bluuebunny/crossref_metadata_2025_split huggingface dataset:
939-P: Dynamic Interference Testing Results with the Libre 2 Continuous Glucose Monitoring Device
Authors: JENSCH HENDRICK , THOMÉ NICOLE , SRIKANTHAMOORTHY GEETHAN , WEINGÄRTNER LEA , SETFORD STEVEN J. , HOLT ELIZABETH H. , GRADY MIKE , KUHL CHRISTIAN , PFÜTZNER ANDREAS 
Published: June 2023

Background: Sensors for continuous glucose monitoring (CGM) are increasingly used by people with type 1 and type 2 diabetes. However, the reaction of the glucose oxidase-based sensor technologies to potentially interfering nutritional, endogenous, or pharmaceutical substances is barely understood. We have developed an in-vitro test method for continuous and dynamic CGM interference testing and explored the sensitivity of the Libre 2 sensor to a panel of 68 individual substances.
Method: In each interference experiment, three sensors were exposed to substance gradients from zero to supra-physiological concentrations generated by HPLC-pumps at a fixed glucose concentration of 200 mg/dL. YSI Stat 2300 Plus was used as the glucose reference method. Interference was assumed if the CGM sensors showed a mean bias of more than ±10% from baseline with a tested substance at any given substance concentration.
Results: Interference was seen with the following substances: xylose (difference from baseline: +178%), galactose (+134%), mannose (+130%), hydroxyurea (+84%), ascorbic acid (+48%), dithiothreitol (+46%), methyldopa (+16%), ibuprofen (+14%), red wine (+12%), N-acetyl-cysteine (+11%), icodextrin (+10%), while no interference was seen with the other substances. Suspected sensor fouling, in that the needle sensors subsequently ceased to operate after exposure to a substance, was not observed with Libre 2.
Conclusions: Our standardized dynamic interference testing protocol identified several nutritional and pharmacological substances that substantially influenced the Libre 2 signal. Clinical trials are now necessary to investigate, whether our findings are of relevance for routine care.

Disclosure
H.Jensch: None. N.Thomé: None. G.Srikanthamoorthy: None. L.Weingärtner: None. S.J.Setford: Employee; LifeScan Scotland Ltd. E.H.Holt: Employee; LifeScan Inc. M.Grady: Employee; Lifescan. C.Kuhl: None. A.Pfützner: Consultant; Novo Nordisk A/S, Research Support; LifeScan Diabetes Institute, Speaker's Bureau; AstraZeneca, Stock/Shareholder; Lifecare A/S, Diakard.

Funding
European Union’s Horizon 2020 Research and Innovation Program (951933); LifeScan Global Corporation
94-OR: Myeloid-Specific ERa Deletion Disrupts Mitochondrial Function Driving Iron Accumulation and Cardiometabolic Disease
Authors: IWASAKI HIROTAKA , LEYVA BRAYDEN K. , MA ALICE , YANG NICOLE L. , TRAN PETER H. , ZHOU ZHENQI , HEVENER ANDREA L. 
Published: June 2023

Sex differences in metabolism and cardiometabolic disease risk are well described. Because estrogen action is thought to underlie female-biased protection of immunometabolism and cardiometabolic health, we selectively deleted the estrogen receptor alpha (ERa, encoded by Esr1) from myeloid cells of mice to understand the impact of estrogen action on macrophage function. Our previous findings in other glucoregulatory cell types point to an important role of ERa in the control of mitochondrial form and function. Mitochondria play a critical role in innate immunity, and disruption of mitochondrial function is linked to the pathogenesis of cardiometabolic disease. In addition to a primary role in energy production, mitochondria are central in the regulation of iron homeostasis, a critical process governing immune cell function. Myeloid-specific Esr1 knockout mice (MACER) showed increased diet-induced glucose intolerance, insulin resistance, adiposity, and atherosclerotic lesion area compared with f/f controls. A key phenotype of MACER mice was marked accumulation of iron in liver, spleen, gonadal white adipose tissue, and bone marrow-derived macrophages compared with f/f controls. Specifically, iron accumulated in mitochondria from macrophages within tissues of MACER mice. Iron accumulation was linked with alteration of mitochondrial inner and outer membrane morphology and mtDNA replication machinery, and associated with increased transferrin receptor (Tfrc) expression and cellular inflammation driven by interleukin-1-β. We utilized chromatin immunoprecipitation approaches to identify novel ERa-regulated chromatin structures and target genes that modulate immunometabolism of macrophages. Our findings indicate that Esr1 is critical in the regulation of mitochondrial metabolism and iron homeostasis in macrophages, and the action of ERa is critical for the protection against inflammation and cardiometabolic-related disease.

Disclosure
H.Iwasaki: None. B.K.Leyva: None. A.Ma: None. N.L.Yang: None. P.H.Tran: None. Z.Zhou: None. A.L.Hevener: None.

Funding
National Institutes of Health (DK128957)
942-P: A1C-Glucose Management Indicator (GMI) Discordance among Continuous Glucose Monitor (CGM)–Wearing Adults with T2D
Authors: JHUANG AN-TING , BACON SAM , KAMRUDIN SAMIRA , THOMPSON NELS , CLARK CALLAHAN 
Published: June 2023

ADA Standards of Medical Care considers 14-day CGM-based GMI an A1c surrogate for clinical management. To date, supporting evidence is from T1D or insulin-treated T2D populations. As CGM demand and access grows, quantifying A1c-GMI discordance in diverse T2D populations can inform practice. We evaluated this discordance, stratified by T2D drugs and A1c. CGM-wearing adults with T2D, an overlapping A1c and GMI date (10/2019 to 3/2022), and CGM data sufficiency (DS) ≥ 70% were included. Prior 3 month pharmacy claims defined drug histories. We calculated the Pearson correlation coefficient (r) and A1c-GMI differences by subgroup. A1c-GMI pairs existed for 2,760 people (mean [SD] age 55 [9]; 46% F; 58% had A1c &lt;7%). Overall, pairs highly correlated (56% differed by &lt;0.5%; r=0.80). Non-insulin T2D drug users (N=1,674) had slightly higher concordance than basal insulin (N=437) and basal-bolus insulin users (N=317), with 58%, 50%, and 56% discordance &lt;0.5% (r=0.79, 0.77, 0.77). On average, A1c underestimated GMI for non-insulin users and overestimated GMI for basal and basal-bolus insulin users. Concordance decreased at A1c extremes, with 61-76% concordance for A1cs from 5.7% to 8%. Sensitivity analyes with lower DS had similar results. A1c-GMI discordance varied by T2D drug class and A1c, highlighting how CGM-derived measures can provide personalized insights for diverse T2D populations.

Disclosure
A.Jhuang: Employee; UnitedHealth Group, Stock/Shareholder; UnitedHealth Group. S.Bacon: Employee; Optum Labs, Research Support; Level2. S.Kamrudin: Employee; UnitedHealth Group. N.Thompson: Employee; Level2, Stock/Shareholder; UnitedHealth Group. C.Clark: Employee; UnitedHealth Group, Stock/Shareholder; UnitedHealth Group.
945-P: Effect of Real-Time Continuous Glucose Monitoring vs. Flash Glucose Monitoring on Glycemic Control and Glycemic Variability in Patients with Type 1 Diabetes—A Systematic Review and Meta-analysis
Authors: CHEN DANRUI , LIU ZHIGU , LIN BEISI , YANG YANLING , YANG DAIZHI , YAN JINHUA , XU WEN 
Published: June 2023

Objectives: Previous studies have shown that real-time continuous glucose monitoring (rtCGM) and flash glucose monitoring (FGM) led to different impacts on glycemic control and glycemic variability in patients with T1D. This meta-analysis aimed to summarize data and compare the effect of the rtCGM and FGM in patients with T1D. Methods: A systematic literature searches of all relevant studies comparing the clinical effectiveness of rtCGM and FGM in T1D on Cochrane Library, PubMed, Embase, Web of Science, and Scopus before October 2022 were performed. Two independent reviewers searched and assessed all literatures according to the standard of Cochrane systematic review. Data extraction and quality assessment were conducted. Stata 15.1 software was used for data analysis. The random effects model was used since there was heterogeneity between studies. Results: Eight studies including three randomized controlled trials and five observational studies conducting in 1649 TID patients were enrolled in this meta-analysis. It was found that there was no difference in reduction of HbA1c levels between rtCGM and FGM. In terms of indexes of glycemic variability, compared to FGM, rtCGM led to better TIR (3.9~10 mmol/L) (SMD = 0.721, 95%CI: 0.438 ~ 1.003, P&lt;0.001), lower TBR (&lt;3.9mmol/L) (SMD = -1.441, 95%CI: -2.090 ~ -0.791, P&lt;0.001), lower TAR (TAR&gt;10.0mmol/L: SMD = -0.299, 95%CI: -0.583 ~ -0.015, P = 0.039; TAR&gt;13.9 mmol/L: SMD = -0.395, 95%CI: -0.702 ~ -0.088, P = 0.012), lower standard deviation (SMD = -0.769, 95%CI: -1.097 ~ -0.442, P&lt;0.001), and lower glucose coefficient of variation (SMD = -0.859, 95%CI: -1.159 ~ -0.559, P&lt;0.001) as well. However, there was no difference between rtCGM and FGM in lowering mean glucose and TBR (&lt;3.0mmol/L). Conclusions: rtCGM accounted for favorable outcomes on improving glycemic variability indices but not HbA1c reduction compared to FGM in patients with T1D.

Disclosure
D.Chen: None. Z.Liu: None. B.Lin: None. Y.Yang: None. D.Yang: None. J.Yan: None. W.Xu: None.

Funding
SHMHDF (DMRFP_II_14)
949-P: Hypoglycemia Detection during Real-Time Continuous Glucose Monitoring in a Real-World Hospital Setting
Authors: BELASCO REBEKAH , FORTMANN ADDIE L. , SPIERLING BAGSIC SAMANTHA R. , BASTIAN ALESSANDRA , LOHNES SUZANNE , RITKO ANNA , SANDOVAL HALEY , CHICHMARENKO MARIYA , SORIANO EMILY C. , TALAVERA LAURA , PHILIS-TSIMIKAS ATHENA 
Published: June 2023

Continuous glucose monitoring (CGM) in the hospital can detect hypoglycemia that may go unnoticed by point-of-care testing (POCT). Following the non-objection of the FDA to the use of CGM in the hospital, using the Dexcom G6 CGM system, the “CGM as Standard of Care” (CGM as SOC) program was implemented at Scripps Mercy Hospital San Diego with a 24/7 remote-monitoring team (RMT) using a Digital Dashboard (DD). The DD alerts for glucose ≤80mg/dL and prioritizes patients by clinical risk. Using these alerts, the RMT notifies on-site bedside nurses (RN). Hypoglycemic events, defined as &gt;15 minutes of consecutive glucose readings &lt;70mg/dL, identified in retrospective evaluation of CGM data were analyzed to 1) evaluate appropriateness of response to events and 2) assess the accuracy of the events. 86/745 (12%) unique admissions enrolled in the CGM as SOC program between January 2021-June 2022 experienced a hypoglycemic event during the RMT period. These patients averaged 60.2 years of age, 62% male, 48% Hispanic and 87% with a type 2 diabetes diagnosis. Median number of events per admission = 1.90, for a total of 163 events. All alerts were acknowledged by the RMT, documentation that bedside RN was alerted was found on 134/163 (82%) events. It is possible that the RMT neglected to document RN outreach in the remaining 29 (18%). 90/163 events (55%) were treated as appropriate clinically, with insulin dosing changes as needed. In the remaining 69/163 (42%) events, patients were determined to not be (or no longer be) in an actionable hypoglycemia range that warranted treatment when evaluated by the RN. A small portion (10/69, 14%) were caused by documented compression on device resulting in artificially low CGM values. There were 4 (3%) events with insufficient documentation. These findings provide preliminary support of the value of an RMT in hypoglycemia surveillance in a real-world hospital setting. Additional data and recommendations for process refinements will be presented.

Disclosure
R.Belasco: None. L.Talavera: None. A.Philis-tsimikas: Advisory Panel; Dexcom, Inc., Novo Nordisk A/S, Sanofi, Other Relationship; Medtronic, Research Support; Novo Nordisk A/S, Lilly, Viking Therapeutics, NIH - National Institutes of Health. A.L.Fortmann: Employee; Dexcom, Inc. S.R.Spierling bagsic: None. A.Bastian: None. S.Lohnes: Consultant; Dexcom, Inc. A.Ritko: None. H.Sandoval: None. M.Chichmarenko: None. E.C.Soriano: None.
95-OR: A New Composite Blood Biomarker Performs Well in the Diagnosis of NASH, Advanced Hepatic Fibrosis, and High-Risk NASH
Authors: HO LEE DAE 
Published: June 2023

Background and Aims: Plasma aldo-keto reductase family 1 member B10 (AKR1B10) well reflects the progression of NAFLD. Thus, we aimed to evaluate whether composite blood biomarkers including AKR1B10 and cytokeratin 18 (CK-18) have acceptable for the diagnosis NASH, advanced liver fibrosis, and high-risk NASH (NASH + significant fibrosis), respectively.
Methods: A total of 116 subjects in our pooled cohort (24 healthy controls and 92 patients with biopsy-proven NAFLD (48 patients with NAFL and 44 patients with NASH) were analysed to assess composite blood-based and imaging-based biomarkers, which included the markers below either singly or in combination: AKR1B10, CK-18, AST, ALT, enhanced liver fibrosis (ELF) score, FIB-4, proton density fat fraction (MRI-PDFF), MR elastography-liver stiffness measurement (MRE-LSM), and the known MRI-AST (MAST) and FibroScan-AST (FAST) scores
Results: Composite blood biomarker comprised of AKR1B10, CK-18, AST, and ALT showed excellent performance for the diagnosis of, NASH, advanced fibrosis, and high-risk NASH, with AUROC curve values of 0.934 (95% CI: 0.888-0.981), 0.902 (95% CI 0.832-0.971) and 0.918 (95% CI 0.862-0.974), respectively. However, the performances of this blood composite biomarker were all inferior to various MR-based composite biomarkers (MRI-PDFF/MRE-LSM/ALT/AST for NASH, AUROC = 0.964; MRE-LSM + FIB-4 for advanced fibrosis, AUROC=0.982; and the MAST score for high-risk NASH, AUROC=0.947), with a better performance than the FAST score (AUROC=0.909) for the diagnosis of high-risk NASH.
Conclusion: Although slightly inferior to the MR imaging-based composite biomarkers, blood composite biomarker composed of AKR1B10, CK-18, AST, and ALT showed excellent performance in the diagnosis of progressive forms of NAFLD.

Disclosure
D.Lee: None.
953-P: The Use of isCGM Improves the Mental Aspect of Quality of Life in Overweight Individuals with Impaired Glucose Tolerance or Mild Diabetes Mellitus
Authors: NISHIKAGE SEIJI , NAKAGAWA YASUSHI , HIROTA YUSHI , YOSHIMURA KAI , UEDA MARIKO , YAMAMOTO AKANE , TAKAYOSHI TOMOFUMI , MATSUOKA ATSUKO , TAKAHASHI MICHIKO , YOKOTA KAZUKI , NAKAMURA TOMOAKI , SAKAGUCHI KAZUHIKO , OGAWA WATARU 
Published: June 2023

Objective: We aimed to investigate the relationship between the use of intermittently scanned continuous glucose monitoring (isCGM) and quality of life (QoL) in overweight individuals with impaired glucose tolerance (IGT) or mild type 2 diabetes mellitus (T2DM).
Methods: Forty overweight individuals (BMI ≥25kg/m2) having IGT or mild T2DM (without taking antidiabetic drugs and with HbA1c ≤7.0%) were recruited. We randomly divided the subjects into two groups: those using isCGM in addition to diet and exercise therapy (isCGM group) and those treated with diet and exercise therapy alone (control group). We conducted a 6-month intervention and assessed QoL using SF36 before and after the intervention.
Results: One participant in the isCGM group withdrew the consent. We thus analyzed 19 participants in the isCGM group (53.8±11.5 years old, BMI 35.2±5.7 kg/m2, HbA1c 6.2±0.3%) and 20 participants in the control group (54.3±14.0 years old, BMI 31.6±6.8 kg/m2, HbA1c 6.2±0.3%). There were no differences in changes in each subscale of the SF36 and component summary scores between the isCGM and control groups. In the isCGM group, Mental Component Summary (MCS) improved significantly after the intervention (43.6/48.2, p&lt;0.05). Changes in SD and Time Above Range (TAR) were negatively correlated with changes in general health perception (GH) (r= -0.50, p&lt;0.05; r= -0.53, p&lt;0.05). The number of scans positively correlated with vitality, mental health, and MCS before and after the intervention.
Conclusions: The use of isCGM improved MCS in overweight individuals with IGT or drug-naïve T2DM. The improvement in SD and TAR with the use of isCGM likely contributed to the improvement in GH. In addition, the number of scans correlated with MCS, suggesting that vitality and mental health are essential for the effective use of isCGM.

Disclosure
S. Nishikage: None. Y. Nakagawa: None. Y. Hirota: Other Relationship; Lilly, Sanofi K.K., Terumo Corporation, Sumitomo Dainippon Pharma Co., Ltd. Research Support; Sumitomo Dainippon Pharma Co., Ltd. K. Yoshimura: None. M. Ueda: None. A. Yamamoto: None. T. Takayoshi: None. A. Matsuoka: None. M. Takahashi: None. K. Yokota: None. T. Nakamura: None. K. Sakaguchi: Research Support; Sumitomo Dainippon Pharma Co., Ltd. W. Ogawa: Advisory Panel; Abbott Japan Co., Ltd. Research Support; Boehringer Ingelheim Japan, Inc., Eli Lilly Japan K.K., Novo Nordisk, Teijin Pharma Limited, Kowa Company, Ltd., Sumitomo Dainippon Pharma Co., Ltd., Abbott Japan Co., Ltd. Speaker's Bureau; Sumitomo Dainippon Pharma Co., Ltd.
96-OR: Liver Fibrosis Scores in Novel Subclusters of Patients at Risk for Type 2 Diabetes
Authors: MINELLI FAIAO VITORIA , SANDFORTH ARVID , KATZENSTEIN SARAH , FRITSCHE ANDREAS , FRITSCHE LOUISE , MACHANN JÜRGEN , SCHICK FRITZ , HÄRING HANS-ULRICH , WAGNER ROBERT , PETER ANDREAS , BIRKENFELD ANDREAS L. , STEFAN NORBERT , JUMPERTZ VON SCHWARTZENBERG REINER 
Published: June 2023

Metabolic diseases such as type 2 diabetes (T2D) are linked to the development of fatty liver, steatohepatitis and liver fibrosis. We have previously described novel clusters of patients at risk for T2D. Three clusters (3, 5 and 6) either had a high risk to progress to T2D or to develop cardiorenal complications. While high-risk clusters differ in liver fat content, it remains unknown if they also harbor a different risk for hepatic fibrosis. Thus, we determined clinically applicable scores of liver fibrosis in 1115 subjects at risk for T2D from the TUEF/TULIP study, which were categorized into high-risk clusters (n=602). Liver fat content was determined by 1H-magnetic resonance spectroscopy. The AST-to-platelet-ratio index (APRI), fibrosis-4 score (FIB-4) and NAFLD fibrosis score (NFS) were used to determine fibrosis risk. ANCOVA model analysis adjusted for liver fat content was performed. Of the high-risk clusters (3: n= 83, 5: n= 203, 6: n= 316), cluster 6 had the highest BMI 44.1±9.7 kg/m² (vs. cluster 3: 29.7±3.1 kg/m², p&lt;0.001 and cluster 5: 42.8.0±8.7, p=0.32) and cluster 5 had the highest liver fat content (13.4±8.8% vs. cluster 3: 8.0±6.5, p&lt;0.001 and cluster 6: 9.0±6.7, p&lt;0.001). All fibrosis scores correlated with liver fat content (e.g. FIB-4: r= 0.45, p&lt; 0.0001). Although FIB-4, APRI and NFS were generally low, they were highest in cluster 5, but despite highest liver fat content, they did not differ from cluster 3 and 6 (e.g. FIB-4: cluster 5: 0.19±0.45 vs. cluster 3: 0.14±0.01, p=0.59 and cluster 6: 0.12±0.15, p=0.39). Interestingly, cluster 3 with the lowest liver fat content exhibited higher FIB-4 compared to cluster 6 (p=0.02). According to clinically applicable scores, the most insulin resistant cluster 5 has the highest FIB-4 score. The insulin deficient cluster 3 has a relatively high FIB-4 score despite relatively low liver fat content and BMI. Further studies are needed to investigate the clinical relevance of these findings.

Disclosure
V.Minelli faiao: None. A.Peter: None. A.L.Birkenfeld: None. N.Stefan: Advisory Panel; Pfizer Inc., Research Support; Sanofi, Speaker's Bureau; AstraZeneca, Boehringer Ingelheim (Canada) Ltd., Lilly Diabetes, Novo Nordisk, Sanofi-Aventis Deutschland GmbH. R.Jumpertz von schwartzenberg: Other Relationship; Sanofi, Amgen Inc., Lilly, Novo Nordisk. A.Sandforth: None. S.Katzenstein: None. A.Fritsche: Advisory Panel; Novo Nordisk, Lilly, Sanofi, Boehringer-Ingelheim, Speaker's Bureau; AstraZeneca, SYNLAB Holding Deutschland GmbH. L.Fritsche: None. J.Machann: None. F.Schick: None. H.Häring: None. R.Wagner: Advisory Panel; Daiichi Sankyo, Speaker's Bureau; Novo Nordisk, Sanofi.
961-P: Comparison of Glucose Metrics by Capillary Blood Glucose and Continuous Glucose Monitoring among People with Type 2 Diabetes on Hemodialysis
Authors: GALINDO RODOLFO J. , GERGES AMANY Y.G. , MOAZZAMI BOBAK , PENG LIMIN , TUTTLE KATHERINE R. , UMPIERREZ GUILLERMO 
Published: June 2023

Background: Reliability of HbA1c in subjects with end-stage kidney disease treated with hemodialysis is poor. Capillary blood glucose (CBG) is widely used, but is limited to 2-4 values/day. Clinical guidelines recommend using continuous glucose monitoring (CGM) to assess glycemic control in this population, but there is limited data.
Methods: Prospective observational study of insulin treated adults with type-2 diabetes (T2D) receiving hemodialysis. Subjects were instructed to wear a Dexcom G6-Pro and perform Nova StatStrip CBG at least 2-4/d for 10-days. We compared mean glucose, hypoglycaemia, and hyperglycaemia rates, time-in-target range (TIR), time above range (TAR), and time below range (TBR) between testing methods.
Results: Glucose metrics are shown in Table 1.
Conclusion: Compared to CBG, CGM provides a comprehensive glycemic evaluation in insulin-treated subjects with T2D on hemodialysis. CGM was superior in assessing glycemic control (TIR), detection of severe hyperglycemia and hypoglycemic excursions, particularly nocturnal and prolonged events. Safer treatment options assessed by CGM metrics are needed for this high-risk population.

Disclosure
R.J.Galindo: Consultant; Novo Nordisk, Eli Lilly and Company, Sanofi, Pfizer Inc., Bayer Inc., WW (Weight Watchers), Research Support; Novo Nordisk, Eli Lilly and Company, Dexcom, Inc. A.Y.G.Gerges: None. B.Moazzami: None. L.Peng: None. K.R.Tuttle: Consultant; Lilly, AstraZeneca, Gilead Sciences, Inc., Research Support; Bayer Inc., Boehringer Ingelheim (Canada) Ltd., Novo Nordisk, Goldfinch Bio, Inc., Traveere Pharmaceuticals. G.Umpierrez: Research Support; Abbott, Dexcom, Inc., Baxter.
968-P: Real-World Comparison of Younger and Older Cohorts Using the Bigfoot Unity System for Six Months
Authors: VAUGHAN SARAH , TILLMAN JOHN , OLSON BYRON P. , NAUREEN SHEIKH F. , MALONE JAMES K. 
Published: June 2023

Background: The Bigfoot Unity® System is an FDA-cleared smart pen cap system incorporating CGM data, real-time alerts, and clinician-directed dose recommendations. The objective was to analyze real world data from younger and older subgroups using the System for MDI.
Methods: We conducted a 6-month retrospective analysis using deidentified data and a prespecified analysis plan for commercial users with ≥50% CGM data in the 6th month (N=127, 24 clinics). A baseline A1C was obtained from clinic medical records (N=118). Outcomes for those &lt;65 (N=58) and ≥65 (N=69) years old were compared.
Results: Most (83%) in each group had T2D; mean age in &lt;65 and ≥65 groups was 54 and 73 years. Mean baseline A1C was 8.6±1.7% and 8.2±1.6% in the &lt;65 and ≥65 groups; mean 6 month GMI was 7.5±0.9% and 7.3±0.8%, respectively. Glycemic outcomes and System use data are shown for age subgroups (Table). Using GMI as an A1C proxy, pairwise comparisons of GMI at 6 months to baseline A1C (N=118) show a 1.1±1.4% improvement overall (P&lt;0.05).
Discussion: The overall cohort consisted mostly of older T2D adults using MDI with suboptimal glycemic control. Given there may be concerns with older people adequately adopting and using new technology to manage diabetes, comparison with those younger highlights similar glycemic control and System engagement with Bigfoot Unity. Both groups demonstrate close adherence to established glycemic targets at 6 months.

Disclosure
S.Vaughan: Employee; Bigfoot Biomedical, Inc. J.Tillman: Employee; Bigfoot Biomedical, Inc. B.P.Olson: Employee; Bigfoot Biomedical, Inc. F.Sheikh: Employee; Bigfoot Biomedical, Inc. J.K.Malone: Employee; Bigfoot Biomedical, Inc.

Funding
Bigfoot Biomedical, Inc.