bluuebunny/crossref_metadata_2025_split huggingface dataset:
1369-P: The Natural Trends in Incidence of Lower Extremity Amputations in South Korea, 2003–2021
Authors: YOUNG JEON JA , KIM NAYOUNG , HWAN BACK JOUNG , LEE NAMI , JIN HAN SEUNG , JIN KIM HAE , JUNG KIM DAE , HO KIM TAE , AN SOYEON , LEE KWANWOO 
Published: June 2023

Introduction: National data in incidence of lower extremity amputations in the population of South Korea is lacking. Diabetes mellitus is a major risk factor for lower extremity amputations. The prevalence of diabetes mellitus is increasing faster than previously estimated in South Korea. Therefore, we investigated the trend of lower extremity amputations not only in people with diabetes, but also in the total (medically documented) population.
Method: We gathered and analyzed the data of the medically documented population, aged 20 years or older, from the Korean Health Insurance Service claims database between 2003 and 2021.
Results: Since 2003, incidence of lower extremity amputations among the total population has steadily increased, more than doubling by 2021 (6.8 to 14.5 amputations per 100,000 of population). The contribution of diabetes mellitus on lower extremity amputation has also elevated from 47% in 2003 to 70% in 2021. During the study period, the incidence of lower extremity amputations was consistently higher by more than three times in men (21.6) than in women (7.3), amputations per 100,000 of population in 2021. When foot amputations were classified by lower extremity parts, the proportion of major amputations (above ankle) has decreased slightly. In the last 10 years, the frequency and proportion of three or more repeated foot amputations has reduced (431 (9.2%) to 207 (4.1%)).
Conclusion: We reported the increasing trend of lower extremity amputation between 2003 and 2021 according to the increase in the prevalence of diabetes mellitus in South Korea. Among all lower extremity amputations, the major amputations and multiple amputations, 3 or more times, are decreasing.

Disclosure
J.Jeon: None. K.Lee: None. N.Kim: None. J.Back: None. N.Lee: None. S.Han: None. H.Kim: None. D.Kim: None. T.Kim: None. S.An: None.
137-LB: Modified Personal Glycemic State Model Predicts the Need for Islet Transplantation in Human
Authors: ORR CHRIS , HACKER-STRATTON JEANNETTE , EL-SHAHAWY MOHAMED , FOROUHAR ELENA , OMORI KEIKO , QI MEIRIGENG , KANDEEL FOUAD R. 
Published: June 2023

Continuous glucose monitoring (CGM) has become a valuable tool for assessing glycemic control. The personal glycemic state (PGS)1 is a mathematical model that considers 5 CGM data elements (mean blood glucose, percent time in range, glucose variability percentage, and frequency of moderate and severe hypoglycemia) equally to generate a score representing the degree of metabolic control. Our adapted personal glycemic state for islet transplant (PGSFIT) targets normoglycemia in islet transplantation by limiting the percent time in range to 70-140mg/dl instead of commonly used 70-180mg/dl, and uses weighted components without limiting the influence of any individual component on the total score. This allowed us to account for T1D patients keeping blood glucose high to avoid hypoglycemia or low to avoid long term complications despite increased hypoglycemia. Using PGS and PGSFIT to analyze glycemic control in 16 subjects with T1D post allogenic islet transplantations showed concordance in classifying the glycemic control as acceptable (PGS/PGSFIT &lt;15) or unacceptable (≥15) in 88% of the cases when variability was low (standard deviation of PGS components ≤ 0.1), and both PGSFIT and PGS models had excellent correlation with fasting c-peptide results. In contrast, when variability was high (standard deviation of PGS components &gt; 0.1), 71% of patients deemed clinically suitable for repeat transplant had PGSFIT score ≥15 but only 14% had PGS score ≥15. In patients who had not yet received their final islet infusion, high parameter variability and PGSFIT ≥15 was associated with lower fasting C-peptide compared to patients with high parameter variability and PGSFIT ≤15 who received the maximum therapeutic dose. PGSFIT significantly improved after repeat transplant in patients with high PGSFIT and high component variability. These results suggest PGSFIT may also be used to identify subjects suitable for first islet transplant.

Disclosure
C. Orr: None. J. Hacker-stratton: None. M. El-shahawy: None. E. Forouhar: None. K. Omori: None. M. Qi: None. F. R. Kandeel: None.

Funding
National Institutes of Health (U24DK098085)
137-OR: Metabolite Ratios and Development of Type 1 Diabetes
Authors: JOHNSON RANDI K. , ROMERO ALEX , WILLEMS EMILEIGH , RICH STEPHEN S. , REWERS MARIAN , FIEHN OLIVER , NORRIS JILL M. 
Published: June 2023

Ratios between metabolites more directly reflect flux through chemical reactions than individual metabolites. Variation in metabolites and their ratios are determined, in part, by genetic factors. Thus, genetic loci associated with variation in metabolite ratios may help disentangle genetic from non-genetic processes captured by the metabolome. We integrated metabolite ratios with genetics to predict changes preceding type 1 diabetes (T1D) in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Quantitative trait loci (QTLs) were identified for 132 metabolite ratios previously associated with progression from islet autoimmunity (IA) to T1D. Ratios were calculated from untargeted metabolomics data available at the time of seroconversion to IA for 338 cases and 921 matched controls in TEDDY. Genotyping was performed using a genome-wide array with custom content with imputation to the TOPMed reference panel. Ratio-SNP associations were estimated using Matrix eQTL software, adjusting for case-control status and genetic relatedness. Genome-wide significant association (P &lt; 4.9×10-9) was observed at 202 independent loci, involving 49 metabolite ratios. Twenty-six loci (12.9%) involved ratios between polyunsaturated fatty-acids (PUFAs) and fatty acid esters of hydroxy fatty acids (FAHFAs), a novel class of bioactive lipids with antidiabetic and anti-inflammatory effects. Variation in the metabolite ratio of eicosadienoic acid to FAHFA (18:1/O-15:1) was significantly determined by a site on chromosome 3 (ITPR1); ITPR1 encodes a receptor integral to calcium signaling and glucose-induced insulin secretion. Other genetic loci contributing to variation of PUFA:FAHFA ratios reside in genes controlling inflammatory and innate immune response (e.g., TSPO, TTLL12, NCAM1) and apoptosis (PPM1L). These novel metabolite ratio QTLs, some with known association with T1D risk, expand potential biomarkers of T1D risk, with PUFA:FAHFA ratios representing candidate FAHFA biosynthesis genes.

Disclosure
R.K. Johnson: None. A. Romero: None. E. Willems: Employee; Amgen Inc. S.S. Rich: None. M. Rewers: Research Support; Provention Bio, Juvenile Diabetes Research Foundation (JDRF), Hemsley Charitable Trust, Dexcom, Inc., Janssen Research & Development, LLC. O. Fiehn: None. J.M. Norris: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R03DK127472); National Institute of Allergy and Infectious Diseases; National Institute of Child Health and Human Development; National Institute of Environmental Health Sciences; JDRF; Centers for Disease Control and Prevention
1370-P: Glycemic Control and Intelligence over 30 Years in Children Diagnosed with Diabetes before 3 Years of Age (CLARiFY Study)
Authors: CAMERON FERGUS , MORAN CHRIS , BROWN AMY , BEARE RICHARD , GBADEYAN OYETUNDE , SAKOWSKI STACEY A. , SRIKANTH VELANDAI , FELDMAN EVA L. , NORTHAM ELISABETH A. 
Published: June 2023

Early childhood onset of type 1 diabetes (T1D) is associated with poorer cognition. Yet, the contribution of glycemic control to poorer cognition is unclear. We examined the association between glycemic control and full-scale intelligence quotient (FSIQ) in a cohort of children diagnosed with T1D before age 3 followed over 30 years. We recruited children presenting to a tertiary hospital in Australia from 1990-1992 in the prospective Cognition and Longitudinal Assessment of Risk Factors over 30 Years (CLARiFY) cohort study. Those with T1D underwent a cognitive test series at entry and 2, 6, 12 and 30 years post-diagnosis. Linear mixed effects modelling examined associations between HbA1c mean and coefficient of variation and FSIQ over time. Data were available for 12 subjects (6 male). The mean diabetes diagnosis age was 1.9 years. The mean HbA1c at each time of 2, 6, 12 and 30 years was 7.9, 8.3, 8.4 and 8.7%, respectively (Fig.1 shows HbA1c plots across time for each subject). We did not find an association between mean HbA1c (β=-3.2, p=0.09) nor HbA1c coefficient of variability (β=23.2, p=0.34) and FSIQ. Future analyses with more data will further document the impact of lifetime glycemic control on IQ and other cognitive measures in later life. Future work will also examine the impact of diagnosis age and acute dysglycemic events on cognitive outcomes 30 years after diagnosis vs healthy controls.

Disclosure
F.Cameron: None. C.Moran: None. A.Brown: None. R.Beare: None. O.Gbadeyan: None. S.A.Sakowski: None. V.Srikanth: None. E.L.Feldman: None. E.A.Northam: None.

Funding
National Institutes of Health (R01DK129320)
1372-P: Micro and Macro Complications Three-Year Follow-up in LANDMARC—Longitudinal Nationwide Study on Real-World Outcomes of Type 2 Diabetes in India
Authors: RAIS NADEEM , DAS ASHOK K. , JOSHI SHASHANK R. , MITHAL AMBRISH , KALRA SANJAY , GOPALAKRISHNAN UNNIKRISHNAN AMBIKA , THACKER HEMANT , SETHI BIPIN , CHOWDHURY SUBHANKAR , SUGUMARAN AMARNATH , SATPATHY ASHWINI , GADEKAR ARVIND , MENON SHALINI K. , NEOGI RENUKA , CHODANKAR DEEPA , TRIVEDI CHIRAG , KUMAR WANGNOO SUBHASH , ZARGAR ABDUL H. , PRASANNA KUMAR K.M. 
Published: June 2023

Microvascular and macrovascular complications were evaluated during the 3 years (yrs) of LANDMARC, a prospective observational study (CTRI/2017/05/008452) that included participants with T2D on ≥2 antihyperglycemic medications. Out of 6222 evaluable participants (mean baseline age: 52.1 yrs, T2D duration: 8.6 yrs and A1C: 8.05%), 5273 participants completed the 3-yr follow-up. The mean A1C decreased by 0.68% (p&lt;0.0001) in 3 yrs. Microvascular complications were noted in 18.02% (1121/6222) of participants, while the incidence of macrovascular complications was 3.29% (205/6222). Neuropathy was the most commonly reported complication (baseline: 11.8% and 3-yrs: 14.8%). The 3-yr results indicate slightly higher complications among those who were overweight, but the difference was non-significant (p=0.8380); and significantly higher complications among those with suboptimal glycemic control (p&lt;0.0001) or having CV risk factors (p&lt;0.0001) (Table). The most common macrovascular complication was MI. A total of 37 CV deaths were reported, with majority being sudden deaths (n=24), followed by fatal myocardial infarction (MI, n=10), coronary artery procedure (n=2), and stroke (n=1). These results offer insights into disease progression and suggest the need for controlling risk factors and timely treatment adjustment in participants with T2D.

Disclosure
N.Rais: Advisory Panel; Bayer Consumer Care AG, Board Member; Abbott, Biocon. A.Sugumaran: Employee; Sanofi. A.Satpathy: Employee; Sanofi. A.Gadekar: Employee; Sanofi. S.K.Menon: Employee; Sanofi. R.Neogi: Employee; Sanofi. D.Chodankar: Employee; Sanofi. C.Trivedi: None. S.Wangnoo: None. A.H.Zargar: None. K.Kumar: None. A.K.Das: n/a. S.R.Joshi: Advisory Panel; Biocon, Zydus Cadila, Torrent Pharmaceuticals Ltd, Franco India, Consultant; Glenmark Pharmaceuticals, Twin Health, Speaker's Bureau; Abbott Nutrition, Sanofi, Abbott, Novo Nordisk, Lupin Pharmaceuticals, Inc. A.Mithal: Advisory Panel; Eris Lifesciences Ltd., Consultant; Glenmark Pharmaceuticals, Lupin Pharmaceuticals, Inc., USV Private Limited, Research Support; Sanofi, Speaker's Bureau; Novo Nordisk, Boehringer-Ingelheim, AstraZeneca, Sun Pharmaceutical Industries Ltd., Novartis. S.Kalra: Speaker's Bureau; Abbott, Bayer Inc., Novo Nordisk, Sanofi. A.Unnikrishnan: Speaker's Bureau; Sanofi, AstraZeneca, Boehringer-Ingelheim, Intas Pharmaceuticals Ltd. H.Thacker: None. B.Sethi: None. S.Chowdhury: None.

Funding
Sanofi India
1374-P: Ultra-processed Food Consumption and Cardiometabolic Risk in Individuals With and Without Type 1 Diabetes Mellitus
Authors: PANG TIANTIAN , ALMAN AMY C. , GRAY HEEWON L. , DAGNE GETACHEW , BASU ARPITA , BURO ACADIA W. , SNELL-BERGEON JANET K. 
Published: June 2023

Background: Ultra-processed foods (UPFs) contribute to almost 60% of energy intake in the American diet. The longitudinal association between UPF consumption and cardiometabolic risk is less known, especially in people with type 1 diabetes mellites (T1DM) who are at a higher risk of developing cardiometabolic diseases than people without diabetes (non-DM).
Methods: We performed a longitudinal analysis of data from the Coronary Artery Calcification in Type 1 Diabetes study (T1DM: n=652; non-DM: n=764) collected at baseline and years 3, 6, and 14. Baseline age was 37.8±9.3 years. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire, and cardiometabolic biomarkers (BMI, waist circumference, triglycerides, HDL-C, LDL-C, and systolic and diastolic blood pressure) were measured at all four time points. NOVA food classification was used to compute UPF consumption (servings/d). Linear mixed-effects models were used to estimate longitudinal associations of UPF consumption with cardiometabolic risk, adjusting for potential confounders (race, age, sex, education, physical activity, smoking, energy intake, antihypertensive and lipid-lowering drugs, and diabetes duration for T1DM).
Results: People with T1DM consumed more UPFs, including processed meat, soft drinks, salty snacks, and margarine, than non-DM at baseline (8.7±7.8 vs. 7.3±6.7 servings/d, P&lt;0.01). Higher UPF consumption was associated with higher anthropometric measures (BMI: β=0.01±0.01, waist circumference: β=0.03±0.01), worse lipid levels (triglycerides: β=0.21±0.09, HDL-C: β=-0.04±0.02), and higher systolic blood pressure (β=0.05±0.02) when adjusted for diabetes status and other covariates (all P&lt;0.05).
Conclusion: UPF consumption significantly worsened the cardiometabolic profile over time in people with and without T1DM. Decreasing UPF intake may reduce the risk of developing cardiometabolic diseases across the lifespan.

Disclosure
T.Pang: None. A.C.Alman: None. H.L.Gray: None. G.Dagne: None. A.Basu: None. A.W.Buro: None. J.K.Snell-bergeon: None.

Funding
American Diabetes Association (7-13-CD-10 to J.K.S-B.), (7-13-CE-02 to A.C.A.); National Heart, Lung, and Blood Institute (R01HL079611, R01HL113029); Diabetes Endocrinology Research Center (P30DK57516, P30DK1116073)
1376-P: Dietary Sodium Intake and Risk of Incident Type 2 Diabetes
Authors: WANG XUAN , MA HAO , TANG RUI , XUE QIAOCHU , LI XIANG , HEIANZA YORIKO , QI LU 
Published: June 2023

Background: Type 2 Diabetes (T2D) and hypertension often coexist and share many common risk factors. High dietary sodium intake is a well-established risk factor for hypertension, whereas few studies have assessed the relation between dietary sodium intake and type 2 diabetes (T2D). In this study, we aimed to evaluate the association between the frequency of adding salt to foods, a surrogate marker for evaluating the long-term sodium intake, and incident T2D risk.
Methods: A total of 402,982 participants from UK biobank, who were free of diabetes, chronic kidney disease, cancer, or cardiovascular disease at baseline, and had completed information on adding salt were analyzed in this study. Cox proportional hazards models were used to estimate the association between the frequency of adding salt to foods and incident T2D.
Results: During a median of 11.8 years of follow-up, 13,120 incident T2D were documented. Compared with participants who Never/Rarely added salt to foods, the adjusted Hazard Ratios (95% confidence interval) were 1.13 (1.08, 1.17), 1.20 (1.14, 1.26), and 1.39 (1.30, 1.49) across the groups of Sometimes, Usually, and Always, respectively (P-trend&lt;0.001). We did not find significant interactions between the frequency of adding salt to foods and baseline hypertension status and other covariates on the risk of incident T2D. The observed positive association was partly mediated by body mass index (BMI), waist to hip ratio, and C-reactive protein, with a significant mediation effect of 32.9%, 36.6% and 7.0%, respectively. The significant mediation effect of BMI was largely driven by the body fat mass rather than the body fat-free mass.
Conclusions: Our findings for the first time indicate that higher frequency of adding salt to foods, a surrogate marker for a person’s long-term salt taste preference and intake, is associated with a higher T2D risk.

Disclosure
X.Wang: None. H.Ma: None. R.Tang: None. Q.Xue: None. X.Li: None. Y.Heianza: None. L.Qi: None.
138-LB: A Retrospective Algorithm to Identify Meal Intakes from CGM Time Series
Authors: CAMERLINGO NUNZIO , SHAAFI KABIRI NINA , PSALTOS DIMITRIOS , ISIK KARAHANOGLU F. , KHAN SHERAZ , MESSINA ISABELLE , WICKER MADISEN , KELLY MEREDITH , ZHANG HAO , MESSERE ANDREW , SANTAMARIA MAR , DEMANUELE CHARMAINE , CAOUETTE DAVID , THOMAS KEVIN C. 
Published: June 2023

The accurate assessment of dietary behavior in clinical trials, including number and size of meal intakes, is essential to evaluate participants’ metabolic health which, in turn, might reflect an increased risk for developing diabetes. Traditional dietary assessments leverage handwritten/digital food logs, which are error-prone and time-consuming for both users and investigators. Instead, glucose timeseries unobtrusively collected by CGM could provide objective measures of meals’ consumption. Here we present a new algorithm to retrospectively identify meal intakes using CGM data only.
In the Geriatric Anorexia Study (NCT04858932), 50 healthy individuals (26 females, mean±SD age: 72.26±5.02 years, BMI: 24.96±3.33 kg/m2) were monitored in free-living conditions for 2 weeks with the Abbott FreeStyle Libre Pro, and recorded meal intakes using the Renpho Smart Food Scale. After removal of days with &lt;2 meals recorded, a total of 1132 meals over 365 days were available for analysis. To identify meal intakes, the proposed algorithm scans CGM data, identifies local maxima, and measures their prominence, i.e., the relative height with respect to a neighborhood window of length L. Peaks with prominence higher than Pmin are labeled as meals. Subject data was divided into a ~70% training set (n=31, 775 meals), where L and Pmin are tuned, and ~30% test set (n=12, 357 meals), where the algorithm is evaluated in terms of absolute percent error (APE) between number of recorded and detected meals.
Across subjects, mean±sd daily APE is 25.1±9.70%. Similar values hold when considering only subjects with &lt;3.5 meals/day (n=6, 144 meals, APE=24.5±13.2%) and ≥3.5 meals/day (n=6, 213 meals, APE=25.5±6.93%), demonstrating the reliability of the algorithm to identify the number of meals in subjects with different dietary behaviors.
These results evidence the suitability of CGM for the automatic quantification of meal intakes. Further assessment of the algorithm should be performed using more controlled meal intake recordings.

Disclosure
N. Camerlingo: Employee; Pfizer Inc. A. Messere: None. M. Santamaria: None. C. Demanuele: None. D. Caouette: Employee; Pfizer Inc. K. C. Thomas: None. N. Shaafi kabiri: None. D. Psaltos: Employee; Pfizer Inc. F. Karahanoglu: None. S. Khan: None. I. Messina: Research Support; Pfizer Inc. M. Wicker: None. M. Kelly: Research Support; Pfizer Inc. H. Zhang: Employee; Pfizer Inc.
1382-P: Relationship between Diabetes Diet–Related Quality of Life and Dietary Fiber Intake among People with Type 2 Diabetes—A Cross-Sectional Study
Authors: TAKAHASHI FUYUKO , HASHIMOTO YOSHITAKA , KONDO YURIKO , HAMAGUCHI MASAHIDE , YAMAZAKI MASAHIRO , FUKUI MICHIAKI 
Published: June 2023

Introduction: This cross-sectional study investigated the association between diabetes diet-related quality of life (QoL) and diet intake in people with type 2 diabetes (T2D) (67.5±10.7 years and 62.2% men).
Methods: Diabetes diet-related QoL and nutritional intake were evaluated using the DDRQoL-R-9, including satisfaction with diet, perceived merits of diet therapy, and burden of diet therapy, and brief-type self-administered diet history questionnaire.
Results: Table shows that perceived merits of diet therapy were positively correlated with glycemic control, although burden of diet therapy was negatively correlated with glycemic control and that dietary fiber intake was negatively correlated with burden of diet therapy, although positively correlated with perceived merits of diet therapy. Dietary fiber intake was associated with perceived merits of diet therapy (β = 0.390, p &lt; 0.001), burden of diet therapy (β = −0.215, p = 0.013), and satisfaction with diet (β = 0.177, p = 0.036), after adjusting for covariates.
Discussion: People who have poor glycemic control despite diet therapy may have been overburdened by the diet therapy. High dietary fiber intake may affect increased burden of diet therapy although the perceived benefits of the diet therapy.
Conclusion: Dietary fiber intake is associated with diabetes diet-related QoL in people with T2D.

Disclosure
F. Takahashi: None. Y. Hashimoto: Speaker's Bureau; Takeda Pharmaceutical Co., Ltd., Sanofi K.K., Kowa Company, Ltd., Novo Nordisk, Sumitomo Dainippon Pharma Co., Ltd., Nippon Boehringer Ingelheim. Y. Kondo: None. M. Hamaguchi: Research Support; Yamada Bee Company, Inc. M. Yamazaki: None. M. Fukui: None.
1383-P: Prevalence of Municipal Policies to Help Reduce Type 2 Diabetes Risk by Providing Environments That Facilitate Healthy Eating and Breastfeeding
Authors: ONUFRAK STEPHEN J. , GALUSKA DEBORAH , PIERCE SAMANTHA L. , MACGOWAN CAROL A. , MOORE LATETIA 
Published: June 2023

Introduction: Communities with high diabetes burden may benefit from local policies that facilitate healthy eating and breastfeeding.
Methods: Data from the 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS HEAL; n=1,927 municipalities) were linked to 2019 county level small area estimates of adult diabetes prevalence (the most recent available) from the Centers for Disease Control and Prevention. We estimated the percentage of US municipalities reporting policies to support healthier food access in supermarkets, convenience stores, and farmers markets and policies to support breastfeeding for municipal employees. Chi-Square tests were used to determine if the presence of policies differed by community diabetes burden.
Results: Among municipalities with the highest diabetes burden (≥10.1%), 33.8% had a policy for supermarkets, 9.3% had a policy for convenience stores, and 62.9% had a policy for farmers markets and the percent of municipalities reporting these policies did not differ significantly by diabetes burden. The percentage of municipalities that provided breastfeeding employees time and space to pump breast milk differed by diabetes burden (p=0.006) and ranged from 47.7% among those with the highest diabetes burden to 69.3% among municipalities with the lowest burden (≤6.5%). Among municipalities with the highest diabetes burden, 38.2% provided any paid maternity leave, and 19.9% provided ≥8 weeks of maternity leave. Frequency of maternity leave policies did not differ significantly by diabetes burden.
Conclusion: Among US municipalities healthy food retail policies did not differ by diabetes burden. Less than half of municipalities with the greatest burden reported policies to support breastfeeding for municipal employees. Opportunities exist to improve support for healthy eating and breastfeeding among communities with high burden of diabetes.

Disclosure
S.J.Onufrak: None. D.Galuska: None. S.L.Pierce: None. C.A.Macgowan: None. L.Moore: None.