bluuebunny/crossref_metadata_2025_split huggingface dataset:
472-P: Pro-B-Type Natriuretic Peptide Strongly Predicts Future Cardiovascular Events in Cardiovascular Disease Patients with NAFLD as Well as in Those without NAFLD
Authors: MAECHLER MAXIMILIAN , SPRENGER LUKAS , MADER ARTHUR , LARCHER BARBARA , VONBANK ALEXANDER , PLATTNER THOMAS , LEIHERER ANDREAS , MUENDLEIN AXEL , DREXEL HEINZ , SAELY CHRISTOPH H. 
Published: June 2023

Elevated pro-B type natriuretic peptide (pro-BNP) has been found to be a strong marker of cardiovascular risk in several high-risk populations. However, the power of pro-B type natriuretic peptide (pro-BNP) to predict future cardiovascular events in patients with the combination of established cardiovascular disease and nonalcoholic fatty liver disease (NAFLD) is unclear and is addressed in the present study. We enrolled 794 patients with established cardiovascular disease, 553 with angiographically proven stable CAD and 241 with sonographically proven peripheral artery disease. Prospectively, cardiovascular events were recorded over a mean follow-up period of 8.7±3.3 years. At baseline, pro-BNP was not significantly different in patients with NAFLD (n=394) than in those who did not have NAFLD (796±2208 vs. 798±2520 pg/ml; p=0.234). During follow-up, 376 patients suffered cardiovascular events; the event rate was significantly higher in patients with NAFLD than in subjects without NAFLD (56.6 vs. 43.4%; p&lt;0.001). Pro-BNP predicted cardiovascular events in the total study population, with a standardized adjusted hazard ratio (HR) of1.36 [1.26-1.46]; p&lt;0.001. Further, pro-BNP predicted cardiovascular events in patients with NAFLD (HR 1.45 [1.28-1.65]; p&lt;0.001) as well as in those who did not have NAFLD (HR 1.34 [1.19-1.50]; p&lt;0.001). Interaction terms pro-BNP x NAFLD were non-significant for cardiovascular events (p=0.198), indicating that the power of pro-BNP to predict cardiovascular events did not differ significantly between cardiovascular disease patients with NAFLD and those who did not have NAFLD. We conclude that pro-BNP strongly predicts cardiovascular events in cardiovascular disease patients with NAFLD as well as in those without NAFLD.

Disclosure
M. Maechler: None. L. Sprenger: None. A. Mader: None. B. Larcher: None. A. Vonbank: None. T. Plattner: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None. C.H. Saely: None.
48-OR: Maternal Triglycerides in Diet-Controlled GDM Correlate with Newborn Triglycerides and Infant Fat Mass at Four Months of Life
Authors: ROZANCE PAUL J. , BARBOUR LINDA (LYNN) A. , DUNN EMILY Z. , FARABI SARAH S. , HIRSCH NICOLE , ROLLOFF KRISTY P. , FRIEDMAN JACOB E. , HERNANDEZ TERI L. 
Published: June 2023

The early hours of newborn (NB) life are critical for metabolic transition from the prenatal to postnatal period and possibly subsequent metabolic development. Although the relationship between maternal glucose and neonatal hypoglycemia in gestational diabetes (GDM) is strongly supported, little is known about the relationship between maternal and NB triglycerides (TG). We tested the hypothesis that maternal TG in GDM would correlate positively with NB pre-feed TG (NBpfTG) at 24hrs, and that NBpfTG would correlate with infant adiposity (Inf%fat). After GDM diagnosis (~28-30 wks), 16 diet-controlled GDM women (mean±SD; BMI 32±1) were randomized to eucaloric diets differing in carbohydrate and fat percentages (all food provided). Fasting (F) and 1-hr/2-hr postprandial (PP) glucose, insulin, and TG were measured during breakfast test meals at 31 and 36 wks. Newborn “fasting” blood (NBpfTG, NBpfGluc) was collected at 24 hrs. Inf%fat was measured at 24 hrs and 4 mos (PeaPod). All women met conventional glucose targets with diet alone; no neonates had hypoglycemia. At 31 but not 36 wks, maternal FTG and PPTG were correlated with NBpfTG (92±7mg/dL)(r=0.52-0.53, p=0.03 both) and NBpfTG correlated with 24 hr Inf%fat (r=0.50, p=0.06). Maternal fasting insulin, HOMA-IR, glucose and PP glucose at 31 and 36 wks correlated with Inf%fat at 24 hrs (r=0.47-0.68, p&lt;0.05 all). Strikingly, NBpfTG were uniquely and highly correlated with Inf%fat at 4 mos (r=0.81, p&lt;0.0001); NBpfGluc was not. Inf%fat was similar between maternal diet groups (p&gt;0.05). These data show that maternal TG soon after GDM diagnosis correlated with NBpfTG, which in turn correlated with Inf%fat at 24 hrs, but had a sustained, stronger correlation with Inf%fat at 4 mos. This connection between 32 wk maternal TG and NBpfTG, and their association with Inf%fat from 24 hrs to 4 mos support future studies to address whether maternal TG might be therapeutically targeted to normalize fetal growth in well-controlled GDM.

Disclosure
P.J.Rozance: None. L.A.Barbour: None. E.Z.Dunn: None. S.S.Farabi: None. N.Hirsch: None. K.P.Rolloff: None. J.E.Friedman: None. T.L.Hernandez: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK101659); Janssen Research and Development; National Center for Advancing Translational Sciences (UL1TR002535)
522-P: HealSmart—Evaluating Key Factors Affecting Diabetic Wound Healing for Personalized Care
Authors: CAY GOZDE , FINCO GRACI , GARCIA JASON A. , SALAZAR ELIA , VIGANO DAVIDE , MACAGNO MAURIZIO , ARMSTRONG DAVID G. , NAJAFI BIJAN 
Published: June 2023

Diabetic foot ulcers (DFUs) are serious complication of diabetes. Offloading devices treat DFUs by distributing force and reducing pressure across the wound. Adhering to appropriate use of offloading devices is a key strategy to promote DFU healing. However, some people who are highly adherent to offloading device use still do not heal. Factors such as wound and diabetes characteristics, motor function, and patient reported outcomes may help distinguish healed and non-healed patients. In our study, we analyzed data from 23 participants. Factors were graded on a scale from 0 to 10 based on thresholds found in the literature (Figure 1). We then calculated the effect size of each factor using Cohen's d between the healed and non-healed groups (Figure 2). Our results showed that cognition had the largest effect size, with a value of d = 1.63.

Disclosure
G.Cay: None. G.Finco: None. J.A.Garcia: None. E.Salazar: None. D.Vigano: Board Member; Sensoria Health Inc. M.Macagno: Board Member; Sensoria Health Inc. D.G.Armstrong: Research Support; Medaxis LLC. B.Najafi: Consultant; BioSensics LLC, Mölnlycke Health US, LLC, Research Support; AVAZZIA, EO2 Concept, LifeNet, Neurometrix, Medline, SmarTek21.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK124789)
527-P: mHealth Intervention for Low-Income Chinese Immigrant Families with Type 2 Diabetes—Feasibility, Acceptability, and Potential Efficacy
Authors: SHI YUN , ISLAM NADIA , ANN SEVICK MARY , LI HUILIN , WANG CHAN , BAO HAN , XU XINYI , LIEU RICKI , JIANG YULIN , HU LU 
Published: June 2023

Objectives: To test the feasibility, acceptability, and potential efficacy of a mHealth intervention tailored for low-income Chinese immigrant families with type 2 diabetes (T2D).
Methods: We conducted a RCT with baseline, 3-, and 6-month measurements. Participating dyads, Chinese immigrants with T2D and their families/friends from NYC were randomized into the intervention group (n=11) or the wait-list control group (n=12). Dyads in the intervention group received 2 videos weekly for 12 weeks. Video topics cover T2D self-management, behavioral techniques, and family-oriented sessions. Study staff helped participants set goals for T2D management, followed their progress biweekly, and addressed any concerns. Feasibility and acceptability were measured respectively by the retention rate and video watch rate, and a satisfaction survey. Patients’ HbA1c, weight, and self-management behaviors were also assessed.
Results: Most patients (n = 23; mean age 56±9 years; 52% male) and families/friends (mean age 54±11 years; 52% female) had high school education or less (69% and 69%), annual household income &gt; $25,000 (68%), and limited English proficiency (87% and 86%). The retention rates at both follow-ups were 87% with a mean watch rate of 76.7% (7.0%). Patients and families/friends rated satisfaction as 9.4 and 10 out of 10. Despite no between-group differences, the intervention group had significantly lower HbA1c (p=0.014) and improved self-management (p=0.009), and lost 12 lbs on average in 6 months (p=0.079).
Conclusions: A culturally-tailored, family-based mHealth intervention is feasible and acceptable among low-income, limited English-proficient Chinese families with T2D in NYC. Significant changes in HbA1c and self-management in the intervention group indicate this intervention may have potential efficacy. Given the small sample size of this study, a future RCT with adequate power is needed to test efficacy.

Disclosure
Y.Shi: None. L.Hu: None. N.Islam: None. M.Sevick: None. H.Li: None. C.Wang: None. H.Bao: None. X.Xu: None. R.Lieu: None. Y.Jiang: None.

Funding
National Institutes of Health (P30DK111022)
54-LB: The Kids Are Not Alright—Capturing the Need for Effective Intervention for Adolescents with Elevated A1C
Authors: WAGNER DAVID V. , CLEMENTS MARK A. , RAYMOND JENNIFER , WONG JENISE C. , NARANJO DIANA , REED ALISON , TORRES KRISTEN A. , MELNICK SYDNEY , FLORES GARCIA JAQUELIN , BONILLA OSPINA ANDREA , HILLIARD MARISA E. , HARRIS MICHAEL A. 
Published: June 2023

Background: Adolescents with T1D and elevated A1c are at high risk of acute and chronic complications. While behavioral health interventions have demonstrated promise in optimizing A1c, real-life clinical practice indicates uncertainty regarding which youth will show improvement, extent of improvement, and factors predicting complications over time.
Methods: This 5-site longitudinal study enrolled caregivers (n=218) of youth aged 12-17 yrs (M=14.6 ±1.6 yrs) with T1D for &gt;1 year and ≥ one A1c &gt;10% in past year. Data included admissions, ED visits, and A1c one year pre- through 6 months post-enrollment. Family members reported on baseline functioning across multiple domains. Inferential tests (e.g., chi square, nonparametric) examined change over time in A1c and utilization as well as predictors of future ED visits.
Results: Acute utilization did not change over time. A1c post enrollment significantly decreased from 11.1% ±1.5% to 10.9% ±2.1% (p=.03), but absolute change was minimal. 40.2% of youth did not have an A1c value available post enrollment. Caregiver reports of higher diabetes distress, higher conflict with healthcare providers, and lower social support were associated with risk of future ED visits (p&lt;.01).
Conclusion: Findings indicate strong need for systematic psychosocial screening and more intensive tailored behavioral intervention efforts for this youth with elevated A1c.

Disclosure
D. V. Wagner: None. A. Bonilla ospina: None. M. E. Hilliard: None. M. A. Harris: None. M. A. Clements: Consultant; Glooko, Inc., Research Support; Dexcom, Inc., Abbott Diabetes. J. Raymond: None. J. C. Wong: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. D. Naranjo: None. A. Reed: None. K. A. Torres: None. S. Melnick: None. J. Flores garcia: None.

Funding
JDRF
553-P: Perspectives on Culture, Health Beliefs, and Diabetes Risk among Asian Indians in Atlanta—A Qualitative Study
Authors: ARORA DIVYA , RAJWANI INAARA , SHAH MEGHA K. 
Published: June 2023

Background and Purpose: South Asians are a fast-growing ethnic minority in the Atlanta metro area and are at high risk for developing diabetes. In order to create culturally competent practices and interventions, it is critical to understand the nuances in health beliefs, attitudes towards diabetes, and cultural and religious practices.
Methods: Design: Key informant interviews were conducted with participants as part of a mixed-methods study. After 5 interviews, a codebook was created with themes through inductive analysis, and interview questions were adjusted for clarity. Analyses were done using MAXQDA. Transcripts were reviewed and coded; any discrepancies in coding were discussed and resolved in weekly meetings. Semi-structured 60 minute interviews (n=8) were conducted online or in-person and recorded.
Results: Of 2,460 participants enrolled in the parent study, 71 were selected for interviews based on age (18-79), gender, and religious backgrounds. Stratifying by generational cohort and nativity revealed differences in beliefs about healthy behavior (including physical activity and nutritional preferences) and interactions with various healthcare systems. Participants’ beliefs on mindfulness, meditation, and cultural foods affected their health and lifestyle choices. Most immigrants had different perceptions of western medicine and experiences with the U.S. healthcare system compared to ayurvedic medicine. Common areas of confusion included prescriptions and obtaining medications, insurance status, and distrust in medical practitioners. Conversely, first generation participants reported greater health knowledge and engagement in healthy practices to prevent diabetes.
Discussion: Health beliefs and practices among South Asians vary by nativity, education, age, generational cohort, and sociocultural customs. Future studies should address how nativity and age might affect engagement in lifestyle change for South Asians.

Disclosure
D.Arora: None. I.Rajwani: None. M.K.Shah: None.
556-P: Early Results of Expanded Options for Demonstrating Risk Reduction in the National Diabetes Prevention Program (National DPP)
Authors: LANDAU ERIN O. , ELY ELIZABETH 
Published: June 2023

In 2012, CDC’s Diabetes Prevention Recognition Program (DPRP) released the first version of the DPRP Standards and Operating Procedures, which defined risk reduction as a minimum 5% mean weight loss for participants who completed the National DPP lifestyle change program (LCP). The most recent version of the Standards, implemented in May 2021, established 3 metrics to show risk reduction: a minimum 5% weight loss; or a minimum 4% weight loss plus a weekly mean of 150+ physical activity minutes; or a 0.2% reduction in HbA1c. As of October 2022, the DPRP has received data from 4,200+ organizations on 650,000+ participants ever enrolled in the LCP. This analysis is limited to 29,352 participants who completed the program after the 2021 Standards were implemented. This study focuses on the 765 participants who provided a pre-intervention HbA1c result within the prediabetes range (5.7%-6.4%), and a post-intervention HbA1c in months 9-12 of the yearlong program. Of those, 211 demonstrated a 0.2% reduction in HbA1c; 53 had a 0.1% reduction in HbA1c; 456 showed no change; and 45 had an increase in HbA1c. The median weight loss for participants who demonstrated a 0.2% reduction in HbA1c was 6.0%, and their median reported physical activity minutes per week was 182.6. This is compared to a 4.5% median weight loss and 156.9 median reported physical activity minutes per week among those who did not demonstrate a 0.2% HbA1c reduction. Those who provided a pre-intervention HbA1c in the prediabetes range (5.7%-6.4%), regardless of whether they provided a post-intervention HbA1c, had a median weight loss of 5.0% compared to those who did not provide a pre-intervention result (4.5% median weight loss). The DPRP has received data on an additional 9,295 participants who have provided a pre-intervention HbA1c but have not yet concluded the program. As a result, those achieving a 0.2% HbA1c reduction may increase over the next 12 months and will provide the opportunity for deeper analysis.

Disclosure
E.O.Landau: None. E.Ely: None.
568-P: Study of the Effect of PPARß/δ Activation on Diabetic Cardiomyopathy
Authors: ROSTAMI ADEL 
Published: June 2023

Diabetic cardiomyopathy (DC), the leading cause of death among people with diabetes, is definedas the occurrence of myocardial dysfunction in diabetic patients that is not directly attributableto coronary artery disease, hypertension, or valve disease. No specific drugs have yet beenapproved for treating DC and the use of Peroxisome Proliferator-Activated Receptor (PPAR)β/δagonists for the treatment of this disease show promise. Here, we examined as to whethertreatment with a PPARβ/δ agonist can prevent or ameliorate this pathology and as to whetherstreptozotozin (STZ)-induced DC is exacerbated in PPARβ/δ-deficient mice. In the STZ-induced mouse model of DC, an increase in cardiac fibrosis and an impairment inglucose and fatty acid metabolism was observed. Treatment with the PPARβ/δ agonist GW0742partially reduced the STZ-induced fibrosis, inflammation and metabolic disturbances, suggestingthat PPARβ/δ activation might be a potential target to prevent this disease suggesting a closerelation between inflammation and fibrosis in cardiac dysfunction of DC. In addition, we showthat PPARβ/δ suppression exacerbated hyperglycemia-induced DC and that PPARβ/δ activationthrough administration of agonists like GW501516 prevented the induction of some of themolecular mechanisms involved in the development of DC in these cells. Overall, these findingsdemonstrate the implication of PPARβ/δ in DC and suggest that its activation might be aneffective therapeutic tool for preventing or treating DC.

Disclosure
A.Rostami: None.
578-P: Effect of Two Timings for Postprandial Exercise Onset on Hypoglycemic Risk in Adults Living with Type 1 Diabetes
Authors: MOLVEAU JOSÉPHINE , MYETTE-CÔTÉ ÉTIENNE , TAGOUGUI SEMAH , TALEB NADINE , HEYMAN ELSA , SUPPERE CORINNE , RABASA-LHORET RÉMI 
Published: June 2023

Introduction: To limit hypoglycemic risk of during postprandial aerobic exercise the importance of reducing prandial insulin dose have been established with exercise starting 90-min after the meal. People with type 1 diabetes also exercise closer or further away of their mealtime and hypoglycemic risk associated with those timings may be different.
Objective: We aimed to evaluate the effect of two different timings for exercise onset (60-min vs. 120-min post-meal) during moderate intensity exercise.
Methods: 37 participants (25 M/ 12 F; HbA1c: 7.4 ± 0.9%) received an ultra-rapid insulin dose reduced by 50% and performed 1 hour of continuous moderate intensity exercise (at 60% of VO2peak) started either 60-min (EX60min) or 120-min (EX120min) after breakfast. Venous blood glucose was measured every 10-min during exercise.
Results: Decrease in blood glucose between exercise onset and nadir (lowest point during exercise) was more important with EX120min (-68.5 ± 43.2 mg/dL, EX60min vs. -75.7 ± 39.6 mg/dL, EX120min, p=0.015). The number of hypoglycemic events during exercise and during recovery (90-min post-exercise) were similar between EX60min and EX120min (3 vs. 4 and 3 vs. 0, respectively). Postprandial glucose excursion before exercise onset was reduced with Ex60min compared to Ex120min.
Conclusion: For postprandial aerobic exercise, with a reduced insulin meal bolus, hypoglycemic risk is comparable if exercise is started at 60 or 120min after the meal. Guidelines established with exercise starting 90min after the meal can probably be used for earlier or later timing.

Disclosure
J.Molveau: None. É.Myette-côté: None. S.Tagougui: None. N.Taleb: Consultant; Viatris Inc. E.Heyman: None. C.Suppere: None. R.Rabasa-lhoret: Consultant; Dexcom, Inc., Abbott, Janssen Pharmaceuticals, Inc., Novo Nordisk Canada Inc., Sanofi, Lilly, Tandem Diabetes Care, Inc., Insulet Corporation.
634-P: Autoantibody Screening Attitudes and Experiences in People Affected by Type 1 Diabetes
Authors: KELLY CAITLIN S. , CHAPMAN KATHERINE S.M. , DUNNE JESSICA L. , CORNELIUS EMILEE M. , PETER MEGAN , PAGAN INDOE ELLEN , WOLF WENDY 
Published: June 2023

Screening for type 1 diabetes (T1D) autoantibodies provides risk information before the onset of symptoms. Yet few individuals undergo screening. We aimed to understand knowledge, attitudes, and experiences regarding autoantibody screening in people affected by T1D. We recruited adults (aged 18+) from the T1D Exchange Online Registry who fell exclusively into one group: persons with T1D (‘PwD’) with a biological child without T1D or plans for a child; caregivers to a biological child with T1D and at least one without (‘caregivers’); and biological children or siblings to a person with T1D (‘relatives’). Eligible participants completed an online survey. As shown in Table 1, participants reported knowledge about autoantibody screening between ‘a little’ and ‘somewhat’ across groups. Perceptions of screening both in general and for their child [themselves] were generally positive, but most participants had not screened. PwD and caregivers reported feeling somewhat confident to independently understand results and explain results to their child. Relatives reported slightly less independence in self-efficacy to understand results. Results suggest more work needs to be done to increase awareness and knowledge about autoantibody screening. Moreover, while perceptions about screening are positive, screening remains underutilized even in a sample of people who are experienced with T1D.

Disclosure
C.S.Kelly: None. K.S.M.Chapman: None. J.L.Dunne: Employee; Janssen Research & Development, LLC. E.M.Cornelius: None. M.Peter: None. E.Pagan indoe: Other Relationship; Johnson & Johnson. W.Wolf: None.
64-LB: Cognitive and Somatic Symptoms of Depression Are Uniquely Related to HbA1c and Suicide Attempt History
Authors: GETTINGS JULIE M. , PANTESCO ELIZABETH J. , ANDORKO NICOLE , WILLI STEVEN M. 
Published: June 2023

Screening for depression and suicide risk is an essential part of care for adolescents and young adults (AYA) with type 1 diabetes (T1D), as increased depression symptoms and suicide attempt history are independently associated with elevated Hba1c. As symptoms of depression and prolonged hyperglycemia may coexist, further insight may be gained from an understanding of how somatic versus cognitive symptoms may uniquely relate to clinical outcomes in AYA with T1D. This study examined the independent relationships between HbA1c and suicide attempt history with cognitive and somatic symptoms on the Patient Health Questionnaire-9 Adolescent Version (PHQ-9) for AYA with T1D. The PHQ-9 was electronically administered (n = 2,491) at routine outpatient medical visits, and PHQ-9 scores, relevant background variables (age, sex, race, ethnicity, diabetes duration), and HbA1c values were obtained via chart review. AYA with T1D were 15.7 years old and had diabetes for 6.2 years, on average. After adjusting for covariates, somatic (B = .08, p &lt;0.001), but not cognitive symptoms (B = .02, p = 0.3), predicted HbA1c levels. Follow up analyses showed this relationship varied by sex, with somatic symptoms and HbA1c related in females (B = .10, p = .002) but not males (B = .05, p = .14), and by race, with somatic symptoms and HbA1c related in those who identify as African American (B = .13, p = .009) but not White (B = .03, p = .32). Logistic regression analyses controlling for relevant background variables showed cognitive symptoms (B = .46, p &lt; 0.001), but not somatic symptoms (B = .06, p = 0.39), were related to suicide attempt history. Findings demonstrate the value of independently monitoring cognitive and somatic symptoms of depression for AYA with T1D. Somatic symptoms are more strongly related to glycemic control, particularly for AYA with T1D who are female and identify as African American, respectively, whereas cognitive symptoms are significantly related to suicide attempt history.

Disclosure
J. M. Gettings: None. E. J. Pantesco: None. N. Andorko: None. S. M. Willi: Advisory Panel; Boehringer Ingelheim International GmbH, Medtronic.