bluuebunny/crossref_metadata_2025_split huggingface dataset:
1401-P: Psychotropic Drug Use in Children and Adolescents with Type 1 Diabetes
Authors: LIU SHENGXIN , LAGERBERG TYRA , LUDVIGSSON JONAS F. , TAYLOR MARK , DONOFRIO BRIAN , LICHTENSTEIN PAUL , GUDBJÖRNSDOTTIR SOFFIA , BUTWICKA AGNIESZKA 
Published: June 2023

Psychiatric disorders in children and adolescents with type 1 diabetes (T1D) have caught increasing attention. While psychotropic drugs offer great value in managing psychiatric symptoms, their adverse effects engender considerable controversy regarding their use in pediatric patients, let alone in those with T1D. Despite the topic’s high visibility, little evidence exists on the patterns of psychotropic drug use in pediatric T1D patients. We thus conducted this cohort study of 3,720,381 children and adolescents (13,191 [0.36%] had T1D) using several Swedish national registers. We examined the trends and patterns (prescription source and treatment duration) of psychotropic drug use and estimated the risk of initiating psychotropic drugs after T1D onset. We found that psychotropic drug use increased significantly in children and adolescents with T1D from 2006 to 2019 (Figure 1), with ADHD medications, SSRI, hypnotics and anxiolytics among the most used ones. The primary prescription source was psychiatric care, and treatment durations were mostly &lt;12 months (except for ADHD medications). Children and adolescents with newly-onset T1D had a higher risk of initiating any psychotropic drug (hazard ratio 1.29, 95%CI 1.20-1.38) than their peers without T1D. Our findings highlight the need for risk/benefit studies of psychotropic drugs among young users with T1D to inform future research and guideline development.

Disclosure
S.Liu: None. T.Lagerberg: None. J.F.Ludvigsson: Research Support; Janssen Pharmaceuticals, Inc., MSD Life Science Foundation. M.Taylor: None. B.Donofrio: None. P.Lichtenstein: None. S.Gudbjörnsdottir: None. A.Butwicka: None.

Funding
Swedish Research Council (2017-00788)
1405-P: Reproducibility for the Diagnosis of Abnormal Glucose Tolerance Is Excellent for A1C and Glycated Albumin but Only Moderate for Fructosamine
Authors: DE DIEU GATETE JEAN , SCHENK BLAYNE R. , HURSTON JAMAIICA , DUBOSE CHRISTOPHER , MABUNDO LILIAN , WORTHY CHARLITA , JAGANNATHAN RAM , SACKS DAVID B. , SUMNER ANNE E. 
Published: June 2023

A1C represents glycated hemoglobin A and is a non-fasting measure of average glycemia which has been used since 2010 to diagnose abnormal glucose tolerance (Abnl-GT) (a summary term for diabetes and prediabetes). However, A1C may not correlate with average glucose in the presence of anemia, G6PD deficiency and certain hemoglobinopathies. Two non-fasting markers of glycemia which have been proposed as alternatives to A1C are fructosamine (FA) and glycated albumin (GA). FA is a measure of all plasma glycated proteins. Whereas GA is a subfraction of FA. Emerging data suggests that in the diagnosis of Abnl-GT, GA is superior to FA. Critical to the value of a diagnostic test is assessing reproducibility. Therefore, we examined the reproducibility of A1C, FA and GA by performing all three tests 9±4d (mean±SD) apart in 209 African-born Blacks living in the Washington, DC area. Diagnostic sensitivity of A1C, FA and GA for the detection of Abnl-GT was determined by thresholds at the upper quartile of each, specifically ≥5.7%, 235 umol/L and 14.6%, respectively. A1C was assessed by high performance liquid chromatography, FA by colorimetric nitroblue tetrazolium assay and GA by enzymatic assay. Coefficients of variation (CV) were calculated. Kappa statistic (k-statistic) was used to measure diagnostic reproducibility. Strength of agreement by k-statistic is: slight: 0.0 to 0.20, fair: 0.21-0.40, moderate: 0.41-0.60, substantial: 0.61-0.80; excellent: 0.81-1.0. The CV for A1C, FA and GA were: 2%, 3% and 2% respectively, and the k-statistics were: 0.86, 0.59, 0.89 respectively. In short, the diagnostic agreement between A1C and GA on different days was excellent but only moderate for FA. This may explain why GA appears to be a better measure of Abnl-GT than FA. Variation in FA may be greater than the variation in GA because FA encompasses all plasma proteins rather than specifically albumin.

Disclosure
J.Gatete: None. B.R.Schenk: None. J.Hurston: None. C.Dubose: None. L.Mabundo: None. C.Worthy: None. R.Jagannathan: None. D.B.Sacks: Other Relationship; Sebia, Trinity. A.E.Sumner: None.
1406-P: Trends in All-Cause and Cause-Specific Mortality in Older Adults With and Without Diabetes—A Territory-Wide Analysis in One Million Older Adults in Hong Kong
Authors: YANG AIMIN , SHI MAI , LAU ERIC S.H. , CHOW ELAINE , CHAN JULIANA C. 
Published: June 2023

Objective: Nationwide data on trends in mortality in older adults with and without diabetes in Asia are lacking. We described the recent trends of all-cause and cause-specific (pneumonia, cardiovascular [CV], and cancer) mortality in adults aged ≥65 years in Hong Kong in 2014-2018.
Methods: We performed a territory-wide analysis in 1,152,418 elderlies who had at least one in- or out-patient attendance in the Hospital Authority. We used the Joinpoint regression to assess patterns of mortality rate.
Results: In 2014-2018, 354,357 (31.7%) and 763,488 (68.3%) old adults with and without diabetes were included respectively. All-cause death rate has declined in older adults with (458.7 vs. 431.2 events/10,000 person-years, average annual percent change [AAPC]: -3.1% [95% CI -4.2%, -2.1%]) and without (337.0 vs. 294.6 events/10,000 person-years, AAPC: -1.6% [-2.7, -0.4%]) diabetes. In 2018, compared with adults without diabetes, those with diabetes had higher all-cause mortality (1.4-fold), CV- (1.9-fold), and pneumonia-cause (1.3-fold) mortality. Pneumonia was the leading cause of death. CV death has declined significantly in old adults with with (AAPC: -5.5% [-6.8, -4.1%]) and without (AAPC: -5.8% [-8.6, -2.9%]) diabetes. There were no declines in cancer death in older adults with (AAPC: -1.6% [-2.7, 0.4%]) and without (AAPC: -1.6% [-2.7, 3.9%]) diabetes, while cancer death has surpassed CV death in old adults with diabetes. Cancer death has increased markedly in men with diabetes versus those without diabetes (AAPC: 2.9% [1.1, 4.6%] vs. 1.8% [-5.0, 1.4%]), particularly in the youngest-older adults (65-74 years) with diabetes.
Conclusions: One in 3 elderlies had diabetes. Overall, cardiovascular-death had declined in these elderlies. Although elderly people with diabetes had a greater decline in all-cause death, they had substantially higher risk of cancer-death than those without diabetes, especially in younger men.

Disclosure
A.Yang: None. M.Shi: None. E.S.H.Lau: None. E.Chow: Research Support; Medtronic, Merck KGaA, Speaker's Bureau; Novartis, Bayer Inc., Sanofi. J.C.Chan: Board Member; Asia Diabetes Foundation, Consultant; Bayer Inc., Celltrion, Boehringer Ingelheim and Eli Lilly Alliance, Sanofi, Research Support; AstraZeneca, Servier Laboratories, Viatris Inc., Hua Medicine, Merck KGaA, Applied Therapeutics Inc., Lee Powder, Pfizer Inc., Speaker's Bureau; Novartis, Stock/Shareholder; GemVCare Ltd.
1411-P: Serum Adipocyte Fatty Acid–Binding Protein Is Related to the Development of Prediabetes—Tokushima Cohort Study
Authors: HATA AKIKO , AKI NANAKO , ICHIHARA TAKAKO , MINAGAWA TAKAKO , TAMURA AYAKO , KUWAMURA YUMI , FUNAKI MAKOTO 
Published: June 2023

Adipocyte fatty acid-binding protein (A-FABP/FABP4) is abundantly expressed in mature adipocytes and presumably secreted into the plasma from these cells. Emerging evidence suggests that FABP4 may be involved in the development of insulin resistance. However, prospective cohort studies to prove their causative relationship are still limited. The aim of the present study was to investigate the association between serum concentration of FABP4 and incidence of prediabetes. Here we analyzed data of a prospective cohort study, which was conducted during 2008-2019 in Japan. A total of 527 subjects without prediabetes aged 20 to 60 years were followed up prospectively. Prediabetes was defined as either: 1) fasting plasma glucose ≥ 100 mg/dl, 2) HbA1c ≥ 5.7% or 3) medication for hyperglycemia. The subjects were divided into three categories based on the tertiles of baseline serum FABP4 for each sex (male: &lt; 7.8, 7.8-11.3 and &gt; 11.3 ng/ml, female: &lt;10.0, 10.0-13.0 and &gt; 13.0 ng/ml). The age- and sex-adjusted incidence of prediabetes significantly increased with increasing tertile of serum FABP4 level at baseline (P for trend&lt;0.001). In multivariate analysis after adjusting for age, sex, BMI, smoking habit, alcohol intake, regular exercise, HDL cholesterol, triglycerides, family history of diabetes, and hypertension, the hazard ratio of prediabetes was 1.65 [95% confidence interval:1.09 to 2.50, P=0.02] in the highest tertile of baseline serum FABP4, when compared with the lowest tertile. In addition, serum FABP4 at baseline was significantly higher in the subjects who developed diabetes, rather than prediabetes, during the follow-up period. Our findings suggest that increased serum concentration of FABP4 is an independent predictor of the incidence of prediabetes in Japanese and is related to the severity of future glucose intolerance. These results imply that altered FABP4 may associate with disorders of glucose metabolism from the early stages.

Disclosure
A.Hata: None. N.Aki: None. T.Ichihara: None. T.Minagawa: None. A.Tamura: None. Y.Kuwamura: None. M.Funaki: Board Member; Mechanogenic, Inc.

Funding
Grants-in-Aid for Scientific Research (to M.F.); Japan Society for the Promotion of Science (25860439 to A.H.)
1412-P: Sleep Patterns and Metabolic Syndrome Severity among African Americans in the Jackson Heart Study
Authors: DUAN DAISY , JUN JONATHAN , AHIMA REXFORD , BERTONI ALAIN , REDLINE SUSAN , ECHOUFFO TCHEUGUI JUSTIN 
Published: June 2023

Objective: To elucidate the relationship between sleep and metabolic dysfunction among African Americans, who are disproportionally affected by cardiometabolic diseases.
Methods: This is a cross-sectional analysis of participants in the Jackson Heart Sleep Ancillary Study (2012-2016) who completed 7-day actigraphy and home sleep apnea studies. We used linear regression to assess the associations between metabolic syndrome (MetS) and actigraphy-derived parameters including: sleep timing, total sleep duration and regularity (night-to-night variation measured by within-individual standard deviation in sleep duration), and sleep continuity (sleep maintenance efficiency and fragmentation index). We assessed MetS severity, expressed as a validated sex- and race/ethnicity-specific z-score (MetS-Z), given the high prevalence of each of the MetS components in this cohort. Models were adjusted for age, socioeconomic factors, physical activity, smoking, alcohol use, and the presence of moderate to severe obstructive sleep apnea.
Results: Among 660 participants (mean age 63 ± 11 yrs, 66% women, mean BMI 31.8 ± 6.9 kg/m2), mean sleep onset was 23:09 ± 1.4h, mid-sleep time was 2:54 ± 1.2h, total sleep duration was 6.7 ± 1.2h, median night-to-night variation was 1.2h (IQR 0.8-1.5), median sleep maintenance efficiency was 88.9% (IQR 85.6-91.4), median sleep fragmentation index was 28.5% (IQR 23.3-34) and mean MetS-Z score was 0.33 ± 1.1. In adjusted models, later mid-sleep time (β 0.09, p&lt;0.01), increased variation in sleep duration (β 0.004, p&lt;0.01), lower sleep maintenance efficiency (β -0.02, p=0.03), and higher sleep fragmentation index (β 0.01, p=0.02) were associated with higher MetS-Z.
Conclusions: Later sleep timing, irregular sleep duration, and poor sleep continuity were associated with higher MetS severity scores among African Americans, highlighting the importance of sleep and circadian disruption as factors that influence metabolic health.

Disclosure
D.Duan: None. J.Jun: None. R.Ahima: None. A.Bertoni: None. S.Redline: Consultant; Eli Lilly and Company, JAZZ Pharmaceuticals, Apnimed. J.Echouffo tcheugui: None.

Funding
National Institutes of Health (K23DK133690)
1413-P: Associations of Age at Menarche with Biomarkers of Inflammation and Glucose Metabolism in U.S. Adult Women—NHANES 1999–2018
Authors: SANTOS MARIA P. , ROMRELL AMANDA M. , BAZZANO LYDIA A. , CARMICHAEL OWEN , HE JIANG , LEY SYLVIA H. 
Published: June 2023

Background: Early age at menarche (AAM) is a risk factor for type 2 diabetes later in life, but the pathways involved remain unknown. We examined the associations of AAM with C-reactive protein, fasting glucose, and fasting insulin among U.S. adult women free of diabetes in adulthood.
Methods: Using the National Health and Nutrition Examination Survey (NHANES) 1999-2018, 19,228 women over 20 years old, free of cancer and diabetes were included in our cross-sectional analysis. AAM was self-reported age of first menstruation. Multiple linear regression was performed on biomarkers measured in adulthood.
Results: The median age was 44 years (IQR, 33-62). Age-adjusted least-square means for AAM categories ≤10, 11, 12, 13, 14, and ≥15 years were 1.42, 1.08, 1.05, 0.80, 0.84, and 0.91 mg/L for C-reactive protein (P-trend=0.006); 84.85, 69.19, 68.11, 67.27, 64.42, and 60.69 pmol/L for fasting glucose (P-trend&lt;0.0001); and 5.54, 5.45, 5.40, 5.39, 5.35, and 5.36 mmol/L fasting insulin (P-trend &lt;0.0001), respectively. When models were further adjusted for demographic, reproductive, and lifestyle variables, the associations remained significant [Table].
Conclusion: Earlier age at menarche is associated with higher levels of C-reactive protein and poorer glucose metabolism in U.S. adult women free of diabetes.

Disclosure
M.P.Santos: None. A.M.Romrell: None. L.A.Bazzano: None. O.Carmichael: Advisory Panel; Novo Nordisk, Research Support; Eli Lilly and Company, Nestlé Health Science. J.He: None. S.H.Ley: None.

Funding
National Institutes of Health (T32HL158290)
1414-P: Stalling of Trends in Glycemic and Risk Factors Control in People with Type 2 Diabetes in Hong Kong in 2000–2019
Authors: WU HONGJIANG , LAU ERIC S.H. , YANG AIMIN , ZHANG XINGE , FAN BAOQI , MA RONALD C. , KONG ALICE P. , CHOW ELAINE , CHAN JULIANA C. , LUK ANDREA 
Published: June 2023

Background: We aimed to examine trends in diabetes control in Hong Kong between 2000 and 2019.
Methods: We conducted a retrospective analysis of data from 360,202 people aged 20 years or older with type 2 diabetes who underwent a territory-wide Risk Assessment and Management Programme-Diabetes Mellitus (RAMP-DM) in primary and secondary settings in Hong Kong between 2000 and 2019. We examined trends in proportion of people with type 2 diabetes achieving target of glycemic control (hemoglobin A1c [HbA1c] &lt;7.0%), blood-pressure control (systolic/diastolic blood pressures [SBP/DBP] &lt;140/90 mm Hg), and lipid control (low-density lipoprotein cholesterol [LDL-C] &lt;130 mg/dl).
Results: The proportion of people with type 2 diabetes who achieved HbA1c &lt;7.0% increased from 40.3% (95% CI: 35.6%, 50.0%) in 2000 to 55.2% (54.4%, 56.0%) in 2014 and then leveled off thereafter. After improvements in blood-pressure control from 2000 to 2014, the proportion of people in whom blood pressure was achieved to below 140/90 mm Hg declined from 71.0% (70.4%, 71.6%) in 2014 to 63.5% (62.8%, 64.2%) in 2019. From 2000 to 2019, the proportion of people with LDL-C &lt;130 mg/dl continued to increase from 32.6% (27.6%, 37.6%) to 59.9% (59.2%, 60.6%). The proportion of people in whom all three targets were simultaneously achieved increased from 9.5% (3.8%, 15.3%) in 2000 to 23.1% (22.1%, 24.1%) in 2014 and plateaued from 2014 to 2019. Conclusions: After major improvements from 2000 to 2014, glycemic control stalled and blood-pressure control declined in people with type 2 diabetes in Hong Kong, while there was a continued encouraging trend in lipid control.

Disclosure
H.Wu: None. A.Luk: Research Support; Novo Nordisk, Boehringer-Ingelheim, Bayer Inc., Speaker's Bureau; Eli Lilly and Company. E.S.H.Lau: None. A.Yang: None. X.Zhang: None. B.Fan: None. R.C.Ma: Advisory Panel; AstraZeneca, Merck & Co., Inc., Other Relationship; Bayer Inc., Boehringer-Ingelheim, Research Support; Tricida, Inc., Roche Diagnostics, Novo Nordisk. A.P.Kong: Advisory Panel; Abbott, Kyowa Kirin Co., Ltd., Speaker's Bureau; Abbott, AstraZeneca, Lilly, Bayer Inc., Boehringer Ingelheim Inc. E.Chow: Research Support; Medtronic, Merck KGaA, Speaker's Bureau; Novartis, Bayer Inc., Sanofi. J.C.Chan: Board Member; Asia Diabetes Foundation, Consultant; Bayer Inc., Celltrion, Boehringer Ingelheim and Eli Lilly Alliance, Sanofi, Research Support; AstraZeneca, Servier Laboratories, Viatris Inc., Hua Medicine, Merck KGaA, Applied Therapeutics Inc., Lee Powder, Pfizer Inc., Speaker's Bureau; Novartis, Stock/Shareholder; GemVCare Ltd.
1416-P: Differences in Treatment and Metabolic Outcome between Males and Females Living with T2D—Results from the Multicenter DPV Registry
Authors: TITTEL SASCHA R. , HESS GREGOR , MUEHLDORFER STEFFEN , GILLESSEN ANTON , JUNG RALF , KARL MANUELA D. , LANZINGER STEFANIE 
Published: June 2023

To explore sex differences in diabetes therapy, outcome, and complications of adults with T2D in Germany. We included 77,587 individuals ≥18 years and ≥1 year of T2D duration that were treated between January 2019 and June 2022. Data was aggregated over the most recent treatment year and most recent diabetes therapy was evaluated. Age and diabetes duration-adjusted regression models are presented as estimated means with standard error mean. Median age was 71.1 [61.3 - 80.0] years, diabetes duration 11.5 [6.3 - 19.7] years, 55% male. Male patients were more often treated with insulin or OADs (51.3% vs. 50.5%, 28.1% vs. 26.5%, resp.). There were no sex differences in GLP1-RA treatment (male: 9.8%, female: 9.4%). SGLT2i treatment was significantly more frequent in males (18.4% vs. 12.2%). Females had a lower HbA1c compared with males, but a higher BMI. Dyslipidemia was more frequent in females compared with males, while hypertension was higher in males. We observed sex differences in treatment, especially newer OADs and GLP1-RA, metabolic control, and complications in all analyzed age groups. While women seem to be more affected by higher BMI and dyslipidemia, their metabolic control is better compared with males, although they have less medical treatment. Sex differences in compliance, adherence or disease perception could be the cause of these differences.

Disclosure
S.R.Tittel: None. G.Hess: Other Relationship; Novo Nordisk. S.Muehldorfer: None. A.Gillessen: None. R.Jung: Advisory Panel; Boehringer Ingelheim Inc., Speaker's Bureau; Novo Nordisk. M.D.Karl: None. S.Lanzinger: None.
1420-P: Predictors of Readmission and Mortality in Adults with Diabetes or Stress Hyperglycemia after Initial Hospitalization for COVID-19
Authors: CHAUGULE AKSHATA S. , HOWARD KYRA , SIMONSON DONALD C. , MCDONNELL MARIE E. , GARG RAJESH K. , GOPALAKRISHNAN GEETHA , MITRI JOANNA , LEBASTCHI JASMIN , PALERMO NADINE E. , WESTCOTT GREGORY P. , WEINSTOCK RUTH S. 
Published: June 2023

Our consortium previously reported that older age, elevated glycemic gap, higher BMI and DKA on admission predicted mortality in adults with diabetes or stress hyperglycemia (glucose &gt;180 mg/dl twice in 24 hrs) admitted with COVID-19 from March 2020 - February 2021 to 5 university hospitals. Here we examine those from this cohort who were readmitted (19.4%) after their initial discharge (Table). Of those readmitted 90.3% were readmitted within 30 days [median (IQR) 4 (0, 14) days]. Older age, lower eGFR, comorbidities, ICU admission, mechanical ventilation, DKA and longer length of stay during the initial hospitalization were associated with readmission. Higher A1c and admission glucose, diagnosed diabetes, glycemic gap and BMI did not predict increased risk of readmission. Hispanics were less likely to be readmitted. Mortality during readmission was 8.0%. Those who died were older than those who survived (74.9±9.5 vs 65.2±14.4 yrs, p= 0.002) and were more likely to have had DKA during the first hospitalization (p&lt; 0.001). Mortality analyses were limited by the small number of deaths (n=23). In conclusion, in adults with diabetes or stress hyperglycemia hospitalized with COVID-19, older age and non-glycemic comorbidities were associated with the risk of readmission, while glycemic gap and higher A1c were not. These results are important for guiding treatment strategies.

Disclosure
A.S.Chaugule: None. G.P.Westcott: None. R.S.Weinstock: Consultant; Jaeb Center for Health Research, Other Relationship; Wolters Kluwer Health, Research Support; Insulet Corporation, Medtronic, Eli Lilly and Company, Novo Nordisk, Boehringer Ingelheim Inc., Hemsley Charitable Trust, National Institute of Diabetes and Digestive and Kidney Diseases, Tandem Diabetes Care, Inc., Kowa Pharmaceuticals America, Inc. K.Howard: None. D.C.Simonson: Stock/Shareholder; Phase V Technologies, Inc., GI Windows. M.E.Mcdonnell: None. R.K.Garg: None. G.Gopalakrishnan: Research Support; Spruce Biosciences, Sparrow Pharmaceuticals Inc, Medtronic. J.Mitri: Other Relationship; Novo Nordisk, Research Support; Kowa Company, Ltd. J.Lebastchi: None. N.E.Palermo: Research Support; Dexcom, Inc.
1424-P: Imprecise Diagnosis of Diabetes Type in Youth
Authors: TOSUR MUSTAFA , HUANG XIAOFAN C. , INGLIS AUDREY S. , SCHNEIDER AGUIRRE REBECCA , REDONDO MARIA J. 
Published: June 2023

Identifying diabetes (DM) type at the time of onset is important to establish the correct management but is increasingly difficult due to overlaps in characteristics between the most frequent DM types. We aimed to evaluate the prevalence and characteristics of youth with imprecise DM type at onset. In a large, tertiary, USA pediatric hospital, we studied (1) 2073 youth with new onset DM (Cohort 1: median age [IQR]: 11.4 [6.2] years, 50% male, 75% White, 21% Black, 37% Hispanic) and compared characteristics of those with DM that was classified by their treating endocrinologists as “unknown type” versus others; and (2) 1019 youth followed for ≥3 years since DM diagnosis (Cohort 2: median age [IQR]: 10.7 [5.7] years, 51% male, 77% White, 19% Black, 34% Hispanic), and compared characteristics of youth whose DM type changed between diagnosis and 3 years later, versus children whose DM classification did not change. In Cohort 1, “unknown” DM type appeared in 62 youth (3%), associated with older age, negative IA-2 antibody, lower C-peptide, and absence of diabetic ketoacidosis after adjustment for confounding factors. In Cohort 2, “changed” DM type appeared in 35 youth (3.4%), and, after adjusting for confounders, was not associated with any single characteristic. Other results are summarized in Table 1. In sum, DM type at onset is unknown or changes 3 years later in 6.5% of youth with DM. These findings warrant further research to optimize DM care in youth.

Disclosure
M.Tosur: Advisory Panel; Provention Bio, Inc. X.C.Huang: None. A.S.Inglis: None. R.Schneider aguirre: None. M.J.Redondo: None.

Funding
National Institutes of Health (R01DK124395 to M.J.R.), (K23DK129821 to M.T.)