bluuebunny/crossref_metadata_2025_split huggingface dataset:
1324-P: Mortality and Glycemic Control in Chronic Pancreatitis With and Without Diabetes—A Single Center, Referral Population Study in the United States
Authors: RAZA RIZVI SHAFAQ , JEET KAUR RAVINDER , AGGARWAL MANIK , ZANILETTI ISABELLA , REID COREY , KUDVA YOGISH C. 
Published: June 2023

Introduction: To our knowledge, limited data are available regarding mortality and glycemic control in patients with chronic pancreatitis (CP) and diabetes mellitus (DM) in the United States.
Methods: After IRB approval, we retrospectively studied 496 subjects with CP at Mayo Clinic, Rochester between 01/01/2013 and 12/31/2015. DM was identified using ICD 9 and 10 codes in 250 patients (CPDM cohort).
Results: CPDM cohort had identified F/M 91/159 with median age of 56 yrs., BMI 24.2 kg/m2 and DM for 9.5 yrs. whereas CP without DM (CPWODM) cohort had F/M 106/140 with median age of 51 yrs. and BMI 26 kg/m2. In CPDM cohort, mean HbA1c was &gt; 7 % from baseline to 5 yrs., hospitalizations due to any reason were highest within 1 yr. of DM diagnosis (Table). CP patients who developed DM had higher rates of 10 yr. mortality compared with those without DM (20.8% vs. 13.4%, Odd ratio 1.7, 95% CI=1.05-2.73, P= 0.03).
Conclusion: Other studies outside the U.S have reported high mortality among CPDM subjects as compared to DM without CP. We report a unique comparison of mortality in CPDM vs. CPWODM in the U.S. CP patients who developed DM had 70% higher risk of 10-year mortality as compared to those who did not develop DM. Studies with larger sample size need to be conducted to confirm these findings. Clinical trials to improve diabetes in CP are warranted and could impact morbidity and mortality.

Disclosure
S.Rizvi: None. R.Kaur: None. M.Aggarwal: None. I.Zaniletti: None. C.Reid: None. Y.C.Kudva: Advisory Panel; Novo Nordisk, Research Support; Dexcom, Inc.
1329-P: Prevalence of Diabetic Burn-Out in Patients on Dialysis—A Rapid Evidence Review and Meta-analysis
Authors: COYE TYLER L. , CRISOLOGO PETER , LAVERY LAWRENCE A. 
Published: June 2023

In diabetic patients on dialysis, glycemic control may improve spontaneously, leading to normal glycated hemoglobin (HbA1c) levels and termination of antidiabetic medications; this phenomenon is known as “burnt-out diabetes.” It has been previously shown that diabetic patients on dialysis with normal and less than normal glycated hemoglobin levels may have a higher risk of mortality. The aim of this systematic review and meta-analysis is to determine the prevalence of diabetic burn-out in patients with diabetic nephropathy on dialysis. Web of Science, Scopus, and PubMed were searched from inception to January 2023. Only studies that obtained samples from populations which reported the number of patients with diabetic burn-out, defined as: HgbA1c &lt; 6.0%, cessation of antidiabetic medication, and on dialysis were included. The primary meta-analysis outcome was prevalence of diabetic burn-out. A random effects meta-analysis was carried out using RStudio software. Four studies, conducted between 2007 and 2018, met the inclusion criteria and contributed 139,690 diabetic patients (sample size range, 1296-60,019). The pooled estimation of prevalence of diabetic burn out in patients on dialysis was 28.8% (95% CI, 28.6%-29.0%). Prevalence in the included studies varied from 18.6% to 39.7%. We found a high heterogeneity (I2= 100%, p &lt; 0.000, Q = 6641.79) in prevalence reported among studies. In conclusion, we found that the “burnt-out diabetes” phenomenon may exist in 28.8% of HD patients with diabetes in terms of HbA1c levels. Additional studies are needed to determine the optimal target for hemoglobin A1c levels in hemodialysis patients with diabetes.

Disclosure
T.L.Coye: None. P.Crisologo: None. L.A.Lavery: Research Support; AstraZeneca, Tissue tech, American Diabetes Association, PolarityTE, Inc., Microbion, Jarvis, Integra Lifesciences Holdings Corp, Smith+Nephew.
1330-P: Adverse Clinical Outcomes Attributable to Socioeconomic and Ethnic Disparities among People with Impaired Glucose Tolerance in New Zealand over 25 Years
Authors: YU DAHAI , BAKER JOHN , CUTFIELD RICHARD G. , PICKERING KAREN A. , ORR-WALKER BRANDON J. , OSUAGWU UCHECHUKWU L. , CAI YAMEI , WANG ZHENG , ZHAO ZHANZHENG , SIMMONS DAVID ,   DCSS STUDY GROUP
Published: June 2023

Aim: Future premature death and cardio-renal disease are common with impaired glucose tolerance (IGT). We aimed to quantify contributions of socioeconomic and ethnic disparities to outcomes in IGT in New Zealand (NZ).
Methods: IGT enrolments 01/01/1994-31/07/2018 into the Diabetes Care Support Service (DCSS), an NZ primary care programme linked with national databases were followed up until death or 31/12/2019. Incident outcomes included premature mortality (PM), myocardial infarction (MI), stroke, heart failure (HF), and end-stage renal disease (ESRD). Attributable fraction (AF)s for the entire population and specific groups compared with the least deprived groups or NZ Europeans (NZE) were estimated with adjustment for covariates.
Results: Among 26,031 people with IGT (mean age 57.2 years; 53.8% female), adjusted population AF to deprivation was significant for ESRD (18.90 (0.65-33.80)%) and to ethnicity was significant for MI (8.19 (0.18-15.56)%), stroke (10.33 (1.63-18.26)%), HF (12.15 (5.03-18.74)%) and ESRD (8.18 (0.65-33.80)%), respectively. Compared with NZE with the least socioeconomic deprivation, group-specific AF was higher in the most deprived NZE, Māori, and Pasifika for PM, stroke and ESRD; higher in more deprived NZE and Māori for MI and HF.
Conclusions: Ethnic and socioeconomic disparities are responsible for a substantial proportion of adverse outcomes those with IGT. Disparities were common among Māori irrespective of socioeconomic status and NZE with the most socioeconomic deprivation. Preventative policies need to address both ethnic and socioeconomic disparities.

Disclosure
D.Yu: None. D.Simmons: Consultant; Sanofi, Speaker's Bureau; Abbott Diabetes. Dcss study group: n/a. J.Baker: None. R.G.Cutfield: Speaker's Bureau; Boehringer Ingelheim and Eli Lilly Alliance. K.A.Pickering: None. B.J.Orr-walker: None. U.L.Osuagwu: None. Y.Cai: None. Z.Wang: None. Z.Zhao: None.
1332-P: Comparison of Clinical Characteristics of People Living with Latent Autoimmune Diabetes of the Adult (LADA) and Type 1 Diabetes (T1D) in the Canadian BETTER Registry
Authors: ISSA MOHAMAD , BRAZEAU ANNE-SOPHIE , HAAG SARAH , ROY-FLEMING AMÉLIE , MESSIER VIRGINIE , TALEB NADINE 
Published: June 2023

Introduction: LADA is known for a slow progression of autoimmune destruction of beta-cells with cases that span a spectrum between classic T1D and T2D phenotypes. To date, lacking a good understanding of LADA has prohibited the release of specific clinical practice guidelines and subsequently an optimal management.
Methodology: Cross-sectional analysis of online clinical questionnaires in the Canadian BETTER registry; participants can specify having received a diagnosis of LADA or T1D. Data was analyzed for the first 1464 participants; 131 (9%) reported LADA and 1333 (91%) T1D.
Results: At registration; LADA vs T1D were 49 ± 13 y.o. vs 42 ± 15 y.o; 61% vs. 62% females; diabetes duration 10 ± 9 vs. 24 ± 15 years. LADA vs. T1D were older at diagnosis (39 ± 12 vs. 18 ± 12 years old; p&lt;0.001), only half started insulin in first year of diagnosis (52 vs. 97%; p&lt;0.001), more often reported a family history of T1D (46 vs. 32%; p=0.001). For comparable glycemic control (HbA1c &lt; 8.6 mmol/l, &lt;7%, 38 vs. 32%), fewer cases with LADA reported at least an episode in last month of level II hypoglycemia &lt;54 mg/dL (3.0mmol/L) 63% vs. 77%; p= 0.004, severe hypoglycemia rates were 8% vs. 12%, p=0.15. Diabetes related hospitalizations were 10% in LADA vs. 6%, p=0.11, insulin pumps and glucagon were less used in LADA. In a matched analysis for diabetes duration and gender (1:1), glycemic control was still statistically comparable in LADA vs. T1D (HbA1c &lt;7%: 38 vs 35%, p=0.12) as well as rates of nephropathy (6% vs. 11%, p=0.22), neuropathy (12% vs. 7%, p=0.23) and retinopathy (6% vs. 9%, p=0.07) yet with more cardiovascular disease (5% vs. 2%; p=0.02) and less coeliac disease (3 vs. 5%; p=0.001). Data analysis of 3000 participants is ongoing in early 2023.
Conclusion: Reported differences may impact LADA management. This study sets the stage for building a prospective Canadian cohort of LADA to undergo deep phenotyping, genotyping and interventional trials.

Disclosure
M.Issa: None. A.Brazeau: Other Relationship; Dexcom, Inc., Diabète québec, Ordre des diététistes nutritionnistes du Québec, Research Support; Canadian Institutes of Health Research, Fonds de recherche du Québec en Santé. S.Haag: Other Relationship; Omnipod. A.Roy-fleming: None. V.Messier: None. N.Taleb: Consultant; Viatris Inc.
1333-P: Diabetes Complications in Metropolitan vs. Nonmetropolitan Cities of India—Three-Year Follow-up Results of LANDMARC Trial
Authors: KALRA SANJAY , DAS ASHOK K. , JOSHI SHASHANK R. , MITHAL AMBRISH , PRASANNA KUMAR K.M. , 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. , RAIS NADEEM 
Published: June 2023

Macrovascular and microvascular complications were evaluated in participants from metropolitan versus non-metropolitan cities during the three years of LANDMARC, a nationwide prospective observational study (CTRI/2017/05/008452). LANDMARC included participants with type 2 diabetes (T2D) who were on ≥2 antihyperglycemic medications. Of the total 6222 participants, 2375 and 3847 were from metropolitan and non-metropolitan cities, respectively. Age, T2D duration, and baseline A1C were similar across groups (Table). At the end of three-years, microvascular complications were significantly higher in participants from non-metropolitan than metropolitan cities (13.13% vs. 4.89%; p&lt;0.0001). Neuropathy was the most common microvascular complication in both metropolitan and non-metropolitan cities. Among macrovascular complications, heart failure (p=0.0160) was reported more in non-metropolitan than metropolitan cities (Table). The LANDMARC data demonstrates that T2D participants from Indian non-metropolitan cities may have higher complications, particularly microvascular, and may need to be better understood through future studies. The LANDMARC results elicit a pattern of disease progression among participants with T2D.

Disclosure
S.Kalra: Speaker's Bureau; Abbott, Bayer Inc., Novo Nordisk, Sanofi. 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. N.Rais: Advisory Panel; Bayer Consumer Care AG, Board Member; Abbott, Biocon. 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. K.Kumar: None. A.Unnikrishnan: Speaker's Bureau; Sanofi, AstraZeneca, Boehringer-Ingelheim, Intas Pharmaceuticals Ltd. H.Thacker: None. B.Sethi: None. S.Chowdhury: None.

Funding
Sanofi India
1341-P: The Improvement in Age at Mortality in Individuals with Peritoneal Dialysis Was Less Prominent in Persons with Diabetes in Korea
Authors: MIN KIM HYUN , JU SON KANG , OK SONG SUN 
Published: June 2023

Backgrounds: The most prevalent underlying cause of end-stage kidney disease (ESKD) is diabetes mellitus (DM). If kidney transplantation is not possible, people with ESKD must undergo hemodialysis (HD) or peritoneal dialysis (PD). This study investigated whether the prognosis of individuals with diabetes who received PD improved recently. In addition, we analyzed the age of death and the cause of mortality to determine if there was a difference based on DM or gender from 2006 to 2018.
Methods: We Used data from the National National Health Insurance database maintained by the Korean National Health Insurance Service (NHIS) and mortality records from the National Statistical Information Service (NSIS). The NHIS claims data was merged with NSIS death records from 2006 to 2018 and then analyzed. We excluded those who underwent HD or transplanting from the 93,487 cases of ESKD-related death to include only those who underwent PD.
Results: A total of 11,174 deaths were documented (4,818 individuals with DM and 6,356 individuals without DM). Age at death increased by 0.11 and 0.44 years/year in persons with and without DM, respectively. Changes in mortality age were the biggest in females without DM (0.47 years/year) and lowest among men with DM (0.10 years/year). DM itself, cardio-cerebrovascular diseases, and cancer were the leading causes of death among people with DM receiving PD.
Conclusions: In conclusion, this study, which utilized the entire Korean population, revealed that the death age of individuals with DM receiving PD increased marginally over 12 years, but the change was much smaller than in persons without DM. Based on these results, efforts should be made to improve the prognosis of the person with DM who underwent PD. In addition, identifying the precise cause of death and the optimal management strategy in this population would be important.

Disclosure
H.Kim: None. K.Son: None. S.Song: None.
1344-P: Multiomic Signatures of Gut Dysbiosis and Diabetes in HIV Infection
Authors: LUO KAI , PETERS BRANDILYN , WANG ZHENG , HANNA DAVID B. , LANDAY ALAN L. , SCHNEIDER MICHAEL F. , GUSTAFSON DEBORAH , SHARMA ANJALI , ANASTOS KATHRYN , KAPLAN ROBERT , QI QIBIN 
Published: June 2023

Introduction: Gut dysbiosis has been linked with HIV infection and diabetes. But multiomic signatures of the gut dysbiosis and diabetes in the context of HIV infection remain unknown.
Methods: We examined associations of 97 core gut bacteria genera, 378 plasma metabolites, and 74 serum proteins with prevalent diabetes in 493 women (146 with diabetes; 68% HIV+) of the Women's Interagency HIV Study from 2017 to 2019.
Results: After multivariable adjustment and correction for multiple comparison (FDR &lt; 0.1), we identified 3 genera (Adlercreutzia, Intestinibacter, and Ruminococcus) inversely and 4 genera (Shigella, Escherichia, Megasphaera, and Lactobacillus) positively associated with diabetes. Meanwhile, 76 metabolites, including 2 microbial metabolites (phenylacetylglutamine [PAG] and imidazole-propionate [IMP]) and multiple lipid species (e.g., diradylglycerols [DGs]), and 18 proinflammatory proteins were associated with diabetes. Many metabolites and proteins were associated with the identified diabetes-related gut bacteria. Potential mediation effects of these metabolites and proteins (PAG, IMP, IL-18R1, CD6, OSM, and OPG) on the bacteria-diabetes associations were observed (mediation effects of multiple mediators ranged from 25% for Intestinibacter to 67% for Escherichia). Compared to women without HIV, those with HIV had similar abundances of the identified bacteria but higher circulating levels of many diabetes-related metabolites (PAG, IMP, and several DGs) and proteins (OSM and CD6). The associations of these multiomic features with diabetes tended to be independent of HIV status with little evidence for effect modification by HIV.
Conclusion: Among women with and without HIV, this study identified multiple gut bacteria and circulating metabolites and inflammatory proteins associated with diabetes. The observed bacteria-diabetes associations were partially explained by some microbial metabolites and proinflammatory proteins.

Disclosure
K.Luo: None. R.Kaplan: None. Q.Qi: None. B.Peters: None. Z.Wang: None. D.B.Hanna: None. A.L.Landay: None. M.F.Schneider: None. D.Gustafson: None. A.Sharma: Research Support; Gilead Sciences, Inc. K.Anastos: None.

Funding
National Heart, Lung, and Blood Institute (R01HL140976, K01HL129892); Feldstein Medical Foundation
1349-P: People with Type 2 Diabetes Have a High Prevalence of Nonalcoholic Steatohepatitis with Significant Fibrosis When Screened by NIS4 or Elastography
Authors: KALAVALAPALLI SRILAXMI , GODINEZ LEIVA EDDISON , LOMONACO ROMINA , MARANGI STEPHEN A. , VALDEZ SAENZ ENRIQUE , ORTIZ ROCHA ANDREA , BUDD JEFFREY T. , MOHSENI YASMINE , CHUN KELLY Y. , PREZANT TONI R. , CONNELLY MARGERY A. , BARB DIANA , CUSI KENNETH 
Published: June 2023

Nonalcoholic steatohepatitis (NASH) is a leading cause of cirrhosis. Diagnosis remains challenging as a liver biopsy is usually not feasible. NIS4 is a novel plasma diagnostic test combining the measurement of A1c and 3 biomarkers (miR-34a-5p, A2M, YKL-40) linked to NASH disease activity and higher cirrhosis risk. The aim of this study was to assess the prevalence of high-risk NASH (NASH with significant fibrosis [≥F2]) as estimated by NIS4 or elastography in the outpatient setting. A total 400 participants (age: 55±11 years; BMI: 31.6±6.6 kg/m2; T2DM: 32%; obese without T2DM [OB]: 33%), unaware of having NAFLD, were recruited from PCP and endocrine clinics and screened by: a) Elastography (Fibroscan®) for steatosis (controlled attenuation parameter or CAP ≥274 dB/m) and for fibrosis (liver stiffness measurement or LSM ≥7.0 kPa); and b) NIS4 for high-risk NASH (defined as a NIS4 &gt;0.63; low-risk: &lt;0.36). Among patients with T2DM or OB, 68% had steatosis compared to 35% without obesity or T2DM (CON) (p&lt;0.01), while fibrosis (LSM≥7.0 kPa) was present in 14% of patients with T2DM (CON = 1%; p=0.02). High-risk NASH by NIS4 occurred frequently among patients with T2DM, either with (30%) or without (26%) obesity, and rare in those without T2DM (3%; p&lt;0.001). NIS-4 correlated with steatosis (CAP) (r = 0.35) and fibrosis (LSM) (r = 0.32; both p&lt;0.001). Patients with high-risk NASH by NIS4 compared to those with low-risk NASH, more often had steatosis (82% vs 46%), fibrosis (16% vs 4%), AST≥30 IU/L (41% vs. 8%) and ALT≥30 IU/L (36% vs. 15%), hepatic (HOMA-IR: 68% vs. 25%) and adipose tissue (adipo-IR: 80% vs 56%) insulin resistance (all p&lt;0.01). NIS4 correlated with having metabolic syndrome (r=0.41; p&lt;0.01) and was more often increased in people from endocrine vs. PCP clinics (34% vs. 9%; p&lt;0.05). Conclusion: NASH with significant fibrosis is common in T2DM. Patients with elevated NIS4 often have NAFLD with fibrosis and an unfavorable cardiometabolic profile.

Disclosure
S.Kalavalapalli: None. T.R.Prezant: None. M.A.Connelly: Employee; LabCorp, Stock/Shareholder; LabCorp. D.Barb: None. K.Cusi: Consultant; Poxel SA, Altimmune, Arrowhead Pharmaceuticals, Inc., AstraZeneca, 89bio, Inc., Bristol-Myers Squibb Company, Lilly, Madrigal Pharmaceuticals, Inc., Merck & Co., Inc., Medscape, Myovant, Novo Nordisk, ProSciento, Quest Diagnostics, Sagimet, Sonic Incytes, Terns, Research Support; Echosens, Inventiva, LabCorp, Zydus. E.Godinez leiva: None. R.Lomonaco: None. S.A.Marangi: None. E.Valdez saenz: None. A.Ortiz rocha: None. J.T.Budd: None. Y.Mohseni: None. K.Y.Chun: None.

Funding
National Institutes of Health (R01120331-01A1)
1354-P: Level of Risk for Complications by DM2 in Urban and Rural Population in Xalapa, Veracruz
Authors: RODRÍGUEZ OSCAR E. 
Published: June 2023

Background: DM2 is one of the diseases with the highest prevalence in the Mexico (10.5%), the state of Veracruz is the second with the highest number of patients. The health centers carry out the treatment of around 90% of patients which are distributed in urban and rural areas.
Aim: To determine the level of risk for the appearance of complications in patients with DM2 in urban and rural areas.
Methodology: Quantitative. Descriptive, observational and cross-sectional study. CI= 90% (n= 43 at urban center) and (n=38 at rural center). Clinical, somatometric, biochemical and risk factors were considered to create a staging scale for the level of risk for complications validated by a group of experts based on ADA recommendations (Appendix 1). The Mann-Whitney test was performed and IBS SPSS 25 program was used.
Results: Statistically significant differences were found only in 3 cases: time of diagnosis (p=0.000016), treatment time (p=0.001) and total cholesterol levels (p=0.001). In our staging proposal, most of the respondents from both groups were found in stage 3, moderate risk for complications (p=0.926) (Appendix 2).
Conclusions: The creation of different scales related to the complications of DM2 are necessary to be able to prevent, diagnose and intervene on risk groups. In our study, we found a moderate risk level for the appearance of complications in both urban and rural health center patients, and some indicators of control.

Disclosure
O.E.Rodríguez: Consultant; Adhera Health.
1362-P: The Long-Term Cardiovascular Effects of Metformin on Patients with Newly Diagnosed Type 2 Diabetes
Authors: YUE TONG , WANG XULIN , ZHAO MINZHE , WENG JIANPING , LUO SIHUI , ZHENG XUEYING 
Published: June 2023

Objective: Metformin is the first pharmacological option for preventing and treating type 2 diabetes. However, the use of this drug in preventing cardiovascular disease associated with the development of newly diagnosed type 2 diabetes is unclear. We aimed to examine whether the metformin reduced the incidence of major cardiovascular events over a 20-year follow-up of patients with newly diagnosed type 2 diabetes.
Research Design and Methods: We conducted a retrospective observational cohort study of 48,338 patients with type 2 diabetes from Anhui Provincial Hospital between January 1, 2000, and June 30, 2021. Data were collected for patients with newly diagnosed T2D (within 6 months) who did not have prior cardiovascular disease and took metformin at baseline were compared with those who did not using. The primary outcome was the first occurrence of major cardiovascular events including coronary heart disease (CHD), stroke, and hospitalization due to heart failure (HF). The multivariate Cox proportional hazards regression with inverse probability of treatment weighting. Propensity score matching (PSM) was conducted for reducing the biases of baseline characteristics.
Results: After matching, newly diagnosed T2D patients who used metformin, compared with those who did not use, had significantly lower risk of HF (HR 0.51, 95% CI 0.28 to 0.93) and CHD (HR 0.37, 95% CI 0.13 to 1.09). No difference in the risk incident stroke (HR 0.89, 95% CI 0.68 to 1.17) was observed. In both the original and PSM groups, use of metformin can reduce the risk of CHD events from newly diagnosed T2D patients (adjusted HR 0.74; 95% CI 0.69-0.87; P = 0.029).
Conclusions: In the present retrospective study, metformin use may be beneficial for preventing CHD and HF in newly diagnosed T2D patients. Further randomized controlled trials are needed to confirm these findings.

Disclosure
T.Yue: None. X.Wang: None. M.Zhao: None. J.Weng: None. S.Luo: None. X.Zheng: None.