had a positive relationship with mHealth use, and eHealth literacy and perceived importance of app aesthetics had a moderated mediating effect. Moreover, when patients’ perceived importance of app aesthetics was high, eHealth literacy more positively affected mHealth use. This study implies that it is necessary to enlist the help of family, friends, and neighbors to increase access to internet-based health information and encourage mHealth use among older adults with diabetes. Furthermore, this study suggests developers should consider user experience (UX), such as font size, color, and menu configuration when developing mHealth for older adults with diabetes.

Disclosure
M.Kim: None. B.Kim: None. S.Park: None.