bluuebunny/crossref_metadata_2025_split huggingface dataset:
1197-P: A Pregnancy-Specific GMI Derived from Continuous Glucose Monitoring in Pregnant Women with Type 1 Diabetes
Authors: LING PING , LV JING , YANG DAIZHI , WANG CHAOFAN , ZHENG XUEYING , LUO SIHUI , YANG XUBIN , DENG HONGRONG , XU WEN , YAN JINHUA , WENG JIANPING 
Published: June 2023

Objective: The relationship between glycated hemoglobin (HbA1c) and glucose concentrations was widely explored in patients with diabetes, but all of them excluded pregnancies. The purpose of this study was to derive a best-fitting model to calculate glucose management indicator (GMI) from mean blood glucose (MBG) obtained from continuous glucose monitoring (CGM) among pregnant women with type 1 diabetes mellitus (T1DM).
Methods: A total of 272 CGM data and corresponding laboratory HbA1c from 98 pregnant women with T1DM in the CARNATION study were analyzed in this study. CGM data were collected to calculate MBG, time-in-range (TIR), and glycemic variability parameters. The relationships between the MBG and HbA1c during pregnancy, and postpartum were explored. Mix-effect regression analysis with polynomial terms and cross-validation method was conducted to investigate the best-fitting model to calculate GMI from MBG obtained by CGM.
Results: The pregnant women had a mean age of 28.91±3.78 years, with a diabetes duration of 8.79±6.18 years and a mean BMI of 21.07±2.48 kg/m2. The HbA1c levels were 6.13±1.02% and 6.41±1.00% during pregnancy and at postpartum (P=0.024). The MBG levels were lower during pregnancy than those at postpartum (6.49±1.11 mmol/L vs 7.11±1.46 mmol/L, P= 0.008). After adjusting the confounders of hemoglobin (Hb), BMI, trimesters, disease duration, MAGE and CV%, we developed a pregnancy-specific GMI-MBG equation: GMI for pregnancy (%) = 0.84-0.28* [Trimester]+0.08 * [ BMI in kg/m2 ] +0.01* [Hb in g/mL]+ 0.50 * [MBG in mmol/L].
Conclusion: We derived a pregnancy-specific GMI-MBG equation, which should be recommended for antenatal clinical care.

Disclosure
P.Ling: None. J.Yan: None. J.Weng: None. J.Lv: None. D.Yang: None. C.Wang: None. X.Zheng: None. S.Luo: None. X.Yang: None. H.Deng: None. W.Xu: None.

Funding
Science and Technology Planning Project of Guangzhou (202102010154); Shanghai Medical and Health Development Foundation (DMRFP_II_14); National Natural Science Foundation of China (81941022)
1198-P: Gestational Diabetes Mellitus and Childhood Neurodevelopment Disorders in Offspring—Results from a Large Multi–racial/ethnic Cohort Study
Authors: LIU XINYUE , JANZEN CARLA , SEAMANS MARISSA , NIANOGO ROCH , FEI ZHE , CHEN LIWEI 
Published: June 2023

Objectives: Gestational diabetes mellitus (GDM) has been linked to a higher risk of certain neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in offspring; however, other types of NDDs are rarely studied and whether the associations vary by race/ethnicity remains unknown. Thus, we aimed to examine the association of GDM with different types of NDDs and by race/ethnicity.
Methods: This retrospective cohort study included 14,480 singletons born to mothers without pre-existing diabetes and were followed to at least 1 year old in a large medical system in the US from 3/1/2013 to 8/31/2021. We ascertained GDM using the International Classification of Disease (ICD) codes (ICD-9: 648.8x; ICD-10: O24.4x) and defined NDDs (speech/language disorder [SLD], developmental coordination disorder [DCD], ASD, and others [ADHD, behavioral disorder, intellectual disability, and learning difficulty]) using validated algorithms. We compared the risk of NDDs during the entire follow-up period between offspring born to mothers with GDM and without GDM using multivariable Cox regression models.
Results: During the median of 3.2 years (interquartile range: 2.0-4.9) follow-up period, GDM was significantly associated with a higher risk of SLD (adjusted hazard ratio: 1.62; 95% CI: 1.10, 2.40), DCD (2.35; 95% CI: 1.38, 4.02), ASD (3.28; 95% CI: 1.42, 7.58), and other NDDs (3.20; 95% CI: 1.55, 6.60) among children born to non-Hispanic White mothers. No significant association of GDM with any type of NDDs was observed among other race/ethnicity.
Conclusion: Young children born to non-Hispanic White mothers with GDM had an elevated risk of NDDs. However, the results may be affected by differential outcome misclassification by race/ethnicity.

Disclosure
X.Liu: None. C.Janzen: None. M.Seamans: None. R.Nianogo: None. Z.Fei: None. L.Chen: None.
12-OR: Urine Lactate Is a Disease Biomarker for Diabetic Kidney Disease
Authors: KUGATHASAN LUXCIA , DARSHI MANJULA , SRINIVASAN SRIDHAR VIKAS , DREL VIKTOR , TUMOVA JANA , LIU JIAN-JUN , WANG JIEXUN , PERKINS BRUCE A. , LYTVYN YULIYA , NATARAJAN LOKI , CHI LIM SU , WAIKAR SUSHRUT , OSMAN YAHYA M. , HE JIANG , VALLON VOLKER , HALLAN STEIN , CHERNEY DAVID , SHARMA KUMAR , STUDY INVESTIGATORS CRIC 
Published: June 2023

As lactate (LA) elevation is associated with mitochondrial dysfunction, we examined the role of LA in diabetic kidney disease (DKD) progression. Urine LA (ULA) was measured in patients with type 2 diabetes (T2D) in three independent cohort studies (HUNT3, SMART2D, and CRIC). ULA and plasma LA (PLA) were also measured in patients with type 1 diabetes (T1D) following eu- or hyperglycemic clamp, in mouse kidney sections, and sodium-glucose cotransporter-2 (SGLT2)-deficient mice. Mitochondrial functional changes in human kidney proximal tubule (HK2) cells were assayed in response to exogenous LA. Subjects in HUNT3 with DKD (n=39) had elevated ULA levels compared to healthy controls (n=53, p=0.023) (Fig. 1). In subjects with T2D from SMART2D (n=230) and CRIC (n=889), the third tertile of ULA/creatinine ratio was associated with a greater estimated glomerular filtration rate (eGFR) decline [-1.63 mL/min/1.73m2/year, p=0.007, and -0.63 mL/min/1.73m2, p=0.042], relative to the first tertile. Acute hyperglycemia stimulated PLA (p&lt;0.0001) and ULA (p=0.001) in patients with T1D (n=39), and in kidney sections incubated with high glucose. Compared to wild-type, SGLT2-deficient mice had lower ULA levels. LA above 2.5 mM inhibited oxygen consumption rate in HK2 cells. Elevated ULA/creatinine ratio inhibits mitochondrial function in diabetes and identifies subjects at risk of rapid renal decline independent of chronic glycemic control.

Disclosure
L.Kugathasan: None. L.Natarajan: None. S.Lim: None. S.Waikar: None. Y.M.Osman: None. J.He: None. V.Vallon: Research Support; NIH - National Institutes of Health, Gilead Sciences, Inc., Merck Sharp & Dohme Corp., Novo Nordisk, Maze Therapeutics, Boehringer-Ingelheim, Speaker's Bureau; AstraZeneca. S.Hallan: None. D.Cherney: Other Relationship; Boehringer Ingelheim-Lilly, Merck, AstraZeneca, Sanofi, Mitsubishi-Tanabe, Abbvie, Janssen, Bayer, Prometic, BMS, Maze, Gilead, CSL-Behring, Otsuka, Novartis, Youngene, Lexicon and Novo-Nordisk, Research Support; Boehringer Ingelheim-Lilly, Merck, Janssen, Sanofi, AstraZeneca, CSL-Behring and Novo-Nordisk. K.Sharma: Advisory Panel; Reata Pharmaceuticals, Inc., Otsuka America Pharmaceutical, Inc. Cric study investigators: n/a. M.Darshi: Employee; Janssen Research & Development, LLC. V.Srinivasan sridhar: Other Relationship; Merck & Co., Inc. V.Drel: None. J.Tumova: None. J.Liu: None. J.Wang: None. B.A.Perkins: Advisory Panel; Dexcom, Inc., Insulet Corporation, Novo Nordisk, Sanofi, Vertex Pharmaceuticals Incorporated, Other Relationship; Abbott, Medtronic, Sanofi, Research Support; Novo Nordisk, Bank of Montreal (BMO). Y.Lytvyn: None.
1201-P: Circulating C1q/TNF-Related Protein 6 (CTRP6) and CTRP9 as Potential Biomarkers for Early Gestational Diabetes Mellitus
Authors: LIU YUTING , CHEN YANNA , GU WENSHA , YIN LULU , CAO HUIMIN , SHI MIN 
Published: June 2023

Background: The growing evidence has been verified that C1q/TNF-related protein 6 (CTRP6) and CTRP9, secreted by adipose tissue, can regulate glucose and lipid metabolism. However, the effect of CTRP6 and CTRP9 in gestational diabetes mellitus (GDM) is scarcely known. This study aimed to evaluate the potential clinical value of CTRP6 and CTRP9 in GDM.
Methods: A total of 35 GDM subjects and 37 healthy controls, between 24 and 28 weeks of gestation, were included in the study. Diagnosis of GDM was made according to American Diabetes Association criteria. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of CTRP6 and CTRP9. Fasting insulin (FINS), IL-6, and TNF-α were detected by Luminex-xMAP technology. The main clinical characteristics, such as Anthropological data and metabolic parameters, were also obtained.
Results: Circulating CTRP6, CTRP9, IL-6 and TNF-α were significantly elevated in GDM subjects compared with controls. Pearson correlation analysis showed that CTRP6 and CTRP9 were positively correlated with FPG (r = 0.280, P = 0.017 and r = 0.559, P &lt; 0.001, respectively) and HOMA-IR (r = 0.250, P = 0.035 and r = 0.382, P = 0.001, respectively). Moreover, CTRP9 was also positively correlated with FINS (r = 0.253, P = 0.032), IL-6 (r = 0.283, P = 0.016) and TNF-α (r = 0.266, P = 0.024). The area under the receiver operating characteristic curve (AUC-ROC) indicated that the combination of CTRP6 and CTRP9 was more effective in predicting GDM than single indicators.
Conclusion: Elevated CTRP6 and CTRP9 in GDM patients may be related to insulin resistance. And inflammatory factors may mediate the role of CTRP9 in insulin resistance. In addition, CTRP6 and CTRP9 may serve as candidate predictors in patients with early GDM.

Disclosure
Y.Liu: None. Y.Chen: None. W.Gu: None. L.Yin: None. H.Cao: None. M.Shi: None.

Funding
National Natural Science Foundation of China (81700723)
1202-P: Comparison of the Clinical Characteristics, Glycemic Control, and Pregnancy Outcomes between Wave I and III of COVID-19 Pandemic in Women with Gestational Diabetes Mellitus—A Reference Center Report
Authors: WILK MAGDALENA , KANIA MICHAL , MALECKI MACIEJ 
Published: June 2023

Background: The medical care for gestational diabetes mellitus (GDM) during the COVID-19 pandemic was influenced by changing epidemiological conditions and governmental regulations. Aim To compare the clinical data of GDM women between wave I and III of COVID-19 pandemic.
Materials and methods: We performed retrospective analysis of the medical records from the GDM clinic of the University Hospital in Krakow, and compared the periods of March-May 2020 and March-May 2021, corresponding to wave I and III, respectively.
Results: GDM women during wave I (N=118) as compared to wave III (N=116) were older (33.0±4.7 vs 32.1±4.8 years; p=0.03), booked later (21.8±8.4 vs 20.3±8.5 weeks; p=0.08) and had the last visit earlier (35.5±2.0 vs. 35.7±3.2 weeks; p&lt;0.01). The pregnancy weight gain were similar (8.9±5.6 vs 8.4±5.6 kg; p=NS). Telemedicine consultations were used more frequently during wave I (36% vs 18% of all visits; p&lt;0.01) while insulin therapy less often (64.7% vs. 80.2%; p&lt;0.01). The mean fasting self-control glucose did not differ (4.8±0.3 vs 4.8±0.3 mmol/l; p=0.25) but a worse postprandial glycemia during wave I was reported (6.6±0.9 vs. 6.3±0.6 mmol/l; p&lt;0.01). Pregnancy outcome data were available from 77 and 73 pregnancies, respectively. The groups were similar for the delivery time (38.2±1.4 vs. 38.1±1.6 weeks), cesarean sections (58.4% vs. 61.3%), APGAR score (9.7±1.0 vs. 9.7±1.0 pts) and birth weight (3306.6±460.6 g vs 3243.9±500.2) (p=NS for all), slightly higher length occurred for Wave I (54.3±2.6 cm vs. 53.3±2.6; p=0.02).
Conclusions: We identified differences in many areas between GDM women booking either during wave I or III of COVID-19 pandemic, however, the pregnancy outcomes were mostly similar.

Disclosure
M.Wilk: None. M.Kania: None. M.Malecki: Advisory Panel; Abbott Diabetes, Novo Nordisk, Lilly, Sanofi, Dexcom, Inc., Bayer Inc., Research Support; Medtronic, Speaker's Bureau; AstraZeneca, AlfaSigma, Merck & Co., Inc., BIOTON S.A., Servier Laboratories, KRKA.
1203-P: Elevated HOMA-IR and IL-6 in Pregnant Women with Metabolic-Dysfunction–Associated Fatty Liver Disease and Gestational Diabetes Mellitus
Authors: CHAI THORA Y.L. , PASUPATHY DHARMINTRA , GEORGE JACOB , WAH CHEUNG N. 
Published: June 2023

Background: It is uncertain whether biomarkers differ in singleton pregnant women with metabolic dysfunction-associated fatty liver disease (MAFLD) and gestational diabetes mellitus (GDM).
Methods: A prospective cohort study was conducted. A FibroScan® was performed between 10-24 weeks. A controlled attenuation parameter score ≥233.5dB/m indicated MAFLD. GDM was diagnosed with IADPSG criteria. Between 24-30 weeks, fasting blood was collected to determine serum levels of tumour necrosis factor alpha (TNF-α), interleukin 6 (IL-6), fibroblast growth factor 21 (FGF-21), high molecular weight adiponectin (HMW-APN), glucose and insulin. HOMA-IR was calculated: [insulin (mU/L) × glucose (mmol/L)]/22.5. Four groups of control (no GDM/MAFLD), MAFLD only, GDM only, MAFLD & GDM were formed. Biomarkers were analyzed by general linear models after log transformation, adjusted for age, body mass index, ethnicity and nulliparity.
Results: Of 120 women, 47 were control, 37 MAFLD only, 14 GDM only and 22 MAFLD & GDM. Compared to controls, MAFLD & GDM had 1.8-fold higher HOMA-IR and IL-6, significantly elevated over GDM only and MAFLD only (Table 1). No significant differences in TNF-α, FGF-21 or HMW-APN occurred (Table 1).
Conclusions: Significantly elevated HOMA-IR and IL-6 in pregnant women with MAFLD & GDM suggests a more insulin resistant and inflammatory phenotype.

Disclosure
T.Y.L.Chai: None. D.Pasupathy: None. J.George: None. N.Cheung: None.

Funding
Diabetes Australia Research Program (Y21GCHEW)
1206-P: Benefits of Virtual Shared Medical Appointments for Gestational Diabetes
Authors: EHRENBERG BUCHNER STACEY , HART HILLARY , BEDE KRISTEN M. , ISAACS DIANA 
Published: June 2023

Background: The rate of gestational diabetes (GDM) has increased over the past decade, now effecting up to 14% of pregnancies worldwide. Studies show that these woman benefit from diabetes education, nutrition education and a maternal-fetal medicine (MFM) consultation. However, accommodating this increasing number of women, especially in the middle of a global pandemic, can be challenging.
Purpose: First, to develop a curriculum for women with GDM to empower them to optimally manage their diabetes in pregnancy. Second, to evaluate whether this curriculum could be used in a virtual shared medical appointment (SMA) to accommodate more patients while protecting their health during the COVID-19 pandemic.
Results: A virtual SMA was created in the electronic medical record using a zoom platform. Up to ten women are seen during this 2-2.5 hour visit. From 1/1/2022 through 12/31/22, 159 women participated in the program. On average, women attended the SMA within 12.9 days of the consult request. All women received a copy of the curriculum via email prior to the visit. During the visit, patients received their MFM consult, diabetes education, and nutrition counseling in a group format. The visit included a one-on-one breakout room with a MFM provider to discuss personal history, glucose levels and use of medication if necessary. Women were billed through insurance for the MFM consultation as well as group nutrition counseling. Of the 159 participants, 139 have delivered. Eighty-nine (64%) women had a vaginal delivery and 50 (36%) had a cesarean delivery.
Conclusion: A virtual SMA is an efficient and effective format for educating women with GDM during the COVID-19 pandemic and beyond. Access to these resources was faster for women in the SMA versus those who received individual MFM consultations, nutrition counseling and diabetes education. The rate of cesarean delivery was lower than the rate reported in the literature for women with GDM. Patient reported outcomes regarding this format have also been favorable.

Disclosure
S.Ehrenberg buchner: Advisory Panel; Dexcom, Inc. H.Hart: None. K.M.Bede: None. D.Isaacs: Speaker's Bureau; Dexcom, Inc., Abbott, Eli Lilly and Company, Medtronic, Novo Nordisk.
1209-P: Mapping the Characteristics of Gestational Diabetes Prevention Lifestyle Interventions
Authors: PENA ARMANDO , MILLER ALISON , CAMPBELL ANGELA G. , SCIFRES CHRISTINA M. 
Published: June 2023

Introduction: The literature on gestational diabetes mellitus (GDM) prevention lifestyle interventions is conflicting with heterogeneity across study characteristics. The purpose was to map the sample, intervention, and physiologic outcome characteristics of randomized control trials (RCT).
Methods: Article inclusion criteria: lifestyle intervention RCTs (no medications), all ages and phenotypes, reported on GDM rates. We searched PubMed and CINAHL using key term combinations including lifestyle, physical activity, nutrition, exercise, dietary, intervention, program, gestational diabetes, diabetes during pregnancy, pregnant, pregnancy, nulliparous, gestation, prevention, prevent. Three reviewers considered 87 unique abstracts for full text review. Sample, intervention, and GDM-relevant physiologic outcome (beyond gestational weight gain) characteristics were mapped.
Results: We reviewed 19 studies. Common sample inclusion criteria across studies were gestational age (63% studies), chronological age and weight status (each 58%), singleton pregnancy (47%), and GDM risk factors (26%). Studies represented adults with overweight (M±SD, Age 30.5±1.8 y, pre-pregnancy BMI 29.3±4.3 kg/m2) and gestational age &lt;20 wk. Latinas (n=1 studies) and Blacks (n=4) were underrepresented. Six studies (32%) used multi-disciplinary teams. Dietitians (44% studies), nurses (22%) and exercise specialists (16%) were common implementers with nutritionists, physicians, lifestyle coaches, and research staff each used in &lt;12% studies. Few studies used theoretical frameworks: Social Cognitive Theory (n=3 studies), Control Theory (n=2), Health Belief Model (n=1). GDM criteria most used were ADA (68% studies) compared to WHO (16%). Insulin sensitivity was the most common GDM risk factor (n=5).
Conclusion: GDM prevention lifestyle interventions should prioritize high-risk racial/ethnic groups, multi-level frameworks, multi-disciplinary delivery, and novel biomarkers.

Disclosure
A.Pena: None. A.Miller: None. A.G.Campbell: None. C.M.Scifres: None.
1211-P: Development and Testing of Eating Habits Scale for GDM
Authors: AMAYA MARIKO , SEKIJIMA KAYOKO , KOYAMA YU , YOSHIOKA TAISHI , OHARA NOBUMASA , YAMADA TAKAHO , SODA SATOSHI , YAHATA KAZUAKI , SONE HIROHITO , ASAZAWA KYOKO , ARIMORI NAOKO 
Published: June 2023

In the present study, we have attempted to develop an eating habits scale for gestational diabetes women for supporting diet therapy and maintaining QoL during pregnancy. By searching 552 previous articles, we developed a gestational diabetes scale consist of 44 items related to dietary life in women with gestational diabetes. Next, we introduced this scale into two surveys for evaluating the reliability and validity of the scale. The first survey conducted conforming factor analysis and exploratory factor analysis based on data from a purposive sample of 235 patients. The second survey confirmed the stability of data from 81patients by test-retest. The patients consisted of gestational diabetes women in diet. Scale development involved several phases, including item development, reliability testing, criterion-related validity, and construct validity testing. Construct validity was tested with exploratory factor analysis and resulted in 14 items with a 2-factor solution: “Diet therapy for gestational diabetes” and “Subjective health of gestational diabetes women”. The total score and subscale scores of eating habits scale showed excellent internal consistency. In addition, confirmatory factor analysis indicated that a 2-factor model for 235 patients. Cronbach’s α coefficient was 0.906 for the overall scale, confirming general internal consistency. The model showed approximately good fit to the data by confirmatory factor analysis (GFI = 0.924, AGFI = 0.883, RMSEA = 0.064). A significant correlation was observed between eating habits scale and SF-8 Physical Component Summary (r = 0.039) as well as SF-8 Mental Component Summary (r = 0.047). Sufficient criterion-related validity was not confirmed by the HbA1c value (r = -0.092). We could not show enough validity of eating habits scale for gestational diabetes women in this study. However, high reliability indicated by the stability indicated with repeated testing has shown, therefore, this scale may useful for evaluating eating habits for gestational diabetes women.

Disclosure
M. Amaya: None. K. Sekijima: None. Y. Koyama: None. T. Yoshioka: None. N. Ohara: None. T. Yamada: None. S. Soda: None. K. Yahata: 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. Asazawa: None. N. Arimori: None.

Funding
Japan Society for the Promotion of Science (17K17476)
1212-P: Early A1C vs. Two-Step Method on Adverse Pregnancy Outcomes
Authors: BODYCOT KATHERINE C. , HUANG RACHEL , AL-KOUATLY HUDA B. , MCLAREN RODNEY 
Published: June 2023

There is limited data on the optimal screening method for early gestational diabetes. We sought to determine whether an early A1c or two-step glucose tolerance test (GTT) better identified pregnancies with adverse outcomes.
This was a retrospective cohort study of patients who met the American College of Obstetricians and Gynecologist’s criteria for early screening and delivered between 2017-2020 at a single center. Patients with a A1c and/or the two-step (1-hr GTT, followed by 3-hr GTT) method at &lt;20 weeks were included. Adverse pregnancy outcomes were compared between patients with A1c ≥5.7% and those with A1c &lt;5.7% using univariate and multiple variable analyses. In a similar fashion, patients with a positive or negative two-step method were compared.
There were 883 patients who received either a A1c (N=259) or underwent the two-step method (N=624). Patients with an A1c ≥5.7% had higher rates of macrosomia (21.6% vs. 5.1%) but lower rates of neonatal hypoglycemia (3.4% vs. 14.7%) than those with a A1c &lt;5.7%. Patients who had a positive two-step method had higher rates of cesarean delivery (56.1% vs. 34.5%) and preterm delivery &lt;32 weeks (12.2% vs. 2.2%).
A1c ≥5.7% in early pregnancy was associated with higher rates of macrosomia compared to those with an A1c &lt;5.7%. Despite treatment, screening positive by an early two-step method had higher rates of cesarean delivery and preterm delivery &lt;32 weeks than those who tested negative by the same method.

Disclosure
K.C.Bodycot: None. R.Huang: None. H.B.Al-kouatly: None. R.Mclaren: None.