bluuebunny/crossref_metadata_2025_split huggingface dataset:
1101-P: Glycemia after Pediatric Bariatric Surgery—Outcomes and Predictors
Authors: SISLEY STEPHANIE , SHAH AMY S. , NADEAU KRISTEN J. , KELSEY MEGAN M. , GU TAO , MICHALSKY MARC , JENKINS TODD M. , INGE THOMAS 
Published: June 2023

Background: Metabolic and bariatric surgery (MBS) is a safe and efficacious treatment for children and adolescents with severe forms of obesity. However, there are few data on the effects of pre-surgical fasting insulin homeostasis measures on post-surgical weight loss or glycemia.
Methods: We analyzed data from n=216/242 individuals with ≥ Class 2 obesity prospectively enrolled in the multi-center, Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study for up to eight years. Individuals who had type 1 diabetes, a gastric band procedure, or lacked baseline data for insulin homeostasis measurements were excluded, leaving 216 individuals for analysis. Body composition was assessed through bioelectrical impedance measurements. An analysis of fasting markers of insulin homeostasis using homeostatic model of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), or HOMA-β and outcomes following MBS was performed.
Results: Our cohort had a baseline mean age of 16.5 years, BMI of 52.7 kg/m2, and was 75.4% female. At 8-year follow up, participants had a mean BMI of 43.0 kg/m2. Pre-surgical measures of insulin homeostasis did not predict change in BMI or fat mass over eight years. However, larger improvements in HbA1c were positively associated with younger baseline age, higher baseline HOMA-IR and HOMA-β, and lower baseline HbA1c.
Conclusion: Baseline markers of insulin homeostasis were not significantly associated with weight loss outcomes, but did predict glycemia 8 years after MBS.

Disclosure
S.Sisley: Speaker's Bureau; Rhythm Pharmaceuticals, Inc. A.S.Shah: None. K.J.Nadeau: None. M.M.Kelsey: Other Relationship; Boehringer Ingelheim Inc., Janssen Pharmaceuticals, Inc., Rhythm Pharmaceuticals, Inc., Lilly. T.Gu: None. M.Michalsky: Advisory Panel; Lilly, Other Relationship; Intuitive Surgical, Stock/Shareholder; Intuitive Surgical. T.M.Jenkins: None. T.Inge: None.

Funding
National Institutes of Health (U01DK072493); U.S. Department of Agriculture-Agricultural Research Service (3092-5100-065)
1106-P: Feasibility of Continuous Glucose Monitor Use in Publicly Insured Youth with Type 2 Diabetes
Authors: SHAH SEJAL , ARRIZON-RUIZ NORA , LOYOLA ALONDRA , SAGAN PIPER , CONRAD BARRY P. , LEVERENZ JEANNINE , BISHOP FRANZISKA K. , MAAHS DAVID M. 
Published: June 2023

T2D disproportionately affects youth of minority and lower SES backgrounds with public insurance. Continuous glucose monitor (CGM) use in youth with T1D and adults with T2D benefits glycemia and quality of life. Use of CGM in youth with T2D has not been sufficiently evaluated.
We aimed to determine feasibility of CGM use, measured by % wear time per 2-week period (&gt;75% wear-time as goal) prior to clinic visit, clinical outcomes including time in range (TIR) and HbA1c. Youth were provided or prescribed Libre 2 CGM and followed using established clinic workflows with data collection at each visit. We present the first 6 months (m) of data.
We enrolled 30 youth with T2D, mean age 15.1 y and mean HbA1c 10.2% (6.5%-15.5%) (Table 1). At baseline, 37% had history of prior intermittent CGM use and 53% did not have glucometer data. At 3 m 47% of youth who attended visits were using CGM, at 6 m 79% were using CGM, with no participant using CGM &gt;75% of the time. Mean HbA1c was lower over 6 months (1.3% decrease in 8 youth with 6m CGM data and HbA1c) and TIR was lower between 3 and 6 m among those who attended clinic visits.
CGM use for 6 m was not sustained in youth with T2D, but CGM was worn by a portion of youth and associated with lower HbA1c in those who used CGM. Strategies for CGM use in youth with T2D may differ from adults with T2D or youth with T1D. Additional studies are needed to evaluate facilitators and barriers of CGM use to optimize CGM use in youth with T2D.

Disclosure
S.Shah: Research Support; Boehringer-Ingelheim, Takeda Pharmaceutical Co., Ltd. N.Arrizon-ruiz: None. A.Loyola: None. P.Sagan: None. B.P.Conrad: Advisory Panel; Edgepark medical supplies, Consultant; Abbott Diabetes. J.Leverenz: None. F.K.Bishop: None. D.M.Maahs: Advisory Panel; Medtronic, LifeScan Diabetes Institute, MannKind Corporation, Consultant; Abbott, Research Support; Dexcom, Inc.

Funding
Stanford Diabetes Research Center (P30DK116074)
1109-P: Barriers and Facilitators to Use of Continuous Glucose Monitors for Type 2 Diabetes in Youth
Authors: PEYYETY VAISHNAVI , ZUPA MARGARET , HEWITT BRIANNA , RODRIGUEZ GONZALEZ ADRIANA , MANI ISWARIYA , PRIOLEAU TEMILOLUWA , MCCURLEY JESSICA L. , KUEI LIN YU , ELLEN VAJRAVELU MARY 
Published: June 2023

Objective: Youth-onset type 2 diabetes, most common among racial/ethnic minorities, threatens to widen health disparities due to severe complications in early adulthood and a 15-year reduction in life expectancy. Use of continuous glucose monitors (CGM) improves diabetes management in adults with type 2 diabetes, but socioeconomic and racial/ethnic disparities in diabetes technology use remain. We sought to examine factors impacting the acceptability of CGM use in adolescents and young adults (AYA) with type 2 diabetes.
Methods: In this single center study, we conducted semi-structured interviews with AYA with type 2 diabetes and their parents to determine attitudes about CGM use, including barriers and facilitators. Interviews were audio-recorded, transcribed, and evaluated using thematic analysis.
Results: Twenty AYA and 10 parents participated (n=30 total). AYA were mean age 16.5 years (SD 2.2, range 13.7-20.1) and had median diabetes duration of 1.3 years. Most were female (65%) and minority race/ethnicity (40% non-Hispanic Black; 10% Hispanic; 5% Asian). Seven (35%) used CGM. The primary benefit elicited was convenience over glucometer use. Important barriers included the impact of physically wearing the device and drawing unwanted attention, desire for AYA privacy, and adequate education about the device.
Discussion: In this diverse sample of AYA with type 2 diabetes and their parents, CGMs were generally regarded as convenient, although concerns about worsening stigma and conflict with parents were prevalent. Our findings can guide the development of patient-centered approaches to CGM use for AYA with type 2 diabetes, a critical step toward reducing inequities in diabetes technology uptake.

Disclosure
V.Peyyety: None. M.Zupa: None. B.Hewitt: None. A.Rodriguez gonzalez: None. I.Mani: None. T.Prioleau: None. J.L.Mccurley: None. Y.Lin: None. M.Vajravelu: None.

Funding
Endocrine Fellows Foundation; National Institutes of Health (K23HL157763, K23DK129724, KL2TR001856, K23DK125719, UL1-TR-001857)
111-OR: Effect of Dulaglutide plus Calorie-Restricted Diet vs. Calorie-Restricted Diet on Visceral Fat and Metabolic Profiles in Women with Polycystic Ovary Syndrome—A Randomized Controlled Trial
Authors: ZHANG YUQIN , SHAO XIAOWEN , CAI MEILI , DILIMULATI DILIQINGNA , QU SHEN , ZHANG MANNA 
Published: June 2023

This study investigated whether dulaglutide combined with CRD could further reduce VAT and promote clinical benefits compared with the CRD regimen alone in overweight or obese women with PCOS. This single-center, randomized, controlled, open-label clinical trial was conducted between May 2021 and May 2022. Overall, 243 patients were screened, of which 68 overweight or obese women with PCOS were randomly assigned to receive dulaglutide combined with CRD treatment (n=35) or CRD treatment alone (n=33). The duration of intervention was set as the time taken to achieve a 7% weight loss goal from baseline body weight, which was restricted to 6 months. The primary endpoint was the difference in the change in VAT area reduction between the groups. The secondary endpoints contained changes in menstrual frequency, metabolic profiles, hormonal parameters, liver fat, and body composition. The mean time to achieve 7% weight loss was significantly shorter in the dulaglutide+CRD group than in the CRD group. There was no significant between-group difference in the change in VAT reduction (-0.97 cm2, 95% confidence interval, -14.36-12.42; P=0.884). Compared to CRD alone, dulaglutide+CRD had significant advantages in reducing glycated hemoglobin A1c and postprandial plasma glucose levels. Results of analyses of changes in menstrual frequency, other metabolic profiles, hormonal parameters, liver fat, and body composition were not significantly different between the two groups. Nausea, vomiting, constipation, and loss of appetite were the main adverse events of dulaglutide. These findings support the importance of dietary intervention as first-line management in women with PCOS, and glucagon-like peptide 1 receptor agonist (GLP-1 RA) therapy offers an effective and generally tolerable adjunct therapy to aid in achieving weight target based on dietary therapy in overweight/obese women with PCOS.

Disclosure
Y.Zhang: None. X.Shao: None. M.Cai: None. D.Dilimulati: None. S.Qu: None. M.Zhang: None.

Funding
National Natural Science Foundation of China (81601269)
1112-P: Soluble Suppression of Tumorigenicity 2 Is Directly Correlated with Body Fat, Metabolic Dysfunction, and Inflammation in Children and Adolescents
Authors: HASAN AMAL , KOCHUMON SHIHAB P. , ALBASIRI IMAN D. , ALMULLA FAHD , AHMAD RASHEED 
Published: June 2023

Purpose: Childhood obesity is a major risk factor for chronic diseases such as type 2 diabetes (T2D) and cardiovascular disease. Elevated soluble suppression of tumorigenicity 2 (sST2) is associated with obesity, diabetes, and cardiovascular disease in adults, and is used as a biomarker of cardiometabolic disease. Such biomarkers play an important role in the management of obesity and cardiometabolic disease. In this cross-sectional study, we examined the levels of circulating sST2 in children and adolescents, as well as its association with inflammatory and metabolic markers.
Methods: A total of 85 children and adolescents (aged 5-16 years) were included. Participants' characteristics included being of normal weight (body mass index, BMI &lt;85th percentile; n=13), overweight (BMI 85-94th percentile; n=2), or obese (BMI ≥95th percentile; n=70; a total of 8 with confirmed T2D). Clinical and biochemical markers (including plasma glucose, glycated hemoglobin (HbA1c), insulin, vitamin D, and lipid, liver, and renal profiles) were assessed using established procedures on peripheral blood samples. The levels of sST2, interleukin (IL)-33, IL-6, C-reactive protein (CRP), leptin, and adiponectin, were quantified using commercially available ELISA kits.
Results: sST2 level was directly correlated with body fat % (r=0.3, P=0.016, n=64) and fat to muscle ratio (r=0.37, P=0.01, n=45), but inversely correlated with muscle mass % (r=-0.34, P=0.02, n=45). sST2 level was directly correlated with insulin (r=0.29, P=0.04, n=50), HbA1c (r=0.29, P=0.04, n=51), and urea (r=-0.34, P=0.01, n=54). sST2 level was directly correlated with the inflammatory markers CRP (r=0.34, P=0.008, n=59) and IL-6 (r=0.32, P=0.0045, n=77). The data were consistent after adjustment for age and sex.
Conclusion: Increased circulating levels of sST2 is associated with increased body fat, metabolic dysfunction, and inflammation in children and adolescents.

Disclosure
A.Hasan: None. S.P.Kochumon: None. I.D.Albasiri: None. F.Almulla: None. R.Ahmad: None.

Funding
The Kuwait Foundation for the Advancement of Sciences (RA2011-018)
1113-P: Alanine Aminotransferase Elevation in Youth-Onset Type 2 Diabetes—Prevalence and Risk Factors
Authors: DELACEY SEAN E. , FENG SIYUAN , RANGANNA ADESH , FISHBEIN MARK , BIANCO MONICA E. 
Published: June 2023

Purpose: Fatty liver and Type 2 Diabetes (T2D) are components of insulin resistance, but the prevalence of fatty liver disease at diagnosis of youth onset T2D is unknown. Fatty liver disease is typically identified initially by elevated alanine aminotransferase (ALT). We aim to describe the prevalence of ALT elevation in youth onset T2D at diagnosis and associated risk factors.
Methods: We conducted a single center retrospective review of patients (age≤21) diagnosed with T2D (5/1/2015-12/31/21). Chi-squared and two sample t-tests were used to compare those with ALT values in the highest and lowest quartiles at diagnosis for categorical and linear variables.
Results: Analysis included 455 patients. ALT was elevated at diagnosis and varied widely (mean=70.4 IU/L, standard deviation=76.0 IU/L). At diagnosis 48% of patients had ALT ≥45 IU/L and 14% had ALT ≥135 IU/L. Compared to those with ALT values in the lowest quartile, those in the highest quartile were more likely to be male (p=0.0001), Hispanic (p&lt;0.00001), have a lower HgbA1C (8.9% vs 9.8%, p=0.001), and not identify as Black (p&lt;0.00001). There was no difference in BMI Z-score. A follow-up ALT (6-18 months later) was available in 49% of patients: 37% had ALT≥45 IU/L and 7% had ALT≥135 IU/L (Figure 1).
Conclusions: Elevation of ALT is common at diagnosis of youth onset T2D, but often improves. Those with elevated ALT tend to have a lower HgbA1C and a similar BMI.

Disclosure
S.E.Delacey: None. S.Feng: None. A.Ranganna: None. M.Fishbein: None. M.E.Bianco: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007169)
112-LB: Proof-of-Concept Testing of an Artificial Intelligence–Based Fully Closed-Loop System in Hospitalized Patients with Diabetes
Authors: ZAHEDI TAJRISHI FARBOD , DAVIS GEORGIA M. , PEREZ-GUZMAN MIREYA , GUERRERO ARROYO LIZDA I. , BLANCO GERARDO , SAM VARGHESE JITHIN , HIRA ZAHID SYEDA , DEJOURNETT JEREMY , DEJOURNETT LEON , PASQUEL FRANCISCO J. 
Published: June 2023

Objective: Achieving tight glucose control safely and effectively is challenging in the Intensive Care Unit (ICU). We conducted the first-in-human test of an artificial intelligence (AI)-based fully autonomous glucose control system in a simulated ICU setting.
Methods: We admitted seven participants with type1 and type 2 (n=6) diabetes mellitus for 24-hour closed-loop glucose control sessions that included three unannounced meals. The AI-based system uses glucose control software that controls intravenous insulin and glucose infusions based on real-time continuous glucose monitoring derived data from two real-time CGM devices. The primary efficacy endpoint was the percentage of glucose values within the range of 70-180 mg/dL. The primary safety endpoint was the percentage of glucose values &lt; 70 mg/dL.
Results: Participants were on average 48±9.7 years-old, 71% female, and BMI 36±7.8 m/kg2. Mean time in the target range (70-180 mg/dl) was 87.8%. Mean time in the hypoglycemic range (&lt; 70 mg/dL) was 0.2%, Figure. No adverse events occurred.
Conclusion: This first in-human results show this novel fully autonomous closed-loop glucose control system designed for the ICU setting has the potential to achieve unparalleled glycemic control with minimal risk of hypoglycemia and paves the way for further research in the actual ICU setting.

Disclosure
F. Zahedi tajrishi: None. F. J. Pasquel: Consultant; Dexcom, Inc., Medscape, Research Support; Dexcom, Inc., Ideal Medical Technologies. G. Davis: Consultant; Medscape, Research Support; Insulet Corporation. M. Perez-guzman: None. L. I. Guerrero arroyo: None. G. Blanco: None. J. Varghese: None. S. Zahid: None. J. Dejournett: Stock/Shareholder; Ideal Medical Technologies. L. Dejournett: Employee; Ideal Medical Technologies.

Funding
Ideal Medical Technologies; Dexcom, Inc.
1121-P: Association between Self-Monitored Blood Glucose and Continuous Glucose Monitor in Youth with Type 1 Diabetes and Medicaid
Authors: CHAN JANICE , YEE JENNIFER K. , MOIN TANNAZ , EVERETT ESTELLE M. 
Published: June 2023

Background: In many states, patients with type 1 diabetes (T1D) and public insurance must demonstrate self-monitored blood glucose (SMBG) 3 times per day for continuous glucose monitor (CGM) approval. On January 2022, a policy change in California led to less stringent criteria for CGM approval, allowing for the evaluation of whether lower baseline SMBG leads to poor compliance and outcomes with CGM use.
Method: We used electronical health record data of pediatric patients with T1D, Medicaid at UCLA who started CGM after January 2019. Patients were stratified by SMBG frequency (&lt; 3 times per day vs ≥ 3 times per day). We used descriptive statistics to report baseline demographics, and chi-squared test, t-test and logistic regression to evaluate differences in compliance and change in A1c.
Results: We found 52 patients who met the criteria - 52% with SMBG &lt; 3 vs. 48% with SMBG ≥ 3. The patients were mostly male in both groups (63% vs. 60%). Patients with SMBG &lt; 3 were older at time of T1D diagnosis (10 vs 6.2 years old), started CGM at older age (16.1 vs 11.7 years old), more likely to start CGM after January 2022 (82% vs 40%), and had higher baseline A1c (10.9% vs 9.0%). At 3 and 6 months after starting CGM, there was significantly greater reduction in A1c in those with SMBG &lt;3 (1.6% vs 0.3%, p = 0.021, and 1.5% vs 0.23%, p = 0.01). There was no significant difference in CGM compliance (60% vs 72%, p = 0.21, and 69% vs 80%, p = 0.24, respectively) between the two groups. In adjusted models for 3 and 6 months, there were no significant association between CGM compliance (OR 1.04, 95%CI 0.68-1.60, and OR 1.06, 95%CI 0.76-1.28, respectively) and change in A1c.
Conclusion: Patients with lower baseline SMBG had similar CGM compliance and greater improvement in A1c than patients with higher baseline SMBG. This suggests that restricting CGM approval to those who are adherent to SMBG ≥3 may exclude use in patients who would benefit the most from CGM technology. Larger studies are needed to confirm these findings.

Disclosure
J.Chan: None. J.K.Yee: None. T.Moin: None. E.M.Everett: None.

Funding
University of California, Los Angeles Children's Discovery and Innovation Institute (CDI-FRSA-07012022); National Center for Advancing Translational Sciences (UL1TR001881)
1124-P: Outcomes of Health-Related Social Needs Screening in a Midwest Pediatric Diabetes Clinic Network
Authors: HALPIN KELSEE , RELAN SHILPI , ROGHAIR JASMINE , POMERANTZ RHIANNON , EVANS KATELYN , BARNES MITCHELL S. , FEINGOLD HEATHER , JACOB SAMANTHA N. , WINTERER COURTNEY , COLVIN JEFFREY D. , CLEMENTS MARK A. , DEWIT EMILY L. 
Published: June 2023

Background: Screening for health-related social needs (HRSNs) is recommended as part of standard diabetes care given the strong impact of social factors on health outcomes. We implemented a HRSN screen at routine diabetes clinic visits and assessed differences between youth with positive and negative screens.
Methods: A 6-item questionnaire was adapted from the Accountable Health Communities Health-related Social Needs Screening Tool to screen for HRSNs in 4 domains: 1) housing, 2) utilities 3) transportation, 4) food. A positive screen was defined as any positive response to a HRSN. Cross-sectional data was analyzed using chi-square or independent t-test.
Results: There were 4,119 screens completed over 14 months with 10% (n=438) being positive. The majority of positive screens were positive for a single HRSN (73%), most commonly food insecurity (66%). Table 1 compares youth with positive vs. negative screens. A higher percentage of positive screens was found in minority youth (p&lt;0.001), while a lower percentage was seen in youth with commercial insurance (p&lt;0.001) and diabetes technology use (p&lt;0.001). Most indicators of diabetes control were less optimal in the positive screen group.
Summary: Youth with HRSNs are at risk for adverse health outcomes. Screening for HRSNs can be incorporated into routine pediatric diabetes care and may help enhance health equity in delivery of care.

Disclosure
K.Halpin: None. J.D.Colvin: None. M.A.Clements: Consultant; Glooko, Inc., Research Support; Dexcom, Inc., Abbott Diabetes. E.L.Dewit: None. S.Relan: None. J.Roghair: None. R.Pomerantz: None. K.Evans: None. M.S.Barnes: None. H.Feingold: None. S.N.Jacob: None. C.Winterer: None.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust
1125-P: Real-World Pediatric Outcomes of Hybrid Closed-Loop Systems at a Large Urban Center
Authors: TILLOTSON CARA V. , NICHOLS PRESLEY H. , MOFFORD KAISHA , LEIBEL NATASHA , GANDICA RACHELLE 
Published: June 2023

Objectives: To study the real-world effect of hybrid closed loop systems (HCLS) on glycemic control and quality of life (QoL) in pediatric patients with T1D.
Methods: Patients 2-20 years old with T1D for ≥ 1 year were recruited when starting t:slim x2 with CIQ (TS) or Omnipod 5 (O5). We collected time in range (TIR), time low (BG &lt;70 mg/dl), A1c, and QoL survey responses at baseline and 3 months. Kruskal-Wallis rank sum test and chi-squared test were used for data analysis.
Results: Baseline data is in Figure 1. TIR improved by 7% after 3 months of HCLS use (p=0.004). Time low was unchanged after 3 months (p=0.3). Figure 2 shows results by subject.
Discussion: In this real-world study, HCLS improved TIR at 3 months without change in hypoglycemia. Data collection, enrollment, and analysis are ongoing with more results (A1c, QoL surveys) expected shortly.

Disclosure
C.V. Tillotson: None. P.H. Nichols: None. K. Mofford: None. N. Leibel: None. R. Gandica: None.

Funding
National Institutes of Health (5T32DK065522-18)
1126-P: Smart Insulin Pens—A Randomized, Crossover Pilot Trial Assessing Glycemic Control and Diabetes-Related Burdens in Adolescents and Emerging Adults with Diabetes
Authors: JACKSON SARAH , KUMAR SEEMA , AL NOFAL ALAA , HENTZ ROLAND , PITTOCK SIOBHAN , CREO ANA 
Published: June 2023

Introduction: Despite advancements in diabetes technology, some adolescents, and emerging adults with type 1 diabetes (T1D) remain on insulin injections. There is a need to reduce the burden of managing T1D in adolescents who use insulin injections.
Objective: To determine whether a smart insulin pen (InPen™) alters the glycemic control, glucose variability, burden of diabetes care, and parental experience in adolescents and emerging adults with T1D.
Methods: We performed a randomized, cross-over prospective pilot trial in participants 13-21 years with T1D. Participants were randomized to either 90 days of standard multiple daily injection management with continuous glucose monitor (CGM) use or 90 days of InPen™ and CGM use with a cross-over design, switching to the other arm for 90 days. We assessed diabetes control, diabetes distress, transition readiness, and parental experience of illness scales.
Results: Fourteen participants were enrolled in the trial, 1 withdrew. At baseline, median HbA1C was 8.1%, (IQR 7.7, 9.1). There was no statistically significant change in HbA1C, average glucose, glucose SD, total insulin dose, or time in range using the InPen™ relative to standard of care. Participants using the InPen™ had declining engagement with time, calculator use was 41.5% (IQR 5.0, 84.0) and 7% (IQR 0.0, 59.0) at 30 and 90 days, respectively. Questionnaire outcomes did not demonstrate statistically significant differences between treatments; diabetes distress did improve but not statistically significant.
Conclusion: InPen ™ use was not associated with improved diabetes control but did trend to decreasing diabetes distress. Low InPen™ calculator use could be a potential factor for the lack of improvement in glycemic control. Larger studies are warranted to study the effect of smart insulin pen technology on glycemic metrics and diabetes-related burdens in adolescents and emerging adults with T1D.

Disclosure
S.Jackson: Research Support; Medtronic. S.Kumar: None. A.Al nofal: None. R.Hentz: None. S.Pittock: None. A.Creo: None.