bluuebunny/crossref_metadata_2025_split huggingface dataset:
1817-PUB: CGM-Derived Metrics and HbA1c in Adults with Type 2 Diabetes (T2D) on Different Insulin Treatment Regimens Not Meeting Glycemic Targets
Authors: LIND NANNA , CHRISTENSEN MERETE B. , NØRGAARD KIRSTEN 
Published: June 2023

Objective: Despite advances in treatment strategies, many individuals with T2D treated with insulin still struggle with inadequate glycemic control. The aim was to describe CGM-derived metrics and HbA1c for adults with T2D and HbA1c ≥7.5% (≥58 mmol/l) using different insulin treatment regimens; basal insulin only or multiple daily injections (MDI).
Methods: Baseline characteristics of participants with T2D entering a randomized controlled trial on the efficacy of using CGM were analyzed including CGM-derived metrics from 10 days blinded CGM (Dexcom G6).
Results: Included were 96 adults (men 61.5%, age 61 (54-67) years and BMI 30.7 (26.7-35.7) kg/m2, all median (+IQR)). Compared to adults on basal insulin only, the MDI treated had a longer diabetes duration of 22 (19-25) vs 18 (14-22) years, a higher HbA1c 9.2 (8.6-9.7) vs 8.3 (7.8-9.1) % and a lower C-peptide 396 (217-630) vs 745 (504-1178) pmol/l. There were no differences in time in range or mean sensor glucose. In contrast, the MDI treated had less time above range (28 (21-32) vs 33 (25-42) %) but a higher coefficient of variation (32 (26-36) vs 26 (23-31)%) and a higher time below range (&lt;3.0 mmol/l).
Conclusion: These results suggest that while MDI treatment may be associated with higher HbA1c levels and greater glycemic variability, this is not consistently reflected in all CGM-derived metrics.

Disclosure
N.Lind: None. M.B.Christensen: Speaker's Bureau; Novo Nordisk A/S, Sanofi. K.Nørgaard: Advisory Panel; Medtronic, Novo Nordisk, Research Support; Medtronic, Dexcom, Inc., Novo Nordisk, Zealand Pharma A/S, Speaker's Bureau; Medtronic, Novo Nordisk, Stock/Shareholder; Novo Nordisk.
1820-PUB: To Compare the Average TIR Metric in Type 2 DM Population across Two Specialty Centers in Urban India Using Different Strategies for CGM Guided Management
Authors: SOWANI ALPANA , CHAWLA PURVI M. , CHAWLA MANOJ S. 
Published: June 2023

Methodology: We analyzed FGM Libre pro data of 394 patients from Centre - 1 and 200 patients from Centre - 2 over last 1 year for Type 2 DM patients visiting 2 different specialty clinics. Centre - 1 was analyzing the data for the blinded CGM at the end of 14 days and capturing the TIR data and making management decisions. Centre - 2 was calling the patient on day 7, analyzing the data, making therapeutic changes and capturing the TIR data at end of 14 days period and making further therapeutic changes.
Discussion/Conclusion: Use of CGM in type 2 DM patients in routine clinic practice is used at very few centers across India due to various challenges including cost of monitoring in a self-pay market. There is a constant search for innovating means to economize cost of treatment and optimize the use of resources. Hence, the practice of calling patients at least once in the intermittent period back to the clinic, while on the blinded CGM to analyze the data and make lifestyle and therapeutic changes, the benefits of which may be seen at the end of 14 days period may seem feasible in Indian settings. This strategy often results in improving TIR metrics at the end of 14 day period as most type 2 patients doing CGM in India may not repeat the same more than 1-2 times per year.

Disclosure
A.Sowani: None. P.M.Chawla: None. M.S.Chawla: None.
1822-PUB: Identifying the Link between In-Hospital Hyperglycemia and Outcomes among Persons Admitted with a Severe Infection
Authors: BAKKER JULIA J. , VAN DER VAART AMARENS , BOUMA HJALMAR , CHOUDHARY PRATIK , VAN DIJK PR 
Published: June 2023

Background: Hyperglycemia is common among hospitalized patients and is associated with suboptimal outcomes. We investigated the impact of hyperglycemia in persons admitted with severe infection (diagnosis of infection according to the treating physician combined with either ≥2 qSOFA-criteria or ≥2 SIRS-criteria) with and without diabetes.
Methods: We prospectively recruited people with a severe infection into this observational study and applied a blinded glucose sensor. No changes were made to usual care.
Results: Here, we present preliminary data from 48 persons (expected recruitment n=200) : 67% male, age 63±17 y). 29% had known diabetes. Urinary (20%), airway (8%), and skin (8%) were the most common infection foci; three persons died during admission. Among all, the mean glucose was 140±64 mg/dL, with hyperglycemia present in 36 (75%) persons (Figure 1). Figure 1 shows the 24h sensor profiles for all (panel A), persons with (panel B) and without diabetes (panel C). Mean glucose was 205 (±75) vs 113 (±33) in people with and without known diabetes. Similarly time in range (70-180 mg/dl) was 11 vs 77% in people with and without diabetes. 18% of those with no known diabetes had &gt;10% time above range (&gt;180 mg/dl)
Conclusion: Hyperglycemia was a frequent finding. We will evaluate the link between sensor-measured glycemic parameters, blood values and detailed outcome data using the Acutelines biobank.

Disclosure
J.J.Bakker: None. A.Van der vaart: None. H.Bouma: None. P.Choudhary: Advisory Panel; Medtronic, Novo Nordisk, Dexcom, Inc., MannKind Corporation, Insulet Corporation, Research Support; Abbott Diabetes, Speaker's Bureau; Sanofi, Lilly. P.Van dijk: None.
1824-PUB: Implementation of an Integrated Care Management Pilot Program Improves Diabetes Quality Outcomes after 12 Months
Authors: TINSLEY LIANE J. , ARIYABUDDHIPHONGS KIM D. , HALPRIN ELIZABETH , BEAULIEU JEREMY , MOREAU MERREDITH , MILLAN-FERRO ANDREINA , RIZZOTTO JO-ANNE , CRONIN BRIAN , MEHTA SANJEEV N. 
Published: June 2023

Care management efforts focused on patients not achieving quality goals can improve performance in value-based care quality programs, but may pose challenges for integration into routine clinical care. We evaluated a 12-month NP-led care management pilot program (CMPP) to improve outcomes for adults with T2DM and A1c&gt;9% (N=62, 40% male) covered under a value-based care quality program and receiving care at a diabetes center. Visits were scheduled as billable encounters between routine clinical visits. Diabetes quality outcomes (A1c≤9%, BP&lt;140/90, and annual retinal screening) were assessed by CMPP participation. For this pilot program, p&lt;0.05 and p&lt;0.10 defined significance and trend, respectively. The CMPP began in November 2020 with 43% (n=27) participation; participants and non-participants had no baseline differences in age, diabetes duration, or baseline attainment of diabetes quality metrics. CMPP participants had more visits compared to non-participants over the 12 month pilot period (10.4 vs. 4.0, p&lt;.001); 62% of participant visits were virtual vs 47% among non-participants (p=.01). At 12 months, CMPP participants had a significant improvement in % A1c≤9% and trended towards improved annual retinal screening. This integrated NP-led CMPP leveraging virtual care may improve diabetes quality outcomes. Future efforts will focus on scaling and implementation in primary care.

Disclosure
L.J.Tinsley: None. K.D.Ariyabuddhiphongs: None. E.Halprin: None. J.Beaulieu: None. M.Moreau: None. A.Millan-ferro: None. J.Rizzotto: None. B.Cronin: None. S.N.Mehta: None.
1825-PUB: Factors Associated with Completion of a Diabetes Transition Program (DTP) in Youth with Diabetes Mellitus
Authors: ALNAYEM WEAM , KRALL JODI S. , SIMINERIO LINDA M. , LIBMAN INGRID 
Published: June 2023

Adolescence and young adulthood are periods of transition when youth with DM typically experience poor outcomes. Programs that equip youth with confidence, support, and knowledge to foster successful lifelong DM management are needed. The DTP was developed to provide care and guided peer-discussions on pertinent topics with a multidisciplinary team over 4 clinic visits annually. To identify predictors for program completion, characteristics of patients who completed the program versus those who did not were examined. A total of 152 subjects were referred (prior to Covid) (53% male, 91% white, mean age at 1st visit 18.8±1.4 years, age at diagnosis 9.8±4.8 years, body mass index (BMI) %ile 74.6±20.6, HbA1c 8.9±2%, 54% on insulin pumps, 17% on continuous glucose monitors (CGM). Half (n=76) completed the program. Characteristics are presented below.
There were no differences between those that completed the program vs those that did not in depression score (measured by (PHQ-9)) (8.8±0.5 vs 8.8±0.4, p=0.87), history of visits to ED (3 vs 7%, p=0.44) or admissions (4.5 vs 7%, p=0.72) in the year prior to referral. Patients referred to the DTP appear to be a high-risk population which may explain why completion of the program was 50%. Moreover, identifying as non-white appears to be associated with non-completion of the program, emphasizing the need for different approaches to reach emerging adults.

Disclosure
W.Alnayem: None. J.S.Krall: Research Support; Sanofi, Becton, Dickinson and Company. L.M.Siminerio: Advisory Panel; Abbott, Research Support; Becton, Dickinson and Company, Sanofi. I.Libman: Advisory Panel; Novo Nordisk.
1826-PUB: Efficacy of Digital Diabetes Care Program in India—Retrospective Analysis
Authors: AGRAWAL NAVNEET , PANJABI ADITYA , DIXIT PRASHANT K. , D BHEEMARAYA 
Published: June 2023

Background: Lack of knowledge in self-management and limited access to specialized healthcare services leads to uncontrolled diabetes. Continuous digital care delivered through a mobile healthcare app aid in metabolic control.
Aims: To analyze the efficacy of BeatO’s digital diabetes care management program among people with diabetes
Methods: A retrospective analysis of 721 participants enrolled in BeatO’s mobile app-based diabetes care program for 3 months, the period of enrollment was between 28th February to 31st August 2022. Participants received remote access to health professionals for diabetes education, nutritional guidance and doctor consultation through the BeatO app. Throughout the care program, they were connected with a dedicated health coach. The medication prescribed by the doctor was delivered to the participant’s home. Regular blood glucose monitoring was done using BeatO’s smartphone-connected glucometer that works in accordance with the BeatO app. The parameters like FBG, PPBG, HbA1c, lipid profile and weight was recorded at baseline and after 3 months.
Results: Of the 721 participants, 96.5 % had Type 2 diabetes. The mean age of the participants was 47.5 years, and the majority (80.8%) were males. T2DM was present in 696, T1DM (11), LADA (9), Prediabetes (3) and GDM (2). Out of these, 704 participants completed the program. A significant improvement in blood glucose control was observed, as reflected by a mean decrease in FBG by 38 mg/dL (p &lt;0.0001), PPBG by 37 mg/dL (p &lt;0.0001) and HbA1c reduced by 2.16% (p &lt; 0.0001) at the end of 3 months. There was a significant weight loss of about 1.8 kg (p = 0.01) and a reduction in total cholesterol by 15 mg/dl through this remote personalized care.
Conclusions: BeatO's digital diabetes care management program among people with diabetes showed good efficacy in terms of glycemic control and weight loss. Hence, the implementation of digital technology in diabetes care can help in increasing access and awareness of diabetes care and achieving glycemic targets.

Disclosure
N.Agrawal: Advisory Panel; Biocon, Eris Lifesciences Ltd., Lupin Pharmaceuticals, Inc., Sanofi, USV Private Limited, Other Relationship; BeatO, Health Arx Technologies Pvt LTD. A.Panjabi: Advisory Panel; Torrent Pharmaceuticals Ltd, USV Private Limited, Consultant; BeatO, Health Arx Technologies. P.K.Dixit: Advisory Panel; USV Private Limited, Intas Pharmaceuticals Ltd., Consultant; Beato, Health Arx Technologies. B.D: Consultant; BEAT-O, HEALTH ARX TECHNOLOGIES.
1834-PUB: Gestational Diabetes Mellitus in Nonobese Women Is Associated with Adipose Tissue Health
Authors: SINHA AJAY K. , BHARTI BISHWA B. , CHOUDHARY BINOD K. , HANS PANKAJ 
Published: June 2023

Background: Health issues are linked to gestational diabetes mellitus (GDM) in both the mother and the foetus. Adipose tissue (AT) health issues and obesity are linked to the emergence of GDM. Recent research has nevertheless demonstrated that decreased AT health can exist even in the absence of fat. In this study, we investigated whether AT health influences the onset of GDM in non-obese women.
Method: GDM-diagnosed expectant mothers were examined. Non-GDM women with matching BMI and age served as the Controls (n=6 per group). Before and during cesarian sections, samples of AT and fasting blood were taken, respectively. Using the Bioplex assay, the serum levels of adiponectin were determined. Western blotting was used to quantify the expression of phosphorylated p38 (p-p38) in AT, and average adipocyte size values were calculated. Two-tailed unequal variance was used to determine the differences in the variables between the groups. P &lt; .0 was regarded as statistically significant for the Student t test.
Results: The pre-pregnancy BMI and age did not differ. The serum level of adiponectin was considerably lower in the GDM group. p-AT p38's expression, however, was noticeably higher. In the GDM group, the adipocyte size was 11% smaller, but the difference did not statistically vary from zero.
Conclusion: Our findings show that among non-obese women, the development of GDM may be significantly influenced by AT health. Future research is necessary to identify the pathways via which AT health, in the absence of obesity, contributes to the development of GDM.

Disclosure
A.K.Sinha: None. B.B.Bharti: None. B.K.Choudhary: None. P.Hans: None.
1843-PUB: Epidemiological Investigation on Diet and Drugs of Adult Diabetes Mellitus in Guangdong Province
Authors: CHEN XUANRONG , JIANG WEI , XIONG FEI , YANG LI , XU WEN , ZENG LONGYI ,   STUDY GROUP THE CHINA NATIONAL DIABETIC CHRONIC COMPLICATIONS
Published: June 2023

Objective: To study the epidemiological characteristics of adult diabetes, and effect of food composition on blood glucose in Guangdong Province.
Methods: The data of this study were from the China DiaChronic Study. This study investigated diabetic patients in eight urban and rural centers in Guangdong Province. Questionnaire survey, physical examination and fundus photography were carried out, and blood and urine indexes were measured. All 1621 subjects were finally included.
Results: (1) The prevalence rates of obesity, hypertension, hypertriglyceridemia, hyper LDL-C, were 15.8%, 37.9%, 50.5% and 79.3% respectively. The prevalence rates of diabetic nephropathy and retinopathy were 33.6% and 16.7% respectively. The treatment rate of subjects was 93.6%, and the compliance rate of HbA1c of them was 49%. (2) In all subjects, the median of total caloric intake of food was 1660 kcal/d, of which grains account for the most with 810 kcal, and milk were the least with 0 kcal. Men's caloric intake in grains, livestock meat, poultry meat and aquatic products were significantly higher than that of women, while women's caloric intake in potatoes and milk were significantly higher than that of men (P&lt;0.05). The caloric intake of grains, vegetables and livestock meat in rural were significantly higher than that in urban, while the caloric intake of miscellaneous grains, potatoes, beans, fruits, milk, poultry meat, aquatic products, eggs and nuts in urban areas were higher than that in rural areas (P&lt;0.05). For subjects with HbAIc&lt;6.5%, the energy intake of vegetables, fruits, poultry meat and eggs was significantly higher than that of them with HbA1c&gt;6.5% (P&lt;0.05).
Conclusion: Despite patients try to control blood glucose, half of them have poor blood glucose control. At present, the diet of rural residents mainly include grains, vegetables and livestock meat. Vegetables, fruits, poultry and eggs may be beneficial to blood glucose control, which needs further research to confirmation.

Disclosure
X.Chen: None. W.Jiang: None. F.Xiong: None. L.Yang: None. W.Xu: None. L.Zeng: None. S.Te china national diabetic chronic complications : n/a.
1849-PUB: RNA Sequencing Analysis Related to Immune Homeostasis in the Skin of a Corticotropin-Releasing Hormone (CRH) Transgenic Mouse Model
Authors: HAK JEONG HYEON , LEE BONGGI 
Published: June 2023

Chronic glucocorticoid exposure in humans is well-known to induce diabetes-like phenotypes associated with Cushing's syndrome. Diabetes mellitus is also closely related to skin abnormalities. To elucidate changes in the transcriptome of the skin in corticotrophin-releasing hormone transgenic (CRH-TG) mice with skin abnormalities and diabetes-like phenotypes, we performed RNA-Seq analysis with a focus on immune homeostasis. Compared to WT-skin, DEG analysis revealed that the levels of 2854 genes were significantly altered in CRH-TG mice (Up-1134 genes, Down-1720 genes). The KEGG analysis further showed that various signaling pathways associated with immune functions were significantly altered, which include signaling pathways related to hematopoietic cells, complement cascade, and major histocompatibility complex class II (MHC class II) molecules. Additionally, qPCR analysis confirmed that the mRNA level of MHC class II molecules, which play an antigen-presenting function, was downregulated in CRH-TG skin. Although further studies are needed, chronic glucocorticoid exposure may lead to immune imbalance, making the skin vulnerable to external and intrinsic stimulations.

Disclosure
H.Jeong: None. B.Lee: None.

Funding
Korean Ministry of Agriculture, Food and Rural Affairs (821030-3)2); Korea Ministry of Oceans and Fisheries (20220252)
1850-PUB: Immune Silencing of Beta Cells for Transplantation Informed by Naturally Occurring Immune-Privileged Cells
Authors: AGUDO JUDITH , SANCHEZ XAVIER 
Published: June 2023

To cure Type 1 Diabetes (T1D) is necessary to restore the lost beta-cells while ensuring their long-lasting survival. This could be done by transplantation of primary or stem cell-derived islets. However, any replacement will irrevocably succumb to the same autoimmune attack that killed the original beta-cells. Moreover, a mismatch between donor cells and recipient patients adds an allo-graft rejection against transplanted cells. Thus, it is of the utmost importance to develop strategies to protect transplanted pancreatic islets from immune attack. Unfortunately, many approaches aiming at restoring tolerance by manipulating immune cells have been tested and, although safe, have shown only limited efficacy. We recently discovered the existence of immune privileged tissue-resident stem cells and found that their ability to resist direct attack by T cells was not dependent on a physical barrier. Instead, it was a cell-autonomous process that allowed cloaking from immune cells. We identified a molecular pathway that reduces antigen presentation allowing protection from T cells while preserving enough MHC class I to not trigger a Natural Killer (NK) cell response. We have exploited such molecular circuits to provide similar protection to beta-cells for transplantation. Since this mechanism of protection is cell intrinsic, changes in the immune system should not jeopardize their survival. Preliminary data engineering beta-cell-like cells demonstrated that targeting this pathway leads to protection both in the Non-Obese Diabetic (NOD) model of T1D as well as in a model of CD8+ T cell-mediated autoimmune attack against beta-cells. Here we report novel candidate genes to engineer beta-cells for transplantation that can allow them to become immune silent.

Disclosure
J.Agudo: None. X.Sanchez: None.

Funding
American Diabetes Association (1-20-ACE-08 to J.A.)
1852-PUB: The Effect of Lactic Acid Fermented Sake Lees in a NASH-HCC Mouse Model
Authors: SUZUKI HIROSHI , WATANABE KENICHI , ARUMUGAM SOMASUNDARAM , REJINA AFRIN MST. , MATSUBAYASHI YASUHIRO , SONE HIROHITO 
Published: June 2023

Nonalcoholic steatohepatitis (NASH) is a liver disease characterized by fatty liver and cirrhosis that van lead to hepatocellular carcinoma. Although NASH prevalence is increasing worldwide, no cure has yet been established. Sake-lees, which are a by-product of sake refinement, have liver-protecting properties. Lactic acid fermented sake lees (FSL) is a food made by lactic acid fermentation of lees, which are then dealcoholized. Although FSL is regarded as a pro-health supplement, whether it has hepatoprotective effects remains unclear. To address this, we used a murine model of NASH to determine whether FSL could suppress progression of the disease. FSL supplementation significantly suppressed the increase in blood glucose impeded the progression of NASH. Protein analysis revealed that FSL also attenuated the increased expression of inflammatory markers. We infer that dietary FSL has anti-inflammatory and anti-hyperglycemic effects that contribute to the inhibition of NASH progression.

Disclosure
H. Suzuki: None. K. Watanabe: None. S. Arumugam: None. M. Afrin: None. Y. Matsubayashi: 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.

Funding
Japan Society for the Promotion of Science (22K17772)
Accounting for the distributions of input quantities in the procedure for the measurement uncertainty evaluation when calibrating the goniometer
Authors: Zakharov Igor , Zadorozhna Iryna , Świsulski Dariusz , Diakov Dimitar 
Published: June 2023

The discords concerning the measurement uncertainty evaluation in the Guide to the Expressing of Uncertainty in Measurement (GUM) and its Supplement 1 are considered. To overcome these discords, the authors of the paper propose to use the kurtosis method and the law of the propagation of the expanded uncertainty. Using the example of the goniometer calibration, the features of accounting for the distribution laws of input quantities in the procedure for the measurement uncertainty evaluation are shown. A model for direct measurements of the value of a reference measure of the angle using a goniometer is written, the procedures for the measurement uncertainty evaluation are described, and uncertainty budgets for each of the methods are given. An example of the measurement uncertainty evaluation when calibrating a digital goniometer using a 24-sided reference prism is described. An estimate of the expanded measurement uncertainty for this example was made based on the web-based software application NIST Uncertainty Machine, which showed a good agreement with the estimates obtained by the considered methods. The technology of applying this software application for the confidence level of 0,9545, which the software lacks, is shown. The estimates of the measurement uncertainty obtained by the proposed methods, Monte Carlo method and methodology of the Guide to the Expressing of Uncertainty in Measurement are compared.