bluuebunny/crossref_metadata_2025_split huggingface dataset:
538-P: Effects of Exercise Timing on Glucometabolic Response in Patients with Type 2 Diabetes Mellitus: A Meta-analysis of Randomized Controlled Trials
Authors: FU YIMAN , TANG XIXIANG , QIN BAODING , GUO XIAODI , HUANG YULI , CHEN YANMING , ZHU YANHUA 
Published: May 2022

Background and purpose: Exercise is widely perceived to benefit glycemic control through remodeling metabolic pathways in patients with type 2 diabetes mellitus (T2DM) . Circadian clock-regulated metabolic pathways could be reprogrammed by dietary challenges, timing of exercise relevant to feeding may also create a divergent effect. Nowadays, the optimal time of day to amplify training-mediated benefits remains unknown. Here, we aimed to evaluate the effects of different exercise timing on glucometabolic response in patients with T2DM.
Data sources and study selection: PubMed/MEDLINE, EMBASE, and Cochrane Library were systematically reached on June 30, 2021 for randomized controlled trials investing the effects of exercise timing on glucometabolic response in patients with T2DM.
Data extraction and data synthesis: Reporting postprandial glucose (PPG) , or fasting blood glucose (FBG) , or incremental area under the blood glucose curve (iAUC) , or glycosylated hemoglobin (HbA1c) , or 24-hours average glucose concentrations, or insulin sensitivity index (HOMA-IS) , or insulin resistance index (HOMA-IR) were extracted. Random effects models were used to calculate the standardized mean differences (SMD) and 95% confidence intervals (CI) . A total of 29 studies were included, involving 516 individuals for analysis. Post-meal exercise improved PPG, iAUC, HbA1c, 24-h average glucose (SMD: -4.03, -1.15, -0.43, -0.83 respectively) , but not in HOMA-IS (SMD: 0.76) and HOMA-IR (SMD: 0.01) . Within 30-120 min after meal consumption lowered PPG, iAUC, HbA1c, and 24-h average glucose by a greater amount (SMD: -4.31, -1.25, -0.46, -0.75, respectively) .
Conclusion: Post-meal exercise exerted the most significant and consistent effects on glucometabolic respons. Within 30-120 min after meal is the optimal exercise timing for glycemic control. Promoting timely post-meal exercise would be of tremendous benefits to patients with T2DM.

Disclosure
Y.Fu: None. X.Tang: None. B.Qin: None. X.Guo: None. Y.Huang: None. Y.Chen: None. Y.Zhu: None.
543-P: Interruptions in Cardiac Rehabilitation Sessions Are Disproportionately Higher in Patients with Diabetes
Authors: KHONG ANTHONY A. , JUNKER MARGARET , GIANCATERINO SHAUN , LABIAK RACHEL , LIU NINA , CORTEZ-TOLEDO ELIZABETH , FAUSTO ALEJANDRA G. , CHEN CHRISTOPHER , SLACK DANIEL H. , LOPEZ JAVIER E. 
Published: May 2022

Background: The clinical benefits of cardiac rehabilitation (CR) are attendance related; hence, interruptions or cancellations (I/C) of CR sessions limit clinical effectiveness. However, data on the frequency of I/C in CR is sparse. In this study, we aim to characterize the prevalence and clinical factors associated with I/C events among CR participants.
Methods: We retrospectively review 251 patients enrolled at our center from 8/2018-9/2021. I/C was defined as at least one event that led to pausing or stopping the exercise session due to a safety or medical concern such as blood pressure, arrhythmia, and/or glycemic control. P-values were determined by t-test, chi-squared, and multivariate logistic regression.
Results: Fifty percent (125) of patients had at least one I/C event during their participation in CR. A history of diabetes mellitus (DM) , coronary artery disease, or hyperlipidemia were significantly associated with I/C (Table 1) . Furthermore, logistical regression revealed that having DM had the strongest independent correlation with I/C events [hazard ratio, 2.66; 95% confidence interval, 1.57-4.52; p&lt;0.0001].
Conclusion: Half of CR patients experienced I/C during their participation. DM was identified as the main risk factor of events. Further studies are needed to understand the root cause and to design preventive measures to maximize the potential of CR participation.

Disclosure
A.A.Khong: None. J.E.Lopez: None. M.Junker: None. S.Giancaterino: None. R.Labiak: None. N.Liu: None. E.Cortez-toledo: None. A.G.Fausto: None. C.Chen: None. D.H.Slack: None.
544-P: Poor Glycemic Control Leads to Major Disruptions of Cardiac Rehabilitation
Authors: KHONG ANTHONY A. , GIANCATERINO SHAUN , JUNKER MARGARET , LABIAK RACHEL , LIU NINA , CORTEZ-TOLEDO ELIZABETH , FAUSTO ALEJANDRA G. , CHEN CHRISTOPHER , SLACK DANIEL H. , LOPEZ JAVIER E. 
Published: May 2022

Background: We have shown that 50% of cardiac rehabilitation (CR) patients have at least one exercise session interrupted or cancelled (I/C) . These disruptions were highly correlated with a diabetes mellitus (DM) diagnosis. The aim of this study was to characterize the frequency of I/C at the level of CR sessions and explore the event’s root cause (s) between patients with and without DM.
Methods: We retrospectively reviewed 5,038 CR sessions from 251 patients during 8/2018-9/2021 at our center. The frequency of I/C was normalized to the individual sessions to account for multiple events occurring to a single patient over time. Potential root causes were categorized as blood pressure control, glycemic control, symptomatic arrhythmias, and/or other cardiac symptoms. P-values were obtained by Fischer exact test and student t-test, as appropriate.
Results: Ten percent of all CR sessions (522) were disrupted during the observation period. No baseline differences between were noted [Table 1]. DM patients had 20.2% of sessions disrupted by I/C events compared to 4.0% in non-DM patients (p&lt;0.00001) . The frequency of each root cause per group is noted in Table 2.
Conclusion: Patients with DM have a five-fold increase in CR disruptions (primarily due to glycemic control) when compared to those without DM. Further studies are needed to develop optimal glycemic control strategies that could minimize the disruption of cardiac rehabilitation.

Disclosure
A.A.Khong: None. J.E.Lopez: None. S.Giancaterino: None. M.Junker: None. R.Labiak: None. N.Liu: None. E.Cortez-toledo: None. A.G.Fausto: None. C.Chen: None. D.H.Slack: None.
545-P: The Impact of Gender on Physical Activity Preferences and Barriers in Adults with Type 1 Diabetes: A Qualitative Study
Authors: LOGAN JESSICA E. , PREVOST MELINDA , BRAZEAU ANNE-SOPHIE , HART SARAH , MALDANER MIRANDA , YARDLEY JANE E. 
Published: May 2022

Exercise studies involving people with type 1 diabetes (T1D) have tested young, fit, men. As such, current insulin adjustment and carbohydrate intake advice may not work for women. A recent secondary analysis found different blood glucose (BG) responses to a weight lifting protocol between male and female T1D participants. It is unclear whether these differences were physiological (i.e., hormones, muscle mass, etc.) or behavioural (i.e., insulin adjustments, carbohydrate intake, etc.) . To explore gender-related differences in physical activity (PA) behaviours and preferences, we recruited men and women with T1D to take part in semi-structured interviews. Questions included demographics, perceived differences between genders (preferred type of PA, motivation, and barriers) , diabetes management strategies (i.e., insulin adjustments, carbohydrate intake, high intensity exercise, etc.) , and PA preferences (frequency, type, motivations, etc.) . Two analysts coded interview transcripts using a framework approach, through open coding of emergent themes. The most common themes were:1) Impact of support on PA success. Both men and women made statements about support, or lack of support, from family members, medical providers, and group exercise. Women reported receiving support from their healthcare team, while men did not.2) Strategies for BG management. This included reducing insulin pre-exercise and consuming extra carbohydrates. Few participants reported using intense exercise.3) Barriers to PA. Men and women reported similar barriers, including hypoglycemia, time limitations, and lack of motivation. Women reported more concerns about dysglycemia.4) Reasons to exercise. The main differences between genders were the importance of enjoyment for men and weight management for women. Overall, men and women with T1D possess similar barriers, sources of support, and BG management strategies around PA, despite differences in motivation.

Disclosure
J.E.Logan: None. M.Prevost: None. A.Brazeau: Research Support; Eli Lilly and Company, Novo Nordisk, Sanofi. S.Hart: None. M.Maldaner: None. J.E.Yardley: Research Support; Abbott, Dexcom, Inc., LifeScan, Speaker's Bureau; Abbott Diabetes.

Funding
Heart and Stroke Foundation of Canada, University of Alberta Undergraduate Research Initiative
546-P: Video Call-Based Assessment of Physical Fitness through Diabefly Digital Therapeutics Program for People with T2D in India
Authors: BHAGAT MADHURA , MANDLEKAR ANURADHA S. , VERMA RITIKA , KULKARNI SAMPADA S. , SELVAN CHITRA , MODI ALOK D. , SHENOY MOHAN T. , JAIN ALPESH L. , DAS RABINDRA , GUNTUR SAIMALA 
Published: May 2022

Background: Exercise is an integral aspect for effective diabetes management. Supervised home-based exercise through exercise prescriptions customized based on a person's exercise status, pain complaints and fitness levels can help in better adherence and low risk of injury while reducing unnecessary hospital visits. The study was aimed at the assessment of physical fitness in people with diabetes (PWD) for the development of a personalized exercise plan.
Methods: Video-call based assessment of physical fitness was done in 470 participants (mean age 44.9 ± 10.4, 31.7% females) of Diabefly® digital therapeutics platform. Trained physiotherapist conducted the assessment with the corresponding tests: upper limb strength (1-min push up test) , lower limb strength (wall sit test) , core strength (1-min sit up test) , flexibility (V-sit and reach test) and cardiorespiratory fitness (6 minute walk test) . The scores of the tests were obtained through gender and age based normative data. Participants were categorized based on the physical activity (PA) status as non-exercisers (less than 150 mins/week of PA) , aerobic exercisers (performed only walking as PA) , exercisers (combined strength training and aerobic PA &gt;150 mins/week) . Descriptive statistics and ANOVA were performed via SPPS v21.
Results: Out of all the participants, 69.4% were in the obese category with 42.1% of participants being non-exercisers, 42.1% were aerobic exercisers while only 15.7% were exercisers. Mild to moderate pain was reported by 36.1% participants. Cardiorespiratory fitness, upper limb strength, core strength and flexibility were significantly lower among non-exercisers as compared to exercisers (P&lt;0.05) .
Conclusion: This study showed the feasibility of video call-based physical fitness assessment in PWD. The assessment along with consideration of pain and current exercise pattern will help in development of personalized exercise prescription for PWD.

Disclosure
M.Bhagat: Employee; Fitterfly Healthtech Pvt Ltd. S.Guntur: Employee; Fitterfly Health Tech Pvt. Ltd. A.S.Mandlekar: Employee; Fitterfly Healthtech Pvt Ltd. R.Verma: Employee; Fitterfly Healthtech Pvt Ltd, Wellthy Therapeutics Pvt Ltd. S.S.Kulkarni: None. C.Selvan: None. A.D.Modi: None. M.T.Shenoy: None. A.L.Jain: None. R.Das: None.
547-P: Changes in Body Weight and Glucoregulatory Markers by Eight-Hour Time-Restricted Eating vs. Daily Calorie Restriction: A 6-Month Randomized Controlled Trial
Authors: CIENFUEGOS SOFIA , LIN SHUHAO , GABEL KELSEY , MCSTAY MARA , MULAS ANDREA , VARADY KRISTA 
Published: May 2022

Background: Intermittent fasting has gained substantial popularity in the past decade. The most popular form of intermittent fasting is time restricted eating (TRE) , which involves eating within a 4-to-10-hour window and water fasting for the rest of the day. Short-term studies (2 months) indicate that TRE produces mild reductions in body weight and markers of glucose regulation. What remains unknown is whether longer durations of TRE (6-months) can lead to even greater improvements in these diabetes risk factors. In addition, whether TRE is more effective than daily calorie restriction (CR) for improving these endpoints, also remains unknown.
Objective: The purpose of this study was to compare the effects of 8-h TRE versus daily CR on body weight, body composition, and markers of glucoregulation, in adults with obesity.
Design: Participants were randomized to 1 of 3 groups for 6-months: 8-h TRE (n = 24, 12-8pm eating window, 8pm-12pm fasting window) , CR (n = 22, 25% energy restriction daily) , or a control (n = 19, no food or meal timing restrictions) .
Results: Weight loss was not significantly different between the TRE (-3.4 ± 0.7%) and CR group (-4.9 ± 1.4%) by month 6. Only the CR group experienced significant weight loss (P = 0.02) versus controls (-0.7 ± 1.1%) . Changes in fat mass, lean mass, and visceral fat mass were not significantly different between groups post-treatment. Likewise, no significant changes in fasting glucose, fasting insulin, or HbA1c were observed. Changes in insulin resistance (assessed via HOMA-IR) did not differ between TRE (-0.50± 0.35 %) , CR (-0.56 ± 0.39 %) , or controls (0.37 ± 0.43%) .
Conclusions: These findings suggest that TRE does not produce greater weight loss than traditional dieting (CR) over 6-months. Our findings also show that neither diet had any beneficial effect on body composition of markers of glucoregulation, versus controls, in adults with obesity.

Disclosure
S.Cienfuegos: None. S.Lin: None. K.Gabel: None. M.Mcstay: None. A.Mulas: None. K.Varady: None.

Funding
R01DK128180 , NIH (NIDDK)
553-P: Changes in Circulating Bile Acids and the Improvements in Glucose and Insulin Metabolism in Response to Weight-Loss Diets: The POUNDS Lost Trial
Authors: HEIANZA YORIKO , WANG XUAN , MA HAO , ROOD JENNIFER , CLISH CLARY B. , BRAY GEORGE , SACKS FRANK , QI LU 
Published: May 2022

Bile acids (BAs) are synthesized from cholesterol in the liver and are essential for nutrient absorption. The host-derived primary BAs are transformed into secondary BAs in the intestine. Various BA subtypes may play pivotal roles as endocrine molecules to affect glucose and insulin metabolism. We tested whether changes in distinct BA subtypes were associated with improved glucose and insulin metabolism among adults with overweight and obesity who participated in a weight-loss diet intervention trial. Circulating primary and secondary unconjugated BAs and their taurine-/glycine-conjugates were measured at baseline and 6 months after the intervention; 6-month changes in BAs were calculated (n=515) . When we analyzed associations of BA changes with changes in fasting glucose, insulin, and insulin resistance at 6 months, more decreases in several primary BAs (CDCA, taurocholate [TCA], and taurochenodeoxycholate [TCDCA]) and secondary TDCA were associated with larger reductions of glucose (PFDR &lt;0.for all) , although the associations were dependent on concurrent weight changes. The decreases in primary BAs (including CA, CDCA, TCA, TCDCA) and secondary BAs (including DCA, GDCA, TDCA, GUDCA) were significantly related to improved hyperinsulinemia and insulin resistance, independent of weight changes. Also, we found significant interactions between dietary fat intake and changes in lithocholate and glycolithocholate for changes in insulin metabolism. Further, the initial changes in several primary and secondary BAs showed significant associations for 2-year improvements in glucose/insulin metabolism.
In conclusion, decreases in distinct primary and secondary BAs during weight-loss dietary interventions were associated with improved glucose and insulin metabolism. Changes in various BA subtypes were related to the improved insulin metabolism independent of weight loss status during the interventions.

Disclosure
Y.Heianza: None. X.Wang: None. H.Ma: None. J.Rood: None. C.B.Clish: None. G.Bray: None. F.Sacks: None. L.Qi: None.

Funding
National Institutes of Health (DK091718, DK100383, DK115679)
555-P: Premenopausal vs. Postmenopausal Women: Effect of Time-Restricted Eating on Body Weight and Metabolic Health Markers
Authors: GABEL KELSEY , VARADY KRISTA , CIENFUEGOS SOFIA , EZPELETA MARK 
Published: May 2022

Background: Time restricted eating (TRE) involves restricting the ad libitum eating window to a specific number of hours daily, while water fasting for the remaining hours.
Objective: This study examined if changes in body weight and metabolic risk factors during TRE, differ in women based on menopausal status. Methods: This is a secondary analysis of an 8-week TRE study (4-6 h eating window, 18-20 h fasting window daily) conducted in adults with obesity. Male participants were excluded, and female subjects were classified in two groups based on menstrual status: premenopausal (n = 13) , or postmenopausal (n = 19) . Perimenopausal women were excluded from the original study.
Results: Body weight decreased in both premenopausal women (-3.3 ± 0.4%) and postmenopausal women (-3.3 ± 0.5%) (main effect of time, P &lt; 0.001) , with no difference between groups (no group × time interaction) by week 8. Adherence in both groups was very high, with premenopausal women adhering to their prescribed eating window on 6.2 ± 0.1 d/week, and postmenopausal women adhering to their window on 6.2 ± 0.2 d/week. Fat mass, lean mass, fasting insulin, insulin resistance, and 8-isoprostane (marker of oxidative stress) were reduced similarly in both groups (main effect of time, P &lt; 0.for all comparisons) . Visceral fat mass, relative skeletal muscle index (RSMI) , blood pressure, LDL cholesterol, HDL cholesterol, triglycerides, fasting glucose, HbA1c, TNF-alpha and IL-6 remained unchanged by 8 weeks in both groups.
Conclusion: These findings suggest that the weight loss and metabolic benefits of TRE do not differ between premenopausal and postmenopausal women with obesity.

Disclosure
K.Gabel: None. K.Varady: None. S.Cienfuegos: None. M.Ezpeleta: None.

Funding
R01DK119783
559-P: The Advancing Care for T1D Obesity Network (ACT1ON) Sequential Multiple Assignment Randomized Trial Pilot Results for Effect on Weight and Glycemia
Authors: IGUDESMAN DARIA , CRANDELL JAMIE , POKAPRAKARN TEERANAN , CORBIN KAREN , ZAHARIEVA DESSI P. , ADDALA ANANTA , THOMAS JOAN , CASU ANNA , RIDDELL MICHAEL , PRATLEY RICHARD E. , KOSOROK MICHAEL R. , MAAHS DAVID M. , MAYER-DAVIS ELIZABETH J. 
Published: May 2022

Background: People with T1D commonly struggle with co-managing weight and glycemia, which increases cardiovascular disease risk. We evaluated the effect of an adaptive Sequential, Multiple Assignment, Randomized Trial (SMART) pilot on weight and glycemia in people with T1D.
Methods: The SMART pilot tested the hypocaloric Look AHEAD (Low Fat) or Low Carbohydrate (Low Carb) ; or Mediterranean (Med, not calorie restricted) diets among young adults with T1D ages 19-30 (BMI 27-39.9 kg/m²) . We report data from the first 3-month diet period pre-pandemic before a shift to a virtual protocol for primary (weight, HbA1c, and % time below range [TBR, 54-69 mg/dl]) and secondary outcomes (body fat % and % time in range [70-180 mg/dl]) . We computed descriptive within-group changes in outcomes. Adjusted models tested diet differences.
Results: Overall weight change was -2.0 kg (95% CI -3.0, -1.1, p&lt;0.0001, n=38) and did not vary by diet. Body fat % decreased overall. Per adjusted models, HbA1c decreased on Low Fat vs. Low Carb (-0.60% [95% CI -1.5, -0.3], p=0.049) and TBR trended towards a decrease on Med vs. Low Carb (-3.1% [95% CI -6.4, 0.083], p=0.056) .
Conclusions: Our intervention decreased adiposity and maintained glycemia in young adults with T1D. We will use these results to power an efficacy trial to co-optimize weight and glycemia among individuals with T1D.

Disclosure
D.Igudesman: None. R.E.Pratley: Other Relationship; Bayer AG, Corcept Therapeutics, Dexcom, Inc., Hanmi Pharm. Co., Ltd., Merck & Co., Inc., Metavention, Novo Nordisk, Pfizer Inc., Poxel SA, Sanofi, Scohia Pharma Inc., Sun Pharmaceutical Industries Ltd. M.R.Kosorok: n/a. D.M.Maahs: Advisory Panel; Abbott Diabetes, Eli Lilly and Company, Medtronic, Novo Nordisk, Sanofi, Consultant; Aditx Therapeutics, Inc., Biospex. E.J.Mayer-davis: None. J.Crandell: n/a. T.Pokaprakarn: None. K.Corbin: None. D.P.Zaharieva: Research Support; Insulet Corporation, International Society for Pediatric and Adolescent Diabetes, Leona M. and Harry B. Helmsley Charitable Trust. A.Addala: None. J.Thomas: None. A.Casu: None. M.Riddell: Advisory Panel; Zealand Pharma A/S, Zucara Therapeutics, Consultant; Eli Lilly and Company, Jaeb Center for Health Research, Speaker's Bureau; Dexcom, Inc., Eli Lilly and Company, Novo Nordisk.

Funding
National Institutes of Health 1DP3DK113358
561-P: The Effect of Time-Restricted Eating on Glycemic Control and Insulin Sensitivity in Women with Prediabetes: A Pilot Study
Authors: CHONDRONIKOLA MARIA , ZHU SHENGJIE , SURAMPUDI PRASANTH , ROSHANRAVAN BABACK , SANCHEZ CEDRICK JOSH 
Published: May 2022

Time-restricted eating (TRE) is a dietary pattern in which daily food intake is restricted to a 6-h period without any caloric intake for the rest of the day. TRE improves glucose homeostasis in animal models even independent of weight loss and calorie intake. However, the weight-loss independent effect of TRE on glucose homeostasis in people remains debatable. We conducted a pilot study to investigate whether TRE without weight loss improves glycemic control and insulin sensitivity in women with prediabetes. Participants were randomized to the TRE (9-h daily eating period) or Control group (15-h daily eating period) for 12 weeks. We studied five participants (TRE n = 3 and Control n = 2) with overweight/obesity, prediabetes, and habitual daily eating period greater than 14 hours ([means and SD] age 50 ± 16 years, BMI 31 ± 5 kg/m2) . The daily eating period decreased in the TRE group (13.8 ± 0.5 vs. 8.5 ± 0.5 h) , but not in the Control group (13.9 ± 0.9 vs. 14.1 ± 1.1 h) . Participants’ weight, diet composition, and number of eating occasions remained unchanged during the study period for both groups. Glycemic control in free-living conditions assessed by using continuous glucose monitoring tended to improve in the TRE group (24-h area under the curve for interstitial glucose concentration: 2572 ± 286 vs. 2161 ± 216 mg/dl/24 h) , but not in the Control group (23± 59 vs. 2374 ± 2mg/dl/24 h) . Skeletal muscle insulin sensitivity assessed by using a hyperinsulinemic-euglycemic clamp procedure tended to increase in the TRE group (median and IQR: 27 (21, 37) vs. 34 (27, 41) μmol/kg/min) , but not in the Control group (41 ± 9 vs. 36 ± μmol/kg/min) . These preliminary results suggest that TRE may lead to weight-loss-independent improvements in glycemic control and insulin sensitivity in women with prediabetes. Further ongoing research will establish the effect of TRE without weight loss on glucose homeostasis and insulin sensitivity in people at high risk for type 2 diabetes mellitus.

Disclosure
M.Chondronikola: None. S.Zhu: None. P.Surampudi: n/a. B.Roshanravan: None. C.Sanchez: None.

Funding
NIH-UL1-TR001860, Clinical and Translational Science Center-Highly Innovative Pilot Award and USDA NationalInstitute of Food and Agriculture, Hatch project numberCA-D-NTR-2618-H