bluuebunny/crossref_metadata_2025_split huggingface dataset:
704-P: Effects of Comorbidity Burden among Adult Medicaid Beneficiaries with Type 2 Diabetes
Authors: MCQUEEN AMY , VERDECIAS NIKO , CABURNAY CHARLENE A. , SMITH RACHEL E. , BROUSSARD DARRELL J. , VON NORDHEIM DAVID A. 
Published: June 2023

Diabetes self-management and health outcomes are complicated by comorbid conditions. Obesity, arthritis, pain conditions and others can create barriers to exercise and blood sugar goals. The burden patients experience managing chronic conditions may affect subsequent behaviors and outlook, creating a negative cycle. Understanding the impact of patients’ perceptions of comorbidity burden may inform future patient-centered healthcare services and community supports. We conducted a secondary data analysis using baseline and 3 month follow up survey data from an ongoing social needs intervention trial involving adult Medicaid beneficiaries with Type 2 diabetes. The sample (N=350) was 24-68 years old (M=52, SD=9), mostly female (n = 274; 78%), African American (n = 232; 66%) or White (n = 98; 28%), and had a mean of 7.6 (SD=3.0) of the 21 conditions, including diabetes, assessed at baseline. Each condition was rated by participants for impact on their daily activities (1=not at all; 5=a lot). Sum scores reflect ratings for diabetes burden only (M=2.9, SD=1.6) and all other conditions combined (M=21.0, SD=12.7). Bivariate correlations showed significant (p&lt;.05) positive associations between diabetes burden and three month outcomes: sum social needs (r= .17), stress (r= .11), depression (r= .14), diabetes distress (r= .35), frequency of checking blood sugar (r= .16), but inverse associations with difficulty sleeping (r= -.17) and diabetes self-efficacy (r= -.15). The associations with other comorbidity burden ratings were similar except stronger with depression (r= .33) and receipt of government assistance programs (r= .17). Although people with diabetes have substantial self-management responsibilities, the effect was not different from other comorbidity burden on social needs and psychosocial outcomes, suggesting that similar or holistic interventions to reduce the negative effects of disease burden may be more efficient and effective to implement than disease-focused interventions.

Disclosure
A.Mcqueen: None. N.Verdecias: None. C.A.Caburnay: None. R.E.Smith: None. D.J.Broussard, jr.: None. D.A.Von nordheim: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK115916-01)
705-P: Examining Psychosocial Correlates of HbA1c Testing Frequency
Authors: MCQUEEN AMY , HERRICK CYNTHIA J. , LI LINDA , SMITH RACHEL E. , VERDECIAS NIKO , BROUSSARD DARRELL J. , VON NORDHEIM DAVID A. 
Published: June 2023

Evidence supports guidelines for quarterly HbA1c testing for optimum diabetes control. Understanding patient-level factors associated with testing frequency may inform future interventions. Previous research with insured patients found greater testing frequency was associated with older age, uncontrolled baseline HbA1c, and comorbidities. This secondary analysis used baseline survey data from an ongoing intervention trial with the first 383 adult Medicaid beneficiaries with type 2 diabetes to have 12 months of follow up and medical claims data. Participants had an HbA1c test date &lt;4mo prior to enrollment and reported the value &gt;7.0 or “don’t know”. Associations with ≤2 vs. 3+ test dates over 12 months and demographic, health, and psychosocial correlates were examined. Participants were female (77%), White (30%), Black (70%), age M=51.66 (SD=9.32), had M=2.90 social needs (SD=1.70), and including diabetes, had M=7.62 (SD=3.05) chronic conditions. Of 1,710 HbA1c claims; 119 were excluded for &lt;30 days of a previous claim. Participants with 1-2 claims (N=110, 29%) were compared to those with 3+ claims (N=273, 71%). Greater testing frequency was associated (p&lt;.05) with: less likelihood of having children at home, more likely to be on insulin, more likely to report an HbA1c &gt;9.0 or “don’t know”, more compliant with diabetes medicine and glucose testing at home, poorer physical functioning and general health, less future time orientation, and more diabetes distress. Testing frequency was not associated with age, race, employment, disability, sum social needs, sum comorbidities, stress, depression, diabetes self-efficacy or social functioning. Only having children at home (OR=0.53; 95%CI 0.53-0.88) and future time orientation (OR=.50; 0.30-0.82) were significant in a multivariable model. Some participants with 3+ tests may be more engaged in better diabetes care due to fewer family demands. Others in better health with less diabetes distress may need messaging to increase the perceived need for quarterly testing.

Disclosure
A.Mcqueen: None. C.J.Herrick: Consultant; Teladoc Health, Other Relationship; Merck & Co., Inc., Eli Lilly and Company. L.Li: None. R.E.Smith: None. N.Verdecias: None. D.J.Broussard, jr.: None. D.A.Von nordheim: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK115916-01)
708-P: Within-Person Relationships of Sleep Duration with Next-Day Stress and Affect in the Daily Life of Adults with Type 1 Diabetes
Authors: JIN HAOMIAO , GONZALEZ JEFFREY S. , PYATAK ELIZABETH , SCHNEIDER STEFAN , HOOGENDOORN CLAIRE J. , HERNANDEZ RAYMOND , LEE PEY-JIUAN , SPRUIJT-METZ DONNA 
Published: June 2023

Introduction: Daily short sleep duration may negatively impact individuals with type 1 diabetes’ (T1D) ability to manage emotional well-being and to cope with daily stressors. Nevertheless, existing research is limited and mostly focused on between-person differences rather than impact of fluctuations in sleep duration on individuals.
Methods: Participants in the Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D) study completed 14 days of intensive longitudinal data collection. Sleep duration was derived by synthesizing objective (actigraphy) and self-report measures. General and diabetes-specific stress, positive affect (PA), and negative affect (NA) were measured via ecological momentary assessment (5-6 times per day at 3-hr intervals). Multilevel regression was used to examine within-person relationships between sleep duration and next-day stress and affect. Cross-level interactions were used to explore whether gender and baseline depression and anxiety moderated these relationships.
Results: Adults with T1D (N=166) with at least 7 days of complete data were analyzed. Participants were 41.0 years, and 54.8% female. Average sleep duration was 7.3 hours (SD=1.2). Longer sleep was significantly associated with lower general stress (p&lt;0.001) but not diabetes-specific stress (p=0.18) on the next day. Longer sleep was related to lower levels on all next-day NA (overall, p=0.002; disappointed, p=0.05; sad, p=0.05; tense, p&lt;0.001; upset, p=0.008; anxious, p=0.04). There were no significant associations with PA (all p&gt;0.05). Examination of interaction effects did not reveal significant differential relationships by gender, depression or anxiety.
Conclusion: Findings from this study suggest optimizing sleep duration as an important intervention target for better managing stress and improving daily emotional wellbeing of individuals with T1D.

Disclosure
H.Jin: None. J.S.Gonzalez: Consultant; Virta Health Corp. E.Pyatak: Research Support; Abbott Diabetes. S.Schneider: None. C.J.Hoogendoorn: None. R.Hernandez: None. P.Lee: None. D.Spruijt-metz: None.

Funding
National Institutes of Health (1R01DK121298)
71-OR: The Landscape of Pharmacogenetic Variants Associated with Noninsulin Antidiabetic Drugs in the Indian Population
Authors: SIVADAS AMBILY , SAHANA S. , JOLLY BANI , BHOYAR RAHUL C. , JAIN ABHINAV , SHARMA DISHA , IMRAN MOHAMED , SENTHIVEL VIGNESHWAR , DIVAKAR MOHIT K. , MISHRA ANUSHREE , MUKHOPADHYAY ARPITA , VENKAT NARAYAN K.M. , SIVASUBBU SRIDHAR , SCARIA VINOD , KURPAD ANURA 
Published: June 2023

Genetic variants contribute to differential responses to non-insulin antidiabetic drugs (NIADs), and consequently to variable plasma glucose control. India’s distinct genetic architecture and its exploding burden of Type 2 Diabetes (T2D) warrants a population-specific survey of NIAD-associated pharmacogenetic (PGx) variants. We mined 1029 Indian whole genomes for PGx variants, drug-drug (DDI) and drug-drug-gene interactions (DDGI) associated with 44 NIADs. Overall, we found 76 known and 52 predicted deleterious common PGx variants associated with response to T2D therapy among Indians. We report remarkable inter-ethnic differences in the relative cumulative counts of decreased and increased response-associated alleles across NIAD classes. Indians and South Asians showed a significant excess of decreased metformin response-associated alleles compared to other global populations. Network analysis of shared PGx genes predicts high DDI risk during co-administration of NIADs with other metabolic disease drugs. We also predict an increased CYP2C19-mediated DDGI risk for CYP3A4/3A5-metabolized NIADs, saxagliptin, linagliptin and glyburide when co-administered with PPIs. Our findings provide an actionable resource for accelerating future diabetes PGx studies in Indians and reconsidering NIAD dosing guidelines to ensure maximum efficacy and safety in the population.

Disclosure
A.Sivadas: None. A.Mishra: None. A.Mukhopadhyay: None. K.Narayan: None. S.Sivasubbu: None. V.Scaria: None. A.Kurpad: None. S.Sahana: None. B.Jolly: None. R.C.Bhoyar: None. A.Jain: None. D.Sharma: None. M.Imran: None. V.Senthivel: None. M.K.Divakar: None.

Funding
DBT/Wellcome Trust India Alliance (IA/E/19/1/504945)
710-P: Material-Needs Security and Food Insecurity in Adults with Type 2 Diabetes in Lebanon
Authors: BASSIL MAYA , SUKKARIEH OLA , EGEDE LEONARD E. 
Published: June 2023

Food insecurity is known to impair diabetes self-management and clinical outcomes. Little is known about the prevalence and social determinants of food insecurity among people with type 2 diabetes (T2DM) in the Middle East and North Africa (MENA) region. Thus, the aim of this study was to assess food insecurity and its relationship with material needs security in Lebanese adults with T2DM of low socioeconomic status. Subjects with T2DM (n=299) were recruited from primary health care centers in Lebanon; sociodemographic and material need variables were collected using self-reported questionnaires. Food insecurity was assessed using the validated US Household Food Security Survey Module: Six-Item Short Form (USDA, 2012). Around 25% of the sample were food insecure. Compared to the food secure group, there were significantly (p&lt;0.05) more participants who were females (58% vs. 44%), and who had low education level (82% vs. 58%) low income (49% vs. 24%), and no health insurance (65% vs. 49%), compared to the food secure group. Sum of material needs security was lower in the food insecure group (7.8±2.0 vs. 9.4±2.1, p&lt;0.05). Results from the fully adjusted logistic regression model showed that material needs security (OR: 1.26; 95% CI: 1.06-1.49; p&lt;0.007) and higher income (OR: 3.34; 95% CI: 1.39-8.05; p&lt;0.007) were independent predictors of food security. Our study highlights the importance of material needs in achieving food security in T2DM in the MENA region. Further research is needed to explore other social determinants of health in this population and potential pathways/mechanisms to guide programs for effective interventions.

Disclosure
M.Bassil: None. O.Sukkarieh: None. L.E.Egede: None.
714-P: Health-Related Quality of Life (HRQOL) in Young Adults with T1D
Authors: BAUDINO MARISSA , CARREON SAMANTHA A. , STREISAND RANDI , TANG TRICIA S. , LYONS SARAH , MCKAY SIRIPOOM , ANDERSON-THOMAS BARBARA J. , MINARD CHARLES G. , BUTLER ASHLEY , HILLIARD MARISA E. 
Published: June 2023

Challenges of young adulthood with T1D include transitioning to adult care, increased self-management responsibility, and developmental changes. Recognizing patterns of HRQOL across demographically and clinically diverse young adults with T1D may help identify who needs additional support as they transfer to adult healthcare. We hypothesized that young adults from racially, ethnically, and socioeconomically marginalized groups and those with higher A1c would report lower HRQOL.
At baseline of a behavioral RCT (≤2 months after last pediatric T1D clinic visit), 82 young adults (Mage=19.9±1.3, MA1c=8.9±2.0%) self-reported demographics and HRQOL; A1c was analyzed via point of care or dried blood spot. ANOVAs, t-tests, and a regression model compare HRQOL by demographic (gender, race/ethnicity, insurance, school enrollment) and clinical variables (device use, A1c).
As detailed in the table, HRQOL was significantly higher for participants in school and men (p&lt;.01). Pump-users reported higher HRQOL on the “Handling Diabetes Well” and “Peer Relationships” subscales (p&lt;.05). Regression analyses yielded gender and school enrollment as significant predictors of HRQOL (p&lt;.01).
Variability across groups of young adults with T1D suggests monitoring HRQOL may be helpful to identify T1D-specific psychosocial needs during this transition. Patterns suggest women and those not in school may benefit from additional support.

Disclosure
M.Baudino: None. M.E.Hilliard: None. S.A.Carreon: None. R.Streisand: None. T.S.Tang: Research Support; Juvenile Diabetes Research Foundation (JDRF), Speaker's Bureau; Abbott Diabetes, Insulet Corporation. S.Lyons: None. S.Mckay: None. B.J.Anderson-thomas: None. C.G.Minard: None. A.Butler: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK119246 to M.E.H.)
716-P: Improving Provider–Patient Relationships in Treatment of Young Adult Type 1 Diabetes
Authors: DIAZ CRYSTAL N. , ONG ALLISON , CHEN CINDY 
Published: June 2023

Aims: Type 1 diabetes mellitus (T1D) is a chronic illness that requires constant monitoring and management of one's blood glucose levels. This study focuses specifically on young adults aged 18-25 living with T1D in the United States and aims to identify strengths and areas of improvement for provider-patient relationships within young adult T1D care.
Methods: An online 15-question Qualtrics survey was distributed across social media over one month, and responses were studied using descriptive, inferential, and causal statistical analysis.
Results: Of the 48 responses, 56% strongly agreed that their provider listens to how they like to do things and conveys confidence in their ability to make changes, whereas 29% didn't feel trust and are unable to be open with their provider. Diabetes-specific stressors and diabetes burnout was the most selected topic that participants wanted their provider to address more often. 56.3% of participants have switched diabetes care providers due to dissatisfaction, and 47.9% have felt belittled or called a bad diabetic by a diabetes provider.
Discussion: Strong provider-patient relationships that facilitate trust, comfort, and connection were related to lower HbA1C, improved diabetes control, and improved diabetes-related stress.

Disclosure
C.N.Diaz: None. A.Ong: None. C.Chen: None.
72-OR: Higher Genetic Risk for Type 2 Diabetes Is Associated with Faster Decline of Beta-Cell Function
Authors: LEE HYUNSUK , CHOI JAEWON , SON HEEJUN , SOO PARK KYONG , CHO NAM H. , HEON KWAK SOO 
Published: June 2023

Objective: Polygenic risk score (PRS) for type 2 diabetes (T2D) has been reported to be associated with beta cell function, but whether it is also associated with the longitudinal change of beta cell function is largely unknown. We aimed to evaluate the association of PRS and the trajectory of beta cell function in a community based prospective cohort.
Method: We analyzed 6,323 participants without T2D at baseline from Ansan-Ansung cohort with 75-g 2-hour oral glucose tolerance tests taken biennially for 14 years. Disposition index (DI), derived from insulinogenic index at 60 minutes and Matsuda index, was used as a marker for beta cell function. PRS was calculated using 1.2 million variants from trans-ancestry T2D genome-wide association study using Bayesian regression (PRS-CSx). Participants were stratified into low (1st quintile), intermediate (2nd to 4th quintiles) and high genetic risk (5th quintile). Lifestyle was categorized as unfavorable, intermediate and favorable lifestyle according to Life’s Essential 8. Linear mixed model was applied.
Result: During a median follow-up of 13 years, 379 (30.6%), 875 (23.0%) and 171 (13.4%) participants developed T2D in high, intermediate and low genetic risk group, respectively. Participants in high genetic risk group, compared to low genetic risk group, had a 33% lower DI at baseline (53 [95% CI 50, 56] vs 79 [74, 84]; P = 7.9×10-15), and a 1.7-fold faster rate of decline in log2(DI) per year (-0.035 [-0.028, -0.042] vs -0.020 [-0.013, -0.027]; P = 0.0026). Notably, we found significant interaction between the rate of decline in DI and T2D PRS (P = 8.5×10-5). Healthy lifestyle was associated with decreased rate of decline in DI across all genetic risk group.
Conclusion: Having a high genetic risk for T2D was associated with not only a lower DI at baseline, but also a faster rate of decline in DI. Genetic information could be used to identify those at risk for rapid decline of beta cell function and emphasize lifestyle modification.

Disclosure
H.Lee: None. J.Choi: None. H.Son: None. K.Park: None. N.H.Cho: None. S.Kwak: None.

Funding
Ministry of Health & Welfare, Republic of Korea
720-P: Material Needs Security and Mental Health Outcomes in Adults with Type 2 Diabetes in Lebanon
Authors: SUKKARIEH OLA , BASSIL MAYA , EGEDE LEONARD E. 
Published: June 2023

Despite their documented significance in type 2 diabetes (T2DM) management, social determinants of health (SDOHs) including material needs security and mental health outcomes (herein referred to as depression and diabetes fatalism) are understudied in the Middle East and North Africa (MENA) region. This study aims to assess the relation between material needs security and mental health outcomes in Lebanese adults with T2DM. Subjects with T2DM (N=299) were recruited from primary health care centers in Lebanon; sociodemographic, material need variables, depression measured by Patient Health Questionnaire (PHQ-9) and Diabetes Fatalism measured by Diabetes Fatalism Scale (DFS) were used. Depression and diabetes fatalism were used as outcome variables. Most of the participants were men, married and with lower educational levels. Multivariate analyses revealed that having material needs security was associated with diabetes fatalism (β=-0.63(-1.13; -0.12)), and depression (β=-0.46(-0.78; -0.13)) after controlling for all relevant confounding variables. Results from the fully adjusted logistic regression model showed that material needs security (OR: 0.82; 95% CI: 0.69; p&lt;0.001). Our study highlights the importance of material needs security on mental health outcomes for adults with T2DM in the MENA region. Clinicians are encouraged to assess impact of material needs on mental health outcomes. Further research is needed to understand potential pathways/mechanisms and options for effective interventions and policy making.

Disclosure
O.Sukkarieh: None. M.Bassil: None. L.E.Egede: None.
726-P: Medication Adherence among American Indians with Type 2 Diabetes—Assessing the Quality of Electronic Health Record Data within a Large Tribal Health Care System
Authors: SCARTON LISA , NELSON TARAH N. , DEVAUGHAN CIRCLES ASHLEY , LEGASPI ANATOLIA , WILKIE DIANA J. 
Published: June 2023

Electronic health record (EHR) systems within tribal healthcare facilities offer a rich but underutilized data source about medication adherence and its potential to predict HbA1c. The purpose of this analysis was to describe data quality issues for medication events in a dataset extracted from a large tribal healthcare EHR system. This analysis was a critical step prior to conducting a study of medication adherence among American Indians with type 2 diabetes (T2D). The EHR dataset from 2017-2021 included 10,506 patients who were enrolled adult tribal citizens, had T2D, and had at least one health system encounter. Tribal pharmacy refill data were linked to the EHR data and included information such as prescription regimen (e.g., drug, dose, route of administration, quantity), date new medication prescribed, date picked up, and refill dates. Data quality indicators were: duplicate data, missing data (e.g., dispense and fill dates, RX number), and data inconsistent with eligibility criteria. The mean age of the sample was 60.2 ±13.4 years and 52% were female. Out of the 1,400,593 patient medication fill/refill events we excluded 64,015 medication events due to a) duplicate prescription fill data (n=112); b) no dispense date (n=1,081); c) no order date (n=0); d) no fill date (n=0); e) no RX number (n=0); f) missing number of days dispensed (n=0); g) missing drug (n=0); h) missing dose (n=0); and i) data extracted not meeting the eligibility criteria (n=62,822). The date the medication was prescribed was not extracted from the EHR. Discovering these results was labor intensive taking more than 6 months. This analysis revealed few data-related concerns. With the exception of one missing variable, the dataset includes high quality data from which we will calculate medication adherence among American Indians with T2D.

Disclosure
L.Scarton: None. T.N.Nelson: None. A.Devaughan circles: None. A.Legaspi: None. D.J.Wilkie: Other Relationship; eNursing llc.

Funding
National Institutes of Health (1R01NR020386-01)
738-P: Lifestyle Intervention Program with Smartphone App Augmented by Intermittently Scanned Continuous Glucose Monitoring for People at High Risk of Diabetes—Randomized Controlled Trial
Authors: KITAZAWA MASARU , SUZUKI HIROSHI , HORIKAWA CHIKA , TAKEDA YASUNAGA , IKEDA IZUMI , HATTA MARIKO , IWANAGA MIDORI , YAMADA TAKAHO , FUJIHARA KAZUYA , SONE HIROHITO 
Published: June 2023

We examined the effects of a lifestyle intervention program with a smartphone app augmented by intermittently scanned continuous glucose monitoring (isCGM) of persons at high risk of developing diabetes in a 12-week randomized open-label trial (UMIN00004640). The program monitored blood glucose fluctuations and lifestyle habits and displayed them in an easy-to-understand interface as well as provided personalized lifestyle intervention messages. The primary endpoint was the change in time in range (TIR) of 70-140 mg/dL between intervention (App) and control (C) groups. Among 168 patients (mean age 48.1 y, mean BMI 26.6 kg/m2, and male 80.4%), 82 and 86 were assigned to the App group and C group, respectively. After 12 weeks, TIR of 70-140 mg/dL significantly improved in the App group compared to the C group (-2.6 min/day vs. +31.5 min/day, p=0.03). Changes in time above range (&gt;140 mg/dL; -20.9 min/day vs. -22.6 min/day, p=0.86) did not differ, whereas time below range (&lt;70 mg/dL; +23.5 min/day vs. -8.9 min/day, p=0.02) improved in App compared to C. BMI (-0.26 vs. -0.59, p=0.017) and carbohydrate intake (-4.4 kcal/day vs. -22.7 kcal/day, p=0.049) also improved in App compared to C. Intervention with a smartphone app and isCGM increased glycemic control with a decrease in carbohydrate intake and weight loss.

Disclosure
M.Kitazawa: 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. H.Suzuki: None. C.Horikawa: None. Y.Takeda: None. I.Ikeda: None. M.Hatta: None. M.Iwanaga: None. T.Yamada: None. K.Fujihara: None.