bluuebunny/crossref_metadata_2025_split huggingface dataset:
1204-P: The Effect of Eating Behaviour, BMI, and Glycaemia in Women with Gestational Diabetes
Authors: KUSINSKI LAURA C. , TOBOLSKA PATRYCJA , JONES DANIELLE , ATTA NOORIA , OUDE GRIEP LINDA M. , GRIBBLE FIONA M. , MEEK CLAIRE L. 
Published: June 2023

Introduction: Maternal obesity and poor diet choices are often attributed as the cause of gestational diabetes. Maternal eating behaviour during pregnancy and the influence of this on the disease aetiology remains poorly understood. We aimed to compare eating behaviour in women with gestational diabetes to non-pregnant adults to determine which of the eating behaviour traits are associated with BMI as well as glucose metrics.
Methods: Participants (total n=448) including men (n=67), non-pregnant women (n=181) and women with gestational diabetes during a singleton pregnancy (n=200; 29 weeks’ gestation; NICE / Covid-19 criteria) were recruited prospectively and completed a three-factor eating questionnaire (TFEQ-R18). Cross-sectional associations between continuous glucose measurement metrics and BMI with uncontrolled eating (UE), emotional eating (EE) and cognitive restraint (CR) were assessed using linear regression.
Results: Women with gestational diabetes had significantly lower UE scores compared to men (53% vs 63%; p&lt;0.001) and non-pregnant women (53% vs 65%; p&lt;0.001), and lower EE scores compared to non-pregnant women (60% vs 71%; p&lt;0.001). In women with gestational diabetes, only EE scores were significantly associated with BMI (Coeff 7.8; 95%CI 3.9-11.7; p&lt;0.001), while UE and CR scores have no association. However, EE, UE and CR were not significantly associated with glucose metrics such as average glucose levels, time above range or time below range.
Conclusions: Favourable eating behaviour was observed in women with gestational diabetes when compared to men and non-pregnant women. Data showing EE is strongly associated with BMI suggest that interventions which consider this may be more impactful for weight management in women with gestational diabetes and, as such, exploring this avenue may be an important aspect to address when considering new translational approaches.

Disclosure
L.C.Kusinski: None. P.Tobolska: None. D.Jones: None. N.Atta: None. L.M.Oude griep: None. F.M.Gribble: Other Relationship; Kallyope, Research Support; AstraZeneca, Eli Lilly and Company. C.L.Meek: Research Support; Dexcom, Inc.

Funding
Diabetes UK (17/0005712)
121-OR: Fear of Falling and Its Relation to Balance Task Performance in Individuals with Chronic Diabetes
Authors: HABASHI KIAN , IIDA THOMAS , YEE BRIANNA 
Published: June 2023

Background: Older adults with type 2 diabetes mellitus (T2DM) have lower balance confidence and a higher risk and fear of falling. This may lead to fear of falling avoidance behaviors (FFAB). It has been shown that balance training may attenuate fall risk, but it is unclear how balance task performance and learning is associated with FFAB.
Methods: Participants included in the study were greater than 50 y.o., with or without T2DM, able to walk 50m, and able to stand for 5 min. FFAB was assessed using a 14-item questionnaire (FFABQ). Balance task performance was measured using a stabilometer, a wooden platform connected to a single axis to allow for bidirectional sway and a potentiometer to measure rotation of the board (±18° maximum). Participants underwent 3 days of balance training, each of which consisted of at least ten, 30 second trials. Participants were encouraged to keep the board in balance, defined as ±5° from the midline, and time in balance (TIB) was the primary outcome measure for each trial. Statistical analysis was done by independent sample T-tests through IBM SPSS software.
Results: To date, data collection has been completed for 37 patients, 17 with T2DM and 20 without. T2DM participants had a significantly higher FFABQ score than controls (12.41 ± 14.22 vs 2.59 ± 4.22; p = 0.006). The T2DM group had significantly lower TIB than the control group on day 1 (6.16 ± 1.89 vs 8.91 ± 3.05; p=0.001) and day 3 (8.099 ± 2.91 vs 12.28 ± 4.69; p=0.001). However, there was no statistically significant difference in balance task improvement between T2DM and controls (34.1% ± 34.4 vs 32.5% ± 39.5; p = 0.447). Similarly, there was a significant negative correlation between FFABQ scores and day 1 stabilometer performance but no correlation between FFABQ and balance task improvement [(day 3-day 1)/day 1)].
Conclusions: These results suggest that T2DM participants exhibited greater FFAB and poorer balance performance; however, with training they are still able to improve at the same rate as control participants.

Disclosure
K.Habashi: None. T.Iida: None. B.Yee: None.
1213-P: Artificial Intelligence–Based Body Composition Analysis Using Computed Tomography Images Predicts Both Prevalence and Incidence of Diabetes—A Cross-Sectional and Longitudinal Analysis of 10-Year Retrospective Cohort in Korea
Authors: HYUNG KIM YOO , SON HEEJUN , YOON JIWON , JEE CHOE HUN , JUNG OH TAE , MIN CHO YOUNG 
Published: June 2023

Background: We aimed to assess how the ageing-related changes in body composition contribute to the prevalence and incidence of diabetes using artificial intelligence (AI)-based analysis of abdominal computed tomography (CT) images.
Methods: In this retrospective cohort study, we identified 15330 subjects age ≥18 years with abdominal CT scans at baseline, who underwent medical checkup at Seoul National University Hospital Healthcare System Gangnam Center from January 1, 2011 to September 30, 2012. Of these, 11693 subjects with available follow-up data were included in the longitudinal analysis. The volume of each body segment involved in abdominal CT images was measured by using an AI-based image analysis software.
Findings: The ratio of visceral fat to subcutaneous fat (VF/SF ratio) increased with ageing. The optimal cutoffs of VF/SF ratio to predict the prevalence of diabetes were 1.2 and 0.5 in men and women, respectively. A VF/SF ratio over the cutoff was associated with a higher prevalence of diabetes (age and BMI adjusted OR 2.1, [95% CI 1.8-2.4] in men; 3.1, [2.4-3.9] in women). The same cutoffs of VF/SF ratio were used to predict incident diabetes in ten years of follow-up. Subjects with normal glucose tolerance at baseline who had higher VF/SF ratio had increased risk of progression to prediabetes or diabetes (age and BMI adjusted HR 1.2, [95% CI 1.1-1.4] in men; 1.4, [1.2-1.6] in women). Subjects with prediabetes at baseline who had higher VF/SF ratio also more frequently progressed to diabetes (age and BMI adjusted HR 1.4, [95% CI 1.2-1.6] in men; 1.8, [1.5-2.3] in women).
Interpretation: VF/SF ratio in the abdomen change with ageing and are associated with the prevalence and future incidence of diabetes. AI-based analysis of abdominal CT images may help easily obtain body composition data to clinically assess the risk of incident diabetes.

Disclosure
Y.Kim: None. H.Son: None. J.Yoon: None. H.Choe: None. T.Oh: None. Y.Cho: Consultant; LG Chem.

Funding
Ministry of Health & Welfare, Republic of Korea
1232-P: Risk of Cardiovascular Diseases &gt;30 Days after COVID-19 Diagnosis among U.S. Adults With and Without Diabetes
Authors: KOYAMA ALAIN , IMPERATORE GIUSEPPINA , ROLKA DEBORAH B. , LUNDEEN ELIZABETH A. , RUTKOWSKI RACHEL , JACKSON SANDRA , HE SIRAN , KUKLINA ELENA V. , PARK SOYOUN , PAVKOV MEDA E. 
Published: June 2023

Growing evidence suggests an increased risk of incident chronic diseases such as cardiovascular diseases (CVDs) after COVID-19. We evaluated the risk of CVDs &gt;30 days after a COVID-19 diagnosis and compared it to a contemporaneous control group without a COVID-19 diagnosis. We included adults ≥20 years with a COVID-19 diagnosis from March 1, 2020 through December 1, 2021 from the IQVIA insurance claims database. The contemporaneous control group comprised adults with ≥1 healthcare encounter and without diagnoses for COVID-19 or other acute respiratory infections. Control group index dates were randomly selected to match the distribution of COVID-19 diagnosis dates. All diagnoses were ascertained from ICD-10 codes. Individuals with diagnostic codes of CVDs within 2 years prior to the index date were excluded. We used Cox regression models (adjusted for age, sex, health insurance type, U.S. Census division, Charlson comorbidity score) to assess the risk of incident CVDs, stratifying by diabetes status. The analytic sample included 13,078,827 adults (mean age 49.4 years [SD: 15.7], 50.2% female, and mean follow-up 8.5 months [SD: 5.8]). Among patients with and without diabetes, COVID-19 diagnosis was significantly associated with increased risk of each CVD outcome (See Figure). Regardless of diabetes status, monitoring for incident CVD may be pertinent beyond the first 30 days of COVID-19.

Disclosure
A.Koyama: None. M.E.Pavkov: None. G.Imperatore: None. D.B.Rolka: None. E.A.Lundeen: None. R.Rutkowski: None. S.Jackson: None. S.He: None. E.V.Kuklina: None. S.Park: None.
1235-P: High Burden of Undetected Hypertension among People with Type 2 Diabetes in India
Authors: MOHAN SAILESH , JARHYAN PRASHANT , PRABHAKARAN DORAIRAJ 
Published: June 2023

Purpose: Despite the huge burden of diabetes and hypertension, limited information is available on the burden of undetected hypertension and associated factors among diabetics in India.
Methods: We conducted a cross-sectional study and selected 12284 adults aged ≥ 30 years, using a multistage cluster random sampling technique, from rural and urban areas of North and South India. Trained interviewers administered a questionnaire to collect data on socio-demographics, lifestyle characteristics and phlebotomists collected venous blood samples. Blood pressure was measured using standard protocols. Diabetes was defined as FPG ≥ 126 mg/dl or HbA1C ≥ 6.5% or self-reported physician diagnosis or treatment and the known-diabetes was defined as self-reported physician diagnosis or treatment. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or self-reported physician diagnosis or treatment and undetected hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥ 90 mmHg without self-reported physician diagnosis or treatment.
Results: The age-adjusted prevalence of diabetes was 17.5% (16.9-18.2), known diabetes was 10.2% (9.7-10.7) and hypertension among those with diabetes was 47.3% (45.0-49.6). The age-adjusted prevalence of undetected hypertension among those with known-diabetes was 27.0% (22.0-31.9). The prevalence of undetected hypertension among known-diabetics was higher in urban area [29.4% (23.2-35.6)] than the rural area [21.5% (13.2-29.7)]. In the multinomial logistic regression, undetected hypertension among those with known-diabetes was positively associated with older age [adjusted Relative Risk Ratio (aRRR): 3.4 (1.7-6.9)], dyslipidemia [aRRR: 2.2 (1.2-4.1)] and chronic kidney disease [aRRR: 3.3 (1.2-9.2)].
Conclusions: There is a need to implement health system interventions to increase the detection of hypertension among diabetics.

Disclosure
S.Mohan: None. P.Jarhyan: None. D.Prabhakaran: None.
1239-P: The Time Point of Blood Pressure Measurement Rather than the Application of U.S. vs. European Blood Pressure Categorizations Is Important for Cardiovascular Risk Prediction in Patients with the Metabolic Syndrome
Authors: LEIHERER ANDREAS , BROZEK WOLFGANG , MUENDLEIN AXEL , ULMER HANNO , SAELY CHRISTOPH H. , PLATTNER THOMAS , VONBANK ALEXANDER , MADER ARTHUR , SPRENGER LUKAS , MAECHLER MAXIMILIAN , LARCHER BARBARA , FRAUNBERGER PETER , NAGEL GABRIELE , ZITT EMANUEL , DREXEL HEINZ , CONCIN HANS 
Published: June 2023

This observation study (OS) recorded cardiovascular mortality over 21 years in a cohort of 1497 cardiovascular disease patients (median 65 years), of whom 680 had the metabolic syndrome (MetS). We analyzed the predictive value of blood pressure (BP) when measured at baseline of the OS or when measured in a health survey (HS) having enrolled the identical patients fifteen years prior to the OS, applying varying high BP categorizations from the US (ADA/ACC/AHA) and from Europe (EASD/ESC/ESH). Cardiovascular mortality risk increased with increasing BP categories when measured at HS but not when measured at OS (figure), irrespective of whether US or European BP categorizations were used. According to integrated discrimination improvement, the power of BP to predict cardiovascular mortality did not differ significantly between US and European categorizations (p=0.965), however, the power was significantly higher when using BP measurements at HS instead of at OS (p&lt;0.001). This held true both among patients with the MetS (p=0.017) and also in those without the MetS (p&lt;0.001). We conclude that earlier in life BP (HS) readings outperform BP readings done at a more advanced age (OS baseline) in terms of risk prediction for cardiovascular mortality both in MetS patients and in subjects without the MetS.

Disclosure
A.Leiherer: None. M.Maechler: None. B.Larcher: None. P.Fraunberger: None. G.Nagel: None. E.Zitt: None. H.Drexel: None. H.Concin: None. W.Brozek: None. A.Muendlein: None. H.Ulmer: None. C.H.Saely: None. T.Plattner: None. A.Vonbank: None. A.Mader: None. L.Sprenger: None.
1249-P: Lack of Concordance of Blood Pressure Control among Heterosexual Couples with Diabetes—An Analysis of Aging Cohorts from USA, China, and India
Authors: SAM VARGHESE JITHIN , LI CHIHUA , LU PEIYI 
Published: June 2023

Background: Previous studies observed high concordance of diabetes and hypertension among married or partnered couples globally due to assortative mating and cohabitation. However, whether there is concordance in controlled blood pressure (BP) among couples with diabetes, an important risk factor for micro/macrovascular complications, is unknown.
Methods: Using cross-sectional data from Health and Retirement Study (HRS 2016-17, n = 1749) and its international partner studies from China (CHARLS 2015-16, n = 923) and India (LASI 2017-19, n = 4582), we identified couples (aged 21-97 years) among whom at least one partner had diabetes and both partners had standardized BP measurements. We defined controlled BP as systolic BP &lt; 140 mmHg and diastolic BP &lt; 90 mmHg. We used multiple imputation and survey-weighted modified Poisson regression to study the association of controlled BP between couples for wives and husbands respectively. We adjusted for current medication use, individual and household characteristics. We additionally examined between-country differences in the association.
Results: Our analytic sample consisted of 3802 wives and 4504 husbands with diabetes. The proportion of wives with controlled blood pressure were 76.6% [73.2, 80.1] in the USA, 67.5% [63.3, 71.8] in China and 65.1% [62.6, 67.6] in India. The proportion of husbands with controlled blood pressure were 70.8% [67.4, 74.1] in the USA, 63.6% [58.5, 68.6] in China and 60.0% [57.8, 62.3] in India. Partner’s control of BP was not associated with own controlled BP for wives (prevalence ratio, PR: 1.05 [0.97, 1.14]) and husbands (PR: 1.07 [0.94, 1.21]) with diabetes. Estimates of association were null across all countries. Estimates were similar when restricted to couples (n = 1076) when both partners had diabetes.
Conclusions: Lack of concordance in BP control among couples with diabetes suggest continuation of strategies for individualized management of high blood pressure.

Disclosure
J.Varghese: None. C.Li: None. P.Lu: None.
126-LB: Effect of a Digital Diabetes Solution on All-Cause Health Care Resource Utilization Charges for Patients with Type 2 Diabetes—A Retrospective Cohort Study
Authors: WILSON LAURA , MALONE DANIEL C. , KUMAR POTUKUCHI PRAVEEN , THINGALAYA NITA , LEE KENI C. , EDWARDS ALISON , YU XINYAN , LEE FELIX , KENNEDY ADEE , HAN-BURGESS EDWARD JONATHAN K. , BRIXNER DIANA 
Published: June 2023

Background: Dario Diabetes Solution (DDS) is a digital health application (app) for type 2 diabetes mellitus (T2DM) management that combines a blood glucose (BG) meter and a mobile app, allowing patients (pts) to track BG levels in real time. This study compared all-cause healthcare resource utilization (HCRU; inpatient + ER) and charges for DDS users vs matched nonusers.
Methods: This retrospective cohort study (pt selection window: 1JAN2017 - 31APR2021) included adults (≥18 years) with T2DM receiving antidiabetic medication(s) with ≥1 inpatient or ≥2 outpatient visits ≥30 days apart during the baseline (BL) period. BL was 1 year before index date (users, 1st DDS registration; nonusers, 1st claim date in the quarter); follow up was 1 year. User and nonuser cohorts were matched 1:3 using exact and propensity score matching. Study assessed HCRU rates and charges. A 2-part gamma distribution model was used to determine 1) likelihood (odds ratio, OR) of users vs nonusers to incur charges, then 2) total charges per patient per year (PPPY) including all-cause HCRU and office visit (OV) charges.
Results: Of 9779 pts, 2445 DDS users and 7334 nonusers were matched; mean age, 58.2±10.6 and 58.3±12.5 years, respectively. At 1 year, users were 9% less likely to incur all-cause HCRU charges vs nonusers (OR, 0.91; P=0.07). All-cause HCRU charges were 26% lower for users vs nonusers (P&lt;0.0001; $12552 [adjusted] PPPY savings). Users were more likely to incur all-cause OV charges vs nonusers (P=0.04). However, users had 19% lower all-cause OV charges vs nonusers (P&lt;0.0001; $1790 [adjusted] PPPY savings). The percentages of pts who incurred T2DM related HCRU charges were low (users, 3.1%; nonusers, 3.0%).
Conclusions: In this retrospective cohort study, pts with T2DM who utilized DDS incurred significantly lower all-cause HCRU and OV charges vs nonusers.

Disclosure
L. Wilson: Employee; Sanofi. D. C. Malone: Consultant; Sanofi Genzyme, Avidity, Sarepta, Pear Therapeutics, Gilead Sciences, Inc., Novartis. P. Potukuchi: None. N. Thingalaya: None. K. C. Lee: Employee; Sanofi. A. Edwards: Other Relationship; Sanofi. Employee; Symphony Health, an ICON plc company. X. Yu: None. F. Lee: Employee; Sanofi. Stock/Shareholder; Sanofi. A. Kennedy: None. E. K. Han-Burgess: Employee; Sanofi. D. Brixner: Consultant; Sanofi.

Funding
Sanofi
1279-P: The INNODIA Natural History Study of Children, Adolescents, and Adults Newly Diagnosed with Type 1 Diabetes
Authors: LOREDANA MARCOVECCHIO M. , DELFIN CARL , HULSMANS MARGO , OVERBERGH LUTGART , PAZMINO SOFIA S. , PICTON DIANE E. , STEENACKERS NELE , VAN DER SCHUEREN BART , HENDRIKS ALLAIRD E.J. , MATHIEU CHANTAL ,   INNODIA CONSORTIUM
Published: June 2023

Using the INNODIA consortium European infrastructure, we aimed to discover novel biomarkers of T1D progression. Here we report clinical and biochemical characteristics of people with new-onset T1D during the first year from diagnosis. Children and adults (age 1-45 yrs) were recruited within 6 weeks from T1D onset in 11 European countries. Baseline clinical characteristics, C-peptide (fasted and mixed meal tolerance test), HbA1c, autoantibodies, and their overtime changes were assessed across 3 age groups: &lt;10, 10-17, ≥18yrs. The study population included 655 individuals (280: &lt;10 yrs; 274: 10-17 yrs; 101: ≥18 yrs): 57% male; age: 12.1±8.4 yrs; 96% were positive for ≥1 autoantibodies. Autoantibody frequency was IAA 77%, GAD 73%, IA-2A 69%, ZnT8A 66%. Diabetic ketoacidosis prevalence was 35%, with the highest rate in the 10-17 yrs group (44%). At baseline, median [IQR] fasting and area-under-the curve (AUC) C-peptide were 242[140-384] and 753[469-1109]pmol/L, with levels increasing with age (p&lt;0.001; Fig). Over time C-peptide remained lower in participants &lt;10yrs but rates of decline were similar between age groups. HbA1c significantly decreased during the first 3 months (p&lt;0.001). In this large cohort with new-onset T1D, we identified age-related differences in clinical and biochemical parameters. Of note, C-peptide was lower in younger children but there was no age effect on its rate of decline.

Disclosure
M.Marcovecchio: None. C.Mathieu: Advisory Panel; Novo Nordisk A/S, Boehringer Ingelheim Inc., Eli Lilly and Company, Medtronic, Vertex Pharmaceuticals Incorporated, Roche Diabetes Care, Imcyse, Speaker's Bureau; Novo Nordisk A/S, AstraZeneca, Boehringer Ingelheim Inc., Eli Lilly and Company, Medtronic, Vertex Pharmaceuticals Incorporated. Innodia consortium: n/a. C.Delfin: Employee; Novo Nordisk A/S. M.Hulsmans: None. L.Overbergh: None. S.S.Pazmino: None. D.E.Picton: None. N.Steenackers: None. B.Van der schueren: None. A.E.J.Hendriks: Advisory Panel; Alira Health.

Funding
Innovative Medicines Initiative 2 Joint Undertaking (115797, 945268)
128-LB: Accessing Glucose Fluctuation—The Role of FPG, PPG, and HbA1c
Authors: MA JIANHUA , SU XIAOFEI , FENG LINGGE , DING BO , YAN RENNA , SUN RUI , ZHANG YUMEI , DUAN YANLI 
Published: June 2023

Background: Time in range (TIR) has been widely used clinically to investigate the glucose fluctuation in diabetes management. Studies have been done in exploring the relationship between TIR and HbA1c to estimate TIR without multi-invasive measurements. Beyond the univariate correlation model, this study incorporated fasting plasma glucose (FPG), postprandial glucose (PPG) obtained from glucose tolerance test, which can to some extent reflect glucose fluctuations, and revealed the advantage and the potential of the multi-variate linear or no-linear model to estimate TIR.
Method: This study involved 399 Chinese T2DM patients. TIR were calculated from continuous glucose monitoring (CGM) data with a coverage of at least 70%. FPG, PPG were measured by oral or mixed-meal glucose tolerance test. Univariate, multivariate linear regression and non-linear random forest (RF) regression were used in regression analysis. Model performance was assessed using MAE, RMSE and MSE.
Results: Regression analysis between glucose tolerance test data and CGM suggests that FPG were strongly linked to trough glucose while PPG were strongly correlated with peak glucose. Regression analysis revealed a stronger correlation between TIR and a triad of FPG, PPG, HbA1c than single HbA1c variable. And the performance of RF model is superior (correlation = 0.79, MAE = 14.77), among multivariate linear (0.73, 16.67) and univariate linear (0.62, 21.29) model.
Conclusion: Our study shows that FPG and PPG are closely associated to trough and peak glucose in CGM data, as they provide a more complete picture of glucose fluctuations compared to HbA1c alone. The TIR estimation model that based on FPG, PPG, and HbA1c outperformed univariate model. However, the performance of RF based non-linear model suggests a more complex relationship between those parameters, indicating personalized models for different populations is needed in TIR estimating without long-term invasive glucose monitoring.

Disclosure
J. Ma: None. X. Su: None. L. Feng: Employee; Hua Medicine. B. Ding: None. R. Yan: None. R. Sun: None. Y. Zhang: None. Y. Duan: None.

Funding
Nanjing Municipal Health Commission (ZKX22038)