bluuebunny/crossref_metadata_2025_split huggingface dataset:
546-P: Impact of the COVID-19 Public Health Emergency on Enrollment and Outcomes in the National Diabetes Prevention Program
Authors: ELY ELIZABETH 
Published: June 2023

The National Diabetes Prevention Program is a partnership of public and private organizations working to build a nationwide delivery system for a lifestyle change program (LCP) to prevent or delay type 2 diabetes. Using data submitted to the Diabetes Prevention Recognition Program (DPRP), this study examines the impact of the COVID-19 public health emergency (PHE) on delivery of the LCP by looking at how adapting delivery from in-person to virtual allowed the 12-month intervention to continue. Participant start dates were categorized into 3 groups: 1) enrolled/concluded pre-PHE start, 2) enrolled pre-PHE start/concluded post-PHE start, and 3) enrolled/will conclude post-PHE start. As of October 2022, enrollment was at 658,385: 348,672 in group 1, 124,077 in group 2, and 185,636 in group 3. Mean reported weekly physical activity (PA) minutes and mean weight loss (WL) were calculated for each quarter of the LCP for each group. Despite the PHE causing abrupt changes in daily life, results show that participants whose time in the LCP overlapped or was entirely within the PHE, had strong PA and WL outcomes. Regardless of phase, participants who attended sessions in the 3rd quarter and the 4th quarter, on average, met programmatic goals of 150 PA minutes and 5% weight loss. These outcomes are indicative of lifestyle change, contributing to reducing the risk of developing type 2 diabetes.

Disclosure
E.Ely: None.
555-P: Identifying High-Priority Cardiovascular and Diabetes Topics for the Dissemination of Evidence-Based Best Practices—Results from a Statewide Needs Assessment
Authors: BEVERLY ELIZABETH A. , KOOPMAN GONZALEZ SARAH , DUNGAN KATHLEEN M. , WRIGHT JACKSON T. , BAUGHMAN KRISTIN R. , WEXLER RANDY , DWORKIN LANCE D. , SOLOMON GLEN D. , LAMB JAMES F. , KINSELLA AUDREY , LAMMERT LORI J. , NEVAR ANN , IRWIN GILLIAN , ROLLINS CLAIRE , KONSTAN MICHAEL W. , BOLEN SHARI D. 
Published: June 2023

Background: The Ohio Cardiovascular and Diabetes Health Collaborative (Cardi-OH) unites the 7 medical schools in Ohio to improve cardiovascular (CV) and diabetes health outcomes and eliminate disparities in Ohio’s Medicaid population. The purpose of the Cardi-OH needs assessment was to identify high priority clinical topics for the dissemination of evidenced-based best practices to providers across the state.
Methods: The cross-sectional survey was distributed via REDCap (research electronic data capture) to Cardi-OH members and its external contacts (i.e., people who have engaged with Cardi-OH but are not members) in 2022. Question topics were identified by Cardi-OH members based on perceived gaps in existing content.
Results: A total of 88% (n=103) of 117 Cardi-OH members and 8% (n=98) of 1,204 external contacts participated. Of those, 51% (n=53) of Cardi-OH members and 47% (n=46) of external contacts provided direct clinical care. The top items for Cardi-OH members (clinical and non-clinical combined) were: 1) lifestyle prescriptions (n=50, 49%), 2) atypical diabetes (n=38, 37%), 3) COVID-19 and cardiovascular disease (CVD) (n=38, 37%), and 3) mental health and CVD (n=38, 37%). For external contacts, the top topics were: 1) lifestyle prescriptions (n=53, 54.1%), 2) mental health and CVD (n=39, 39.8%), 3) alcohol and CVD (n=27, 27.6%), and 3) CV complications (n=27, 27.6%). Regarding social determinants of health (SDOH), Cardi-OH members prioritized: 1) weight bias and stigma (n=44, 43%), 2) family-focused interventions (n=40, 39%), and 3) adverse childhood experiences (ACEs, n=37, 36%). External contacts selected: 1) family-focused interventions (n=51, 52%), 2) implicit bias (n=43, 43.9%), and 3) ACEs (n=39, 39.8%).
Conclusions: Shared prioritized topics included lifestyle, SDOH, and behavioral health; these may be useful to other professional organizations as they consider dissemination priorities.

Disclosure
E.A.Beverly: None. A.Kinsella: None. L.J.Lammert: None. A.Nevar: None. G.Irwin: None. C.Rollins: None. M.W.Konstan: None. S.D.Bolen: None. S.Koopman gonzalez: Research Support; Bristol Myers Squibb Foundation. K.M.Dungan: Board Member; Elsevier, Consultant; Eli Lilly and Company, Dexcom, Inc., Other Relationship; UpToDate, Research Support; Dexcom, Inc., Abbott, ViaCyte, Inc., Sanofi, Speaker's Bureau; Academy for Continued Healthcare Learning, Cardiometabolic Health Congress, Medscape, Integritas. J.T.Wright: Advisory Panel; Medtronic. K.R.Baughman: None. R.Wexler: None. L.D.Dworkin: None. G.D.Solomon: None. J.F.Lamb: None.

Funding
Ohio Department of Medicaid’s Medicaid Technical Assistance and Policy Program
558-P: Online Medical Education Advances Physicians’ Knowledge and Competence for the Use of Basal Insulin
Authors: TRIER JOACHIM , BAJAJ HARPREET S. , PHILIS-TSIMIKAS ATHENA 
Published: June 2023

Background and aims: Despite various alternative treatment options basal insulin continues to play an important role in the management of patients with type 2 diabetes (T2D). The goal of this activity for primary care physicians (PCP) and diabetologists/endocrinologists (D/E) was to improve their understanding of the continued role of basal insulin in the management of T2D, address barriers to its initiation, and increase the awareness of novel once-weekly basal insulin formulations.
Materials and methods: Two diabetes experts joined a 24-min online video discussion with synchronized slides. Educational effect was assessed using a repeated-pair design with pre-/post-assessment. 3 multiple choice questions assessed knowledge/competence, 1 question rated on a Likert-type scale assessed confidence. A paired samples t-test was conducted on overall average number of correct responses and for confidence rating, a McNemar’s test was conducted at the question level (5% significance level). Cohen’s d with correction for paired samples estimated the effect size of the education on number of correct responses. Data collection from 10/25/22 to 12/13/22.
Results: • PCPs (n=73) improved their knowledge regarding basal insulin therapy in the management of T2D by 69% (p&lt;.001) • D/E (n=126) improved their knowledge regarding the clinical profile of emerging once-weekly basal insulin formulations by 52% (p&lt;.01) and their competence related to the identification of patients with T2D as suitable candidates for future treatment with once-weekly basal insulins by 192% (p&lt;.001) • 40% of PCP (P&lt;.001) and 31% of D/E (P&lt;.001) increased their confidence in initiating basal insulin therapy in their patients with T2D
Conclusion: Participation of D/E and PCP in an online video expert discussion improved their understanding of basal insulin therapy, the profile of emerging once-weekly formulations and the identification of appropriate patients with T2D significantly.

Disclosure
J.Trier: None. H.S.Bajaj: Research Support; Amgen Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Anji Pharmaceuticals, Eli Lilly and Company, Kowa Company, Ltd., Novo Nordisk, Pfizer Inc., Sanofi, Tricida, Inc. 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.
562-P: Improved Glycemic and Cardiometabolic Parameters in Type 2 Diabetes Using AI-Enabled Digital Precision Care with Remote Monitoring
Authors: KN MANOHAR , SUNDARI B BHAVANI , KHAYUM KHADAR ABDUL , MOHAN DRISYA , MANI MOHANIESHWARI , PILLAI ANJU R. , S CHANDRAKUMAR , CHANNABASAVAIAH RAJKUMAR 
Published: June 2023

In India, the average HbA1c in adults with type 2 diabetes is 8.9 ± 2.1% with associated increase in prevalence at 74.2 million is a major challenge in health care sector. Barriers includes insufficient knowledge on self management, medication adherence, emotional disturbances, nutrition and activity guidance and personalized care approach. Studies have suggested remote monitoring using technology, bridges the gap between the patient and health care professionals, at their home and at a lower cost. Use of technology for remote monitoring and personalized guidance in real world settings was evaluated using Credo Health precision care programme.
Method: The cohort consists of 72 type 2 diabetes members who enrolled for the diabetes management programme for 3 months at Credo Health. Informed consent was sought from the all the individuals and statistics was applied using GraphPad Prism V-5.0.
Results: Significant improvement was achieved at the end of 90 days in mean Glycosylated A1c (Figure 1) (8.7 ± 2.2; 7.2 ± 1.1, p: &lt;0.0001), FPG (172.3 ±73.1; 128.5 ± 37.9, p: &lt;0.001), PPPG (231.8 ± 95.8; 153.8 ± 41.1, p: &lt;0.001), SBP (128.7 ± 18.3; 119.9 ± 11.8, p: &lt;0.001), Serum TGL (206.4 ± 99.9; 161.0 ± 67.27, p: &lt;0.05). Conclusion: Remote monitoring and personalized precision diabetes care management improved glycaemic and cardiometabolic outcomes in 3 months.

Disclosure
M.Kn: None. B.B: None. A.Khadar: None. D.Mohan: None. M.Mani: None. A.R.Pillai: None. C.S: None. R.Channabasavaiah: None.
564-P: The Need for Mentorship in Diabetes Is Now
Authors: BLUNDEN SARAH , ROY-FLEMING AMÉLIE , SOUTH COURTNEY , GILLIS CHELSIA , BRAZEAU ANNE-SOPHIE 
Published: June 2023

Background: Mentorship for health care professionals is used to offer guidance, knowledge, and transfer experience. Clinical Dietitians (CD) play a key role in diabetes care. Offering mentorship might help build their confidence levels (CL) and grow the profession with the goal of improving outcomes and experiences for people living with diabetes (PWD). The objectives are, in CD (1) to assess the need for mentorship in diabetes and (2) to gather opinions on the structure and content for appropriate mentorship.
Methods: A 28-question online survey was developed, piloted with 8 CD through cognitive interviewing, and shared with CD across the province of Quebec (Canada). Descriptive analysis was used to determine the proportions (%) in survey responses, stratified by years of clinical experience (CE).
Results: From the 284 participants (97% women, mean age 31+/-10 years), 275 (97%) of CD identified a need for mentorship in diabetes. Desire to participate and in what function (mentee, mentor or both) was dependent on the years of CE. Formal mentorship was preferred by 41%, 30% informal and 29% a combination of both which was independent of the years of CE. Finally, 93.5% believe their confidence level in providing care for PWD would increase if they participated in mentorship.
Conclusion: Mentorship in diabetes was perceived as needed to increase Clinical Dietitians confidence level in caring for PWD and for interprofessional collaboration.

Disclosure
S.Blunden: Employee; Dexcom, Inc. A.Roy-fleming: None. C.South: None. C.Gillis: 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.
569-P: Interim Outcomes of a Patient Simulation Educational Activity for Advanced Practice Providers on the Management of Type 2 Diabetes
Authors: BRECHTELSBAUER ERIKA , GUSTAFSON JESSICA , BLACK ROBIN L. 
Published: June 2023

Background: The number of incretin-based therapies for the management of T2D is growing, as is the number of NPs and PAs practicing in primary care, necessitating continuing education to improve knowledge and competence with T2D treatment. Practicing Clinicians Exchange (PCE) developed an educational program on GLP-1 RAs followed by virtual patient simulations to address educational and clinical application needs.
Methods: Following a series of live education, 2 virtual patient simulations were released in October 2022. NPs and PAs received immediate feedback on management decisions.

Conclusions: Patient simulations are effective educational strategy for NPs and PAs to improve competence and application of knowledge with incretin-based therapies for the management of patients with T2D. Patients in both cases were candidates for glycemic control, weight reduction, and CV risk reduction. Glycemic control was achieved by a greater percentage of learners in Case 1 vs Case 2 which could be due to a higher percentage of GLP-1 RA prescriptions (81% vs 65%). More learners achieved weight loss and recommended non-pharmacologic strategies in Case 2. Overall, most GLP-1 RAs prescribed had CV risk reduction benefits with a greater percentage prescribed in Case 1 (87.4% vs 83%). It is important to note a limitation of these findings is more learners completed Case 1 vs Case 2.

Disclosure
E.Brechtelsbauer: None. J.Gustafson: None. R.L.Black: None.

Funding
Novo Nordisk (73471747)
57-OR: Real-World Glycemic Outcomes of &gt;5,900 Adults with Type 1 Diabetes Using the Omnipod 5 Automated Insulin Delivery (AID) System with Cloud-Based Data Management
Authors: LAL RAYHAN , ALEPPO GRAZIA , HUYETT LAUREN M. , SNOW KENNETH , MENDEZ JOSE J. , HADJIYIANNI IRENE , LY TRANG T. 
Published: June 2023

The Omnipod 5 AID System is a novel tubeless hybrid closed-loop system that allows for personalized therapy through customizable glucose targets from 110-150mg/dL in 10mg/dL increments. The System enables automatic upload of data for all users initiating the system, facilitating unprecedented access to evaluate real-world outcomes. Continuous glucose monitoring (CGM) and insulin data from Omnipod 5 users with type 1 diabetes (T1D) aged ≥18y in the US with ≥90 days of data available in the cloud-based data management system were included. Data from 5,968 users with sufficient CGM data (≥75% of days with ≥220 readings) and using the lowest target (110mg/dL) for ≥50% of the time, aged 18 to 25y (n=840), 26 to 49y (n=3,127), 50 to 64y (n=1,423), and ≥65y (n=578) were available at the time of analysis. Users were aged mean±SD 42.8±15.0y with median 139 days of system use. Outcomes are shown in the Table for each age group. Median time in target range (70-180mg/dL) was 69.6%, 73.0%, 74.2%, and 77.4% for each age group, respectively. Time &lt;70mg/dL in each age group was low: median 1.0%, 1.0%, 1.0%, and 0.9%, respectively. These results are the first to demonstrate that in over 5,900 adults using the Omnipod 5 System in a real-world setting, highly favorable glycemic outcomes are achievable and are similar to those first reported in a pivotal trial.

Disclosure
R.Lal: Advisory Panel; Provention Bio, Inc., Consultant; Abbott Diabetes, Biolinq, Capillary Biomedical, Inc., Deep Valley Labs, Gluroo, Tidepool, PhysioLogic Devices, Morgan Stanley. G.Aleppo: Advisory Panel; Medscape, Consultant; Bayer Inc., Insulet Corporation, Research Support; Dexcom, Inc., Eli Lilly and Company, Emmes, Insulet Corporation, Fractyl Health, Inc., WellDoc, Speaker's Bureau; Dexcom, Inc. L.M.Huyett: Employee; Insulet Corporation, Stock/Shareholder; Insulet Corporation. K.Snow: Employee; Insulet Corporation. J.J.Mendez: None. I.Hadjiyianni: Employee; Insulet Corporation, Stock/Shareholder; Insulet Corporation, Eli Lilly and Company. T.T.Ly: Employee; Insulet Corporation.

Funding
Insulet Corporation
570-P: Designing the Deaf Diabetes Can Together Intervention
Authors: LITCHMAN MICHELLE L. , ALLEN NANCY A. , IACOB ELI , MILLER NIC A. , HENDERSON MURDOCK , CANELA SIERRA M. , LEE SHINDUK 
Published: June 2023

Deaf individuals who communicate using American Sign Language (ASL) are 3 times more likely to have diabetes than hearing people, yet experience challenges obtaining diabetes education due to a multitude of systematic barriers. One barrier is communication breakdown between the Deaf patient, an ASL interpreter, and clinician. Due to a lack of unified diabetes medical terms in ASL, confusion can occur when different ASL interpreters are used at diabetes appointments. In collaboration with an all-Deaf Community Advisory Board, a Certified Deaf Interpreter, Deaf health professionals, a universal access designer, and experts in Diabetes care, we co-designed an ASL Glossary of diabetes terms. The ASL Glossary confirmed, clarified, updated, and/or developed new signs and explanatory expansions during a 5-phase process. The ASL Glossary include 42 videos of diabetes terms and 28 explanatory expansions. New signs were developed for the term, ‘insulin’ to help distinguish insulin made within the body and exogenous insulin. A sign clarification was needed to establish the seriousness of prediabetes. The terms ‘diet’ and ‘fat’ were modified to be more politically correct. Technology, such as continuous glucose monitoring, insulin pumps, and smart pens required new signs and/or expansions. The ASL Glossary of diabetes terms addresses systemic barriers that exist in working with Deaf patients and research participants. The ASL Glossary of diabetes terms will support diabetes self-management education and support videos that are being created for the next phase of the Deaf Diabetes Can Together single-arm pilot study. Additionally, the ASL Glossary of diabetes terms will be used to support a future ASL interpreter training.

Disclosure
M.L.Litchman: None. N.A.Allen: Consultant; Diathrive Health, Dexcom, Inc. E.Iacob: None. N.A.Miller: None. M.Henderson: None. S.M.Canela: None. S.Lee: None.

Funding
Gordon and Betty Moore Foundation (GBMF9048); Margolis Foundation
571-P: Theory-Based Design of a Nutrition-Focused Approach at CGM Initiation for People with T2D
Authors: WILLIS HOLLY , JAKA MEGHAN , JOHNSON ELIZABETH A. 
Published: June 2023

Background: CGM can improve glycemic outcomes and has the potential to help people with T2D adopt evidence-based nutrition recommendations. Effective interventions using CGM data to guide food choices that align with nutrition recommendations are sparse. The objective of this work is to describe development of a nutrition-focused approach (NFA) at CGM initiation using the behavior change wheel (BCW), a theory-based intervention development framework.
Methods: The BCW process included 3 parts: 1) specifying the target behavior and existing barriers according to the Capability Opportunity Motivation-Behavior (COM-B) Model and Theoretical Domains Framework (TDF); 2) identifying intervention content to address the barriers (e.g. broad strategies for behavior change and specific behavior change techniques (BCTs)); and 3) assessing feasibility of the intervention and selecting ways to implement content. Rapid literature review, stakeholder discussion, and content analysis were used to achieve these steps.
Results: The target behavior was defined as using CGM data to guide dietary changes that align with current nutrition recommendations and improve TIR. Via content analysis, 80 barriers were coded according to the COM-B and TDF constructs. After feasibility assessment and stakeholder discussions, 12 barriers were selected (e.g. an opportunity barrier is lack of tools supporting use of CGM data to guide food choices). These barriers were mapped to 5 behavior change strategies (i.e. intervention functions; such as training and enablement) and associated BCTs (e.g. habit formation and reframing). The final intervention includes three components: a 1-hr in-person session, a 30-min telehealth session, and nutrition-focused CGM-initiation materials.
Conclusion: Use of the BCW led to the development of a rigorous but pragmatic theory-driven intervention. Effectiveness of the nutrition-focused approach at CGM initiation intervention will be tested in clinical trials.

Disclosure
H.Willis: Other Relationship; Abbott Diabetes, Dexcom, Inc., Research Support; Abbott Diabetes. M.Jaka: None. E.A.Johnson: Speaker's Bureau; Medtronic, Medscape.

Funding
American Diabetes Association (7-22-JDFN-27 to H.W.)
58-LB: Associations between Diabetes Distress and CGM Metrics in Adults in the T1D Exchange Registry
Authors: KELLY CAITLIN S. , NGUYEN HUYEN , CHAPMAN KATHERINE S.M. , CORNELIUS EMILEE M. , PETER MEGAN , WOLF WENDY 
Published: June 2023

Research on diabetes distress in continuous glucose monitor (CGM) users with T1D is divided. Some studies suggest CGM users experience less distress compared to non-users, whereas other studies find no differences in distress. While research shows higher distress is related to higher HbA1c, more work is needed to understand how distress is related to CGM metrics. Thus, we recruited adult CGM users with T1D (n = 199) from the T1D Exchange Registry to complete an online survey about diabetes characteristics and a screener of diabetes distress (DDS-2). CGM metrics (defined in Table 1) were computed from CGM data within 12 months prior to survey completion. Participants were grouped into lower (DDS-2 &lt; 3, n = 120) or higher (DDS-2 ≥ 3, n = 79) diabetes distress. We used Welch’s t-tests to compare mean differences in blood glucose (BG) experiences and CGM metrics between participants with lower and higher diabetes distress. As shown in Table 1, participants with higher diabetes distress reported higher HbA1c, and - via CGM metrics - experienced more time in higher BG ranges and less time within standard target ranges, had higher blood glucose variability, and had higher GMI compared to those with lower distress. Associations between distress and CGM metrics replicated in a MANCOVA after adjusting for duration of T1D. Our results suggest, in CGM users, higher perceived diabetes distress is associated with more time in hyperglycemia.

Disclosure
C. S. Kelly: None. H. Nguyen: None. K. S. M. Chapman: None. E. M. Cornelius: None. M. Peter: None. W. Wolf: None.
582-P: Exercise Training Reverses NAFLD in Mice with Obesity Independent of Changes in Hepatic Mitochondrial Oxidative Capacity
Authors: HEINTZ ELIZABETH C. , DANTAS WAGNER S. , STAMPLEY JAMES E. , DAVIS GREGORY M. , IRVING BRIAN A. , AXELROD CHRISTOPHER L. , KIRWAN JOHN P. 
Published: June 2023

Obesity is a primary cause of hepatic lipid accumulation, leading to nonalcoholic fatty liver disease (NAFLD). As there are no FDA-approved therapies for NAFLD treatment, weight loss through lifestyle intervention is the first-line therapy. Exercise improves hepatic function in patients with obesity related NAFLD. However, the mechanisms whereby exercise mediates the enhancement of liver function are largely unknown. This study evaluated the impact of exercise training on NAFLD in mice with obesity. At 8 weeks of age, mice were randomized to low-fat (LFD) or high-fat diet (HFD). After 4 weeks of dietary intervention, mice were randomized to either control (SED) or exercise training (ExT) with experimental diet for 10 weeks. ExT mice completed 45 minutes of moderate-intensity treadmill running 4 days/week. Body weight was measured weekly, and body composition and maximal treadmill running were evaluated at weeks 0, 4, and 14. Blood lactate accumulation was measured during the final treadmill test. Mice were euthanized 48 hours after the last exercise session for liver histopathology, blood chemistry, and ex vivo mitochondrial function analysis. Liver function was assessed via serum liver panel and quantification of hepatic lipids. High-resolution respirometry was used to determine maximal hepatic fatty acid oxidation, NADH- and succinate-linked oxidative phosphorylation (OXPHOS), and electron transfer capacity in tissue homogenates. HFD increased body mass, which was reduced with ExT. ExT increased maximal running time independent of diet. HFD worsened lactate metabolism, which was improved with ExT. HFD increased liver weight, which was decreased with ExT. HFD-induced increases in hepatic lipid and serum ALT and ALP were reversed with ExT. Hepatic mitochondrial OXPHOS and electron transfer were reduced with HFD relative to LFD. These data suggest that exercise-induced reversal of NAFLD is not mediated by hepatic mitochondrial oxidative capacity.

Disclosure
E.C. Heintz: None. W.S. Dantas: None. J.E. Stampley: None. G.M. Davis: None. B.A. Irving: None. C.L. Axelrod: None. J.P. Kirwan: None.

Funding
Nutrition Obesity Research Center (P30DK072476); Louisiana Clinical and Translational Science Center (U54GM104940); Centers of Biomedical Research Excellence (P20GM103528)