bluuebunny/crossref_metadata_2025_split huggingface dataset:
207-OR: Myostatin Inhibition Synergizes with GLP-1R Agonism to Accelerate Weight Loss in Male, Obese Nonhuman Primates
Authors: MASTAITIS JASON , GOMEZ DANIEL , LE ROUZIC VALERIE , STEC MICHAEL , KHAN NAVEEN , NA ERQIAN , MCWILLIAMS TOYA , MIN SOO , SLEEMAN MARK 
Published: June 2023

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have become standard-of-care for the pharmacological treatment of obesity by inducing clinically meaningful weight loss through a reduction in appetite. While these agents potently reduce fat mass, the caloric restriction also reduces skeletal muscle mass. Strategies to preserve skeletal muscle in the presence of caloric restriction are needed to improve weight loss quality in obese patents. Trevogrumab (∝-MSTN) and garetosmab (∝-ActA) are fully human monoclonal antibodies that potently inhibit two mediators of skeletal muscle atrophy: myostatin (MSTN) and activin A (ActA). We first tested the effects of ∝-MSTN, ∝-ActA and GLP-1RA (Semaglutide [Sema]) on body composition of diet-induced obese mice either alone or in combination. Sema (-29.8%) and ∝-MSTN/∝-ActA (-23.4%) produced significant reduction in fat mass after 4 weeks of treatment vs baseline. Adding MTSN and ActA blockade to Sema produced an additive effect on fat mass (-54.2%). This combination also increased lean mass by 9.8% vs a 1.9% loss with Sema alone. To test this in primates, we performed a 20-week study with the combined administration of either Sema + ∝-MSTN or Sema + ∝-MSTN and ∝-ActA in obese male cynomolgus monkeys. The combination of ∝-MSTN + Sema was sufficient to cause an additive effect on fat mass -43.9% vs -25.1% for Sema alone. The addition of ∝-ActA to the combination produced a similar reduction in fat (-49.6%). The Sema control group also lost -2.5% lean mass after 20 weeks; despite the significant reduction in fat mass, the addition of ∝-MSTN to Sema slightly increased lean mass over the same period (0.5%); the addition of ∝-ActA increased lean mass even further (6.2%). These data suggest the blockade of MSTN and ActA to GLP-1RA treatment could greatly improve the quality of weight loss with this class of anti-obesity agents.

Disclosure
J.Mastaitis: Employee; Regeneron Pharmaceuticals Inc., Stock/Shareholder; Regeneron Pharmaceuticals Inc. D.Gomez: Employee; Regeneron Pharmaceuticals Inc., Stock/Shareholder; Regeneron Pharmaceuticals Inc. V.Le rouzic: Employee; Regeneron Pharmaceuticals Inc., Stock/Shareholder; Regeneron Pharmaceuticals Inc. M.Stec: Employee; Regeneron Pharmaceuticals Inc., Stock/Shareholder; Regeneron Pharmaceuticals Inc. N.Khan: Employee; Regeneron Pharmaceuticals Inc., Stock/Shareholder; Regeneron Pharmaceuticals Inc. E.Na: Employee; Regeneron Pharmaceuticals Inc., Stock/Shareholder; Regeneron Pharmaceuticals Inc. T.Mcwilliams: None. S.Min: Employee; Regeneron Pharmaceuticals Inc., Stock/Shareholder; Regeneron Pharmaceuticals Inc. M.Sleeman: Employee; Regeneron Pharmaceuticals Inc.

Funding
Regeneron Pharmaceuticals Inc.
25-OR: ADA Presidents' Select Abstract: Preclinical Evaluation of TYK2 Inhibitors in Type 1 Diabetes
Authors: SYED FAROOQ , BALLEW OLIVIA , LEE CHIH-CHUN , RANA JYOTI , CASTELA ANGELA , WEAVER STACI A. , THOMAIDOU SOFIA , DEMINE STÉPHANE , COOMANS DE BRACHÈNE ALEXANDRA , ALVELOS MARIA I. , CHANG GARRICK , ORR KARA , YAMADA KENTARO , LIU JING , ZALDUMBIDE ARNAUD , SCHEUNER DONALYN , EIZIRIK DECIO L. , EVANS-MOLINA CARMELLA 
Published: June 2023

Interferon-α (IFNα) plays a prominent role in type 1 diabetes (T1D) pathogenesis and mediates its effects through the IFN receptor (IFNAR) and the protein tyrosine kinases JAK1 and TYK2. Polymorphisms that decrease TYK2 activity are protective against T1D, and TYK2 inhibitors (TYKi) are being evaluated for therapeutic benefit in other autoimmune conditions. To test whether TYK2 inhibitors BMS-986202 and BMS-986165 have similar efficacy in diverse models of T1D, we evaluated their effect in vitro on human islets, EndoC-βH1 cells, and iPSC-derived islet-like aggregates and monitored diabetes incidence in RIP-LCMV and NOD mice following in vivo treatment with BMS-986202. TYK2i prevented IFNα-mediated upregulation of CXCL10, MX1, and HLA-ABC in human islets, iPSCs, and EndoC-βH1 and decreased IFNα-mediated STAT1/2 phosphorylation and apoptosis in human islets. Importantly, BMS-986202 reduced diabetes incidence in RIP-LCMV mice by 80% (n=18 vehicle/18 TYK2i; p&lt;0.001). Flow cytometry analysis 3 days post LCMV injection revealed a decrease in the percentage of CD11b+F4/80+ macrophages (M1) and CD11b+CD49+ NK cells in pancreatic lymph nodes (PLN) and blood and an increase in circulating CD11b-CD49+ tolerogenic-NK cells in TYK2i-treated RIP-LCMV mice. At days 7 and 14 post LCMV, PDI+CD8+T-cells in the blood, spleen, and PLN and PDI+FOXP3+ Treg cells in the spleen were increased in TYK2i-treated RIP-LCMV mice, indicating T-cell exhaustion. Similarly, treatment with BMS-986202 resulted in a 44% decrease in diabetes incidence in NOD mice (n=32 vehicle/34 TYK2i; p=0.0075) and a significant reduction in insulitis (p&lt;0.05). smFISH analysis revealed decreased β cell expression of STAT1 and MX1 in TYK2i-treated RIP-LCMV mice and NOD mice compared to vehicle-treated mice, while T-cell activation upon co-incubation with target human β cells was inhibited by TYK2i treatment. Taken together, our findings demonstrate that TYK2 inhibition protects against β cell inflammation and T1D development in multiple preclinical models.

Disclosure
F.Syed: None. M.I.Alvelos: None. G.Chang: None. K.Orr: None. K.Yamada: None. J.Liu: None. A.Zaldumbide: None. D.Scheuner: None. D.L.Eizirik: None. C.Evans-molina: Advisory Panel; Provention Bio, Inc., DiogenX, Avotres Inc., Neurodon, MaiCell Therapeutics, Other Relationship; Isla Technology, Bristol-Myers Squibb Company, Nimbus Therapeutics, Research Support; Lilly, Astellas Pharma Inc. O.Ballew: None. C.Lee: None. J.Rana: Research Support; Bayer Inc. A.Castela: None. S.A.Weaver: Employee; Eli Lilly and Company. S.Thomaidou: None. S.Demine: None. A.Coomans de brachène: None.

Funding
National Institutes of Health (DK127308, UC4DK104166); JDRF (2-SRA-2019-834-S-B, 5-CDA-2022-1176-A-N)
287-LB: Thiazolidinedione Ameliorates Lipotoxicity-Induced Pancreatic ß-Cell Ferroptosis Partly via ACSL4
Authors: ZHANG MEI , QIN LU , QIN YAO , WEI QIANYING , CHEN XIN 
Published: June 2023

Pancreatic β cells death is a major factor driving the deterioration of glucose control in type 2 diabetes mellitus (T2DM). Ferroptosis is a non-apoptotic form of lipid peroxidation-induced cell death. The long-chain acyl-CoA synthetase 4 (ACSL4) contributes significantly to lipid metabolism and determines ferroptosis sensitivity. Accounting for still limited understanding of lipotoxicity-related ferroptosis in β cells, we aim to identify pancreatic β cells ferroptosis in lipotoxicity-induced diabetes and the role of ACSL4 plays in this process. In this study, we found that fatty acids could induce apoptosis in pancreatic β cells, along with a new form of death called ferroptosis. Pancreatic islets of 16-week HFD-fed mice showed reduced mitochondrial cristae, decreased mitochondrial cristae, and increased bilayer membrane density compared to LFD-fed mice. Iron fluorescence staining showed increased intracellular Fe2+ levels in pancreatic islets. Ferroptosis inhibitor fer-1 had a specific protective effect of on HFD-induced β-cell ferroptosis. Through using the Cre-LoxP system, we performed a ACSL4 knockout model of the HFD-induced metabolic diseases, we found that lipid metabolism dictates ferroptosis in pancreatic β cells through ACSL4, which appear to be related to pancreatic β cells dysfunction. ACSL4 knockdown attenuated fatty acids-induced ferroptosis in pancreatic β cells in vivo and in vitro. ACSL4 overexpression induces ferroptosis in MIN6 cells. Moreover, we observed that troglitazone attenuated AA, DHA, PA and erastin induced ferroptosis in MIN6 cells. These results together provide definitive evidence linking β cells with lipotoxicity-induced ferroptosis and suggest the anti-ferroptosis effect of ACSL4 may be a new therapeutic target for the targeted therapy of T2DM.

Disclosure
M. Zhang: None. L. Qin: None. Y. Qin: None. Q. Wei: None. X. Chen: None.

Funding
National Natural Science Foundation of China (81974103)
32-LB: Oral Care Behaviors among the U.S. Population with Diabetes
Authors: ZHANG YUQING , LEVEILLE SUZANNE , BERGER KIMBERLY , CAMHI SARAH M. , SHI LING 
Published: June 2023

Diabetes self-care skills are necessary to control glucose in people with diabetes (PWD). The ADA recommends self-care behaviors including healthy eating, being active, monitoring, taking medication, consulting diabetes care professionals, and reducing risk for complications. Oral self-care is an important but often overlooked aspect of reducing risk in diabetes self-care. This study examined the relationship between diabetes self-care and oral care behaviors. Using NHANES 2011-2016, we analyzed data from 1,585 dentate adults (≥ 30yrs) with self-reported diabetes. Oral self-care was measured by use of preventive dental care in the past year and flossing frequency (never, 1-6day/week, daily). Descriptive analyses compared people reporting good diabetes self-care (score 4-7, summary score of 7 self-care recommendations) and those with poor diabetes self-care (score 0-3), an approximate median split. Sample weights were applied to derive US population estimates. Multivariable and multinomial logistic regression was performed adjusting for age, gender, race, education, income and health insurance. Among the US PWD, 35% report daily flossing and 29% report never flossing; 48% reported a preventive dental visit in the past year. PWD who performed good diabetes self-care were 47% more likely to report using preventive dental care compared to those with poor diabetes self-care (AOR=1.47, 95%CI 1.18-1.84), and they were 38% more likely to be flossing daily (AOR=1.38, 95%CI 1.07-1.79). PWD who practice good diabetes self-care are more likely to also engage in good oral self-care. However, the association cannot be attributed to diabetes self-management education because until 2023, the ADA standards for diabetes self-management did not address oral health practices or dental care. Continued efforts are needed to incorporate oral self-care practices into diabetes self-care education. Further research is warranted to determine possible disparities in diabetes self-management and oral care.

Disclosure
Y. Zhang: None. S. Leveille: None. K. Berger: None. S. M. Camhi: None. L. Shi: None.
321-OR: Differential Associations of Obesity and Metabolic Syndrome with Polyneuropathy in Early Type 2 Diabetes and Normal Glucose Tolerance
Authors: SIPOLA GUNDEGA , STROM ALEXANDER , BOMBRICH MARIA , WAGNER ROBERT , ZIEGLER DAN , RODEN MICHAEL , BÖNHOF GIDON J. ,   GDS GROUP
Published: June 2023

There is increasing evidence for a role of the metabolic syndrome (MetS) during development of distal sensorimotor polyneuropathy (DSPN). We hypothesized that MetS components are differentially associated with measures of DSPN in individuals with normal glucose tolerance (NGT) and early type 2 diabetes (T2D). Electrophysiological and quantitative sensory testing was performed in 180 participants with NGT and 355 with recent-onset T2D (known diabetes duration &lt;1 year) matched for age from the German Diabetes Study (NGT/T2D [mean±SD]: age: 43.9±14.0/45.1±7.7 years; sex: 61/65% male; BMI: 26.8±5.0/32.3±6.5 kg/m²; HbA1c: 5.2±0.3/6.5±1.0%). Intraepidermal nerve fiber density (IENFD) was assessed in 218 individuals (NGT/T2D: n=117/101). Subsets of participants were followed for 5 years (NGT/T2D: n=48/53). MetS was defined according to International Diabetes Federation (2006) and DSPN according to Toronto consensus criteria (2011). After adjustment for age, sex, height, smoking and HbA1c, a lower IENFD was associated with higher weight (β=-0.306), number of MetS components (NMetSC; β=-0.222) and presence of central obesity (β=-0.292), while higher malleolar vibration perception threshold was associated with weight (β=0.219) in NGT (P&lt;0.05), but not in T2D. Median motor nerve conduction velocity and sural sensory nerve action potential were inversely associated with weight (β=-0.182/-0.286), NMetSC (β=-0.127/-0.128), presence of central obesity (β=-0.163/-0.165), and MetS (β=-0.169/-0.203) in T2D (P&lt;0.05). Higher weight predicted the presence of DSPN at 5 years (β=0.652, P=0.001) in NGT, while increasing NMetSC and MetS prevalence predicted a decline in IENFD over 5 years (β=-0.533/-0.388, P=0.001/0.013) in T2D. This suggests that obesity indices can predict DSPN over 5 years in NGT, while MetS and its components are differentially associated with measures of DSPN in early, well-controlled type 2 diabetes compared with NGT.

Disclosure
G.Sipola: None. A.Strom: None. M.Bombrich: None. R.Wagner: Advisory Panel; Daiichi Sankyo, Speaker's Bureau; Novo Nordisk, Sanofi. D.Ziegler: None. M.Roden: Advisory Panel; Eli Lilly and Company, Consultant; TARGET PharmaSolutions, Inc., Research Support; Boehringer-Ingelheim, Novo Nordisk, Novartis, Sanofi. G.J.Bönhof: None. Gds group: n/a.

Funding
German Federal Ministry of Health; Ministry of Innovation, Science, Research and Technology of the state North Rhine-Westphalia; German Federal Ministry of Education and Research
330-OR: Healthy Eating Index Correlates with Better Glycemic Control among People with Type 1 Diabetes
Authors: GILLINGHAM MELANIE B. , MARAK CHASE , CALHOUN PETER , NEUBIG KARISSA E. , PATTON SUSANA R. , CASTLE JESSICA R. , JACOBS PETER G. , GAL ROBIN L. , MARTIN CORBY K. ,   T1DEXI STUDY GROUP
Published: June 2023

The amount and type of food consumed impacts glycemic response and insulin needs of people with type 1 diabetes (T1D). Day to day variation in types of foods consumed or diet quality may acutely impact glycemic levels and insulin needs within an individual with T1D. As part of the Type 1 Diabetes Exercise Initiative (T1Dexi), we examined the impact of overall daily diet quality on glycemic control. Diet quality was assessed by the Healthy Eating Index-2015 (HEI) where a score of 100 indicates highest quality diet characterized by intake of more vegetables, fruits, and whole grains and less intake of saturated fat and added sugar. Dietary intake was captured on up to 12 different days per participant during the one-month study via food photography with the T1Dexi app. Food photos were analyzed for nutrient intake by the Remote Food Photography Method. Mean HEI score for all participants was 57, similar to the general US population. Each day of dietary intake was classified as low (HEI≤57) or high (HEI&gt;57) within a participant and only participants with at least two low and two high HEI days were included in the analysis. CGM and insulin metrics were compared using a linear mixed effect model with a random subject effect. Participants (n=223) were 19-68 years (37±14 years), 76% identified as female, had a mean HbA1C of 6.6±0.7 and a mean body mass index of 25.1±3.6. On high HEI days (mean score: 66±4), total time in range (70-180 mg/dl) was greater (77.2±14% vs 75.7±14% p=0.01), while time above 180 mg/dl (19±14% vs 21±15%, p=0.01) and mean glucose (143±22 vs 145±22 mg/dl, p=0.02) were lower compared to low HEI days (mean score: 47±5). Total daily insulin dose was lower on high HEI days (0.52±0.18 vs 0.54±0.18 U/kg/day p=0.01). Higher diet quality correlates with improved glycemia and lowered insulin needs during that 24-hour period of time within an individual T1D participant but the impact of diet quality was smaller than the impact of exercise and represents an incremental improvement among well-controlled subjects.

Disclosure
M.B.Gillingham: None. T1dexi study group: n/a. C.Marak: None. P.Calhoun: None. K.E.Neubig: None. S.R.Patton: None. J.R.Castle: Advisory Panel; Novo Nordisk, Zealand Pharma A/S, Research Support; Dexcom, Inc., Stock/Shareholder; Pacific Diabetes Technologies. P.G.Jacobs: Board Member; Pacific Diabetes Technologies, Other Relationship; Pacific Diabetes Technologies, Research Support; Dexcom, Inc. R.L.Gal: None. C.K.Martin: Board Member; EHE Health, Wondr Health, Other Relationship; ABGIL, Research Support; Pack Health, Evidation Health, Lilly, WW International, Inc.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust; Verily Life Sciences; Dexcom, Inc.
397-P: Epigenetic Regulation of the Chemokine CXCL2 in Acute Kidney Injury in Diabetes
Authors: NAGARJUN BATCHU SRI , GANESH YERRA VEERA , HONG YUQING , PLANT PAMELA , LIU YOUAN , ADVANI ANDREW 
Published: June 2023

People with diabetes are much more likely to develop acute kidney injury (AKI) than people who do not have diabetes. Here we took a reverse translational approach to identify factors that increase the risk of AKI in diabetes. Aged diabetic high fat diet-fed (DM-HFD) mice and nondiabetic controls were randomized to sham or bilateral renal ischemia reperfusion injury (IRI) surgery, with phenotyping performed 24h later. DM-HFD mice with IRI had increased plasma BUN and creatinine and increased tubule injury in comparison to either nondiabetic mice with IRI or DM-HFD mice that underwent sham surgery. NanoString nCounter analysis of AKI kidneys revealed that 47 of 248 inflammatory genes were differentially expressed in the kidneys of DM-HFD IRI mice in comparison to nondiabetic mice with IRI. The top hit was the chemokine Cxcl2, which was upregulated 2429-fold compared with sham-operated nondiabetic mice and 92-fold compared with nondiabetic mice with IRI. Urine CXCL2 excretion was increased &gt;200-fold in DM-HFD IRI mice. By RNAscope in situ hybridization, Cxcl2 was observed to be upregulated in DM-HFD IRI kidneys, being localized primarily to infiltrating inflammatory cells, but also expressed in glomeruli and scattered tubule epithelial cells. Stimulation of bone marrow-derived macrophages (BMDMs) with lipopolysaccharide caused release of CXCL2 into the culture medium, with a significant increase in CXCL2 secretion by BMDMs from mice with myeloid cell deletion of the histone demethylase KDM6A (LysMCre+Kdma6fl/ymice). In summary, augmented AKI in aged diabetic high fat diet-fed mice is accompanied by upregulation of the myeloid cell chemoattractant CXCL2, which itself is under the influence of the histone demethylating enzyme KDM6A. The findings provide insights into the molecular causes of worsened AKI in diabetes and they illustrate that, like chronic kidney disease in diabetes, AKI processes in diabetes are also under epigenetic regulation.

Disclosure
S. Batchu: None. V. Yerra: None. Y. Hong: None. P. Plant: None. Y. Liu: None. A. Advani: None.

Funding
Canadian Institutes of Health Research (PJT166083 to A.A.)
502-P: Correlation of Periodontal Inflamed Surface Area and Clinical Attachment Loss with Glycemic Status, Serum IL6, and Serum Lipoprotein(a) in Subjects Having Type 2 Diabetes Mellitus With and Without Diabetic Retinopathy
Authors: JAMAL T P NUSREEN , R CHANDNI , VADAKKEKUTTICAL ROSAMMA J. 
Published: June 2023

Background: The two-way relationship between periodontitis and type 2 diabetes mellitus (T2D) is well established. An inflammatory link exists between diabetic retinopathy (DR) and periodontitis. This study was undertaken to compare the prevalence, extent and severity of periodontitis, to correlate clinical attachment level (CAL) and periodontal inflamed surface area (PISA) with glycemic status, serum IL-6 and lipoprotein a [Lp (a)] in T2D subjects with and without DR.
Method: This cross-sectional study comprised 40 T2D subjects with DR and 40 T2D subjects without DR. All were assessed for periodontal parameters (BOP, PPD, CAL, OHI-S Index, PI Index and PISA) and systemic parameters (HbA1c, FBG, PPBG, FLP, serum IL-6 and serum Lp (a)).
Results: The Proportion, Extent and severity of periodontitis and PISA were higher in T2D with DR compared to T2D without DR. T2D with DR subjects had a mean of 69% sites with gingival bleeding and 40% in T2D without DR. HbA1c was positively correlated with CAL (r = 0.123, p=0.001) and PISA (r = 0.154, p=&lt; 0.001) in T2D with DR. A positive correlation was found between PISA and IL6 (Pearson correlation coefficient 0.651, p &lt; 0.0001); PISA and Lp (a) (Pearson correlation coefficient 0.59, p &lt; 0.001); CAL and IL6 (Pearson correlation coefficient 0.527, p &lt; 0.0001) and CAL and Lp (a) (Pearson correlation coefficient 0.631, p &lt; 0.001). Serum IL-6 and Lp (a) are higher in retinopathy patients with periodontitis than those without periodontitis.
Conclusion: Despite both groups having poor glycemic control and comparable plaque scores, the periodontal and inflammatory parameters were higher in the DR group compared to T2D without the DR. The presence of diabetic retinopathy may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of diabetic retinopathy. Support: Ophthalmology faculty

Disclosure
N.Jamal t p: None. C.R: None. R.J.Vadakkekuttical: None.
684-P: Momentary, Daily, and Long-Term Impacts of Diabetes on Daily Activities—The Function and Emotion in Everyday Life with Type 1 Diabetes (FEEL-T1D) Study
Authors: PYATAK ELIZABETH , SPRUIJT-METZ DONNA , LEE PEY-JIUAN , SCHNEIDER STEFAN , PETERS ANNE L. , CRANDALL JILL P. , AGARWAL SHIVANI , JIN HAOMIAO , HOOGENDOORN CLAIRE J. , CRESPO-RAMOS GLADYS , HERNANDEZ RAYMOND , PHAM LOREE T. , GONZALEZ JEFFREY S. 
Published: June 2023

Introduction: While it is widely recognized that T1D can interfere with daily activities, the extent and impact of these disruptions are poorly understood. Using FEEL-T1D study data, we examined how T1D interfered with daily activities, and the association between activity disruptions, illness intrusiveness, and diabetes-related quality of life (DQoL).
Methods: FEEL-T1D prompted 14 days of surveys via smartphone at 3-hr intervals 5-6x/day. At each survey, participants indicated what activity they were doing, their activity performance and satisfaction, and whether/how T1D interfered with the activity. At end-of-day, they noted activities they could not do due to T1D. At study end, participants completed the T1D and Life (T1DAL) measure of DQoL and Adapted Illness Intrusiveness Rating Scale (AIIRS). Descriptive statistics and multilevel regressions were used to identify daily activity disruptions and their associations with DQoL and illness intrusiveness.
Results: Overall, 190 participants (40±14 yrs old, 54% female, 29% White, 40% Hispanic/Latinx, 31% other) completed 14,387 momentary surveys, of which 12.1% indicated activity disruptions, most often personal care (16.1% disrupted), sleep (14.6%), and housework/errands (13.4%). Participants were unable to do desired activities due to T1D on 8.2% of days, most often housework/errands (3.8% of days), work/school, personal care, and leisure (2.6% for each). Performance and satisfaction were poorer for disrupted vs. non-disrupted activities (p&lt;.0001). Those with more activity disruptions had greater illness intrusiveness (p&lt;.0001) and lower DQoL (p&lt;.0001).
Discussion: T1D-related activity disruptions are common and associated with poorer activity performance/satisfaction, more illness intrusiveness, and lower DQoL. Validating the impact of T1D on daily activities, and seeking strategies to minimize this impact, may improve QoL for adults with T1D.

Disclosure
E.Pyatak: Research Support; Abbott Diabetes. G.Crespo-ramos: None. R.Hernandez: None. L.T.Pham: None. J.S.Gonzalez: Consultant; Virta Health Corp. D.Spruijt-metz: None. P.Lee: None. S.Schneider: None. A.L.Peters: Advisory Panel; Abbott Diabetes, Medscape, Novo Nordisk, Vertex Pharmaceuticals Incorporated, Zealand Pharma A/S, Research Support; Abbott Diabetes, Dexcom, Inc., Insulet Corporation, Stock/Shareholder; Omada Health, Inc., Livongo. J.P.Crandall: Research Support; Abbott Diabetes. S.Agarwal: Advisory Panel; Medtronic, Consultant; Beta Bionics, Inc., Research Support; Abbott Diabetes, Dexcom, Inc. H.Jin: None. C.J.Hoogendoorn: None.

Funding
National Institutes of Health (1R01DK121298)