bluuebunny/crossref_metadata_2025_split huggingface dataset:
497-P: Ten Years of the National Diabetes Prevention Program: The Effect of Interventions on Priority Population Enrollment
Authors: LANDAU ERIN O. , ELY ELIZABETH 
Published: May 2022

In 2010, Congress authorized the creation of the National Diabetes Prevention Program to build a nationwide delivery system for a lifestyle change program (LCP) proven to prevent or delay onset of type 2 diabetes. In 2012, the Diabetes Prevention Recognition Program (DPRP) approved its first CDC-recognized organization and in 2012 and 2017, CDC awarded funding to organizations (grantees) to increase enrollment of priority populations. In 2015 and 2018, DPRP Standards expanded approved delivery modes to include online delivery (2015) and distance learning and combined delivery (2018) . As of October 2021, the DPRP has received data from 2,200 organizations on 550,000+ participants ever enrolled in the LCP; this analysis is limited to participants who enrolled prior to 2020. From the end of 2017 to the end of 2019, total enrollment in the LCP more than doubled from 217,115 to 470,7participants. The proportion of participants who identified as Hispanic grew among grantee organizations (6.5% in 2017 to 15.7% in 2019) but remained constant in non-grantee organizations (2.3% in 2017 to 2.2% in 2019) . The proportion identifying as non-Hispanic Black varied across years but overall was higher among grantee organizations (19.9% in 2017, 20.5% in 2018, and 16.2% in 2019) compared to non-grantee organizations (12.0% in 2017, 12.4% in 2018, and 12.8% in 2019) . Between 2017 and 2019, 80-85% of participants identifying as Hispanic enrolled in in-person programs, compared to 11-16.5% in online, 1.1-1.7% in distance learning, and 1.8-2.5% in combination programs. Among participants identifying as non-Hispanic Black, 50.1-58.2% enrolled in online programs each year, compared to 35.8-41.8% in in-person, 3.0-8.3% in combination, and 0.7-2.0% in distance learning programs. These results suggest that enabling organizations to reach priority populations and tailoring delivery modes to each population are effective strategies to increase enrollment.

Disclosure
E.O.Landau: None. E.Ely: None.
505-P: Fasting in Ramadan during the Peak of COVID-Pandemic: DAFNE Graduates Experience
Authors: IRSHAD MOHAMMAD , ELSAMAD ABEER K. , ABDULLAH AMAL , AZIZIEH MAJDOLEEN , ALKANDARI JUMANA , VARGHESE ANISHA , MURAD SAHAR , TAGHADOM ETAB , MEGAHED AMIRA , ALOZAIRI EBAA S. 
Published: May 2022

Background: The lockdown due to the COVID-pandemic in April 2020 led to the suspension of face-to-face diabetes care and education. In this period, management of diabetes emergency was a challenge because it needed rapid recognition, diagnosis and treatment. Despite adverse situations, many DAFNE graduates had chosen to fast during Ramadan. This was supported virtually to DAFNE graduates through intermittently scanned continuous glucose monitoring (isCGM) . Aims: This study aimed to compare the isCGM glucose metrics of people with T1D who fasted during Ramadan.
Methods: Baseline and fasting period isCGM data were collected. The primary outcome measures HbA1c, time in range [ (TIR) 3.9- mmol/L], time below range [ (TBR) &lt;3.9 mmol/L], coefficient of variation (CV) , and self-reported adverse events.
Results: A total of 35 people with T1D fasted with a median of 20 days. Mean HbA1c was 7.5 (0.93) % and 7.4 (0.91) % before and after fasting periods, respectively. No significant change in TIR (pre 61.1 ± 17.9% vs. during 61.9 ± 14.9%) and TAR (pre 32.1 ± 19.0% vs. during 33.1 ± 15.6%) were found. However, TBR (pre 6.8 ± 5.4% vs. during 5.0 ± 4.6%) was significantly decreased (p= 0.045) . The CV (-2.3%) and low glucose events (-5.0) also decreased during the fasting period (p≤ 0.010) . No episodes of severe hypoglycemia, DKA, or hospitalization occurred during the fasting period.
Conclusions: DAFNE graduates can fast safely without the fear of hypoglycemia, and safe metrics of glycemia using diabetes self-management skills, including disaster situations like the COVID-pandemic.

Disclosure
M.Irshad: None. E.S.Alozairi: None. A.K.Elsamad: None. A.Abdullah: None. M.Azizieh: None. J.Alkandari: None. A.Varghese: None. S.Murad: None. E.Taghadom: None. A.Megahed: None.
515-P: Harnessing Simulation-Based Corrective Mentoring in Continuing Medical Education to Improve Clinical Decision Making and Identify Persisting Educational Needs
Authors: ROBINSON KATIE , SEIFERT DOUGLAS , FREDERICK JENNIFER , ESGRO ROBERT A. 
Published: May 2022

Rationale: Due to the vast number of treatment options and clinical presentations of patients with T2DM, providers are challenged to individualize treatment. Incorporating corrective mentoring into decision-based continuing medical education (CME) is a proven method to improve clinical decision-making while simultaneously elucidating persisting educational needs.
Methods: Vindico Medical Education and Syandus partnered to develop four virtual clinical scenarios designed to encourage optimal decision making for patients with T2DM by providing immediate feedback via simulated corrective mentoring.
Results: A total of 765 primary care providers (PCPs) and 103 endocrinology providers participated in the simulation. Across all four simulations, only 15% of decisions were optimal on the first selection. At baseline, the most challenging topics were evaluating comorbidities and optimizing the use of SGLT-2 inhibitors (13% and 3% optimal decisions made, respectively) . However, after corrective mentoring, there was a 400% relative increase in optimal decisions made. Relative to PCPs, endocrinology providers were 11% more likely to eliminate non-ideal treatment options for a patient with T2DM, obesity, and ASCVD. Similarly, endocrinologists were 14% more competent than PCPs regarding the use of an SGLT-2 inhibitor for a patient with T2DM and worsening kidney disease. The reason for these findings may be that, relative to endocrinologists, PCPs are nearly twice as concerned with optimizing A1C control versus managing comorbidities such as kidney disease or obesity.
Conclusion: The use of corrective mentoring in simulation-based CME is an impactful way to encourage clinical decision-making in alignment with the latest evidence-based care. Moreover, these data highlight the need to educate PCPs on the importance of considering comorbidities when individualizing treatment for patients with T2DM.

Disclosure
K.Robinson: None. D.Seifert: Other Relationship; Amgen Inc., Merck & Co., Inc. J.Frederick: None. R.A.Esgro: None.

Funding
Independent Educational Grants from Boehringer Ingelheim Pharmaceuticals, Inc. and Lilly USA, LLC; and Merck & Co., Inc.
52-OR: The Burden of Food Insecurity on Quality of Life in Adults with Diabetes
Authors: WALKER REBEKAH J. , THORGERSON ABIGAIL , MOSLEY-JOHNSON ELISE , EGEDE LEONARD E. 
Published: May 2022

Food insecurity, or the lack of consistent access to enough food for an active, healthy life, is associated with worse glycemic control and higher mortality in adults with diabetes. However, little is known regarding the burden of food insecurity on health-related quality of life, a global measure that captures physical and mental health over time. Using two years of national data collected through the Medical Expenditure Panel Survey (2016-2017) , we investigated the relationship between food insecurity and physical health related (PCS) and mental health related (MCS) quality of life in adults with diabetes. Ten questions asked about running out of food, affording balanced meals, skipping meals, and losing weight due to not eating. Adults scoring 3 or more were considered food insecure. Unadjusted and adjusted linear regression weighted to represent the US adult population was run with PCS and MCS treated as separate continuous outcomes. Food insecure adults with diabetes reported significantly lower physical and mental health related quality of life (PCS 42.2 vs. 35.9; MCS 51.5 vs. 42.7) . After adjusting for demographics, insurance coverage, and comorbidities, food insecure adults with diabetes maintained significantly lower scores compared to food secure adults with diabetes (PCS: -3.43, 95%CI -4.63,-2.25; MCS: -5.37, 95%CI -6.68,-4.06) . This drop in PCS scores of 3.4 and MCS of 5.4 was similar to or larger than differences between those with comorbidities known to significantly impact quality of life, such as stroke (decrease of 2.6 in PCS and 0.5 in MCS) , joint pain (decrease of 4.5 in PCS and 2.4 in MCS) , and heart disease (decrease of 2.0 in PCS and 3.8 in MCS) . Results highlight the significant burden of food insecurity on both physical and mental health related quality of life in adults with diabetes. Interventions are needed that integrate clinical and social factors impacting health-related quality of life to ensure overall well-being in adults with diabetes.

Disclosure
R.J.Walker: None. A.Thorgerson: None. E.Mosley-johnson: None. L.E.Egede: None.

Funding
American Diabetes Association (1-19-JDF-075) ; National Institute for Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker) , National Institute of Diabetes and Digestive Kidney Disease (K24DK093699, R01DK118038, R01DK120861, PI: Egede)
522-P: Qualitative Findings of a Culturally Tailored Rural Diabetes One-Day DSMES Program in Eastern Colorado
Authors: CURCIJA KRISTEN , OSER TAMARA , LITCHMAN MICHELLE L. , KWAN BETHANY , ZITTLEMAN LINDA K. , NEUBERGER JULIE , SUTTER CHRISTIN , IACOB ELI , GONZALEZ SINDY J. , LATENDRESSE GWEN 
Published: May 2022

DSMES is an essential component to equip people with diabetes to improve health behaviors and outcomes, and accessing culturally tailored and accessible DSMES services in rural communities is challenging. The Rural Diabetes One-Day (R-D1D) intervention used CBPR to adapt complex clinical information about diabetes into locally-relevant, actionable messages and materials. The products accompanied the implementation of a one-day 5-hour long DSMES program tailored to a rural community delivered to English and Spanish-speaking adults with diabetes in eastern Colorado. A second cohort will take place in Spring 2022. As part of an iterative design, key informant interviews were conducted with healthcare professionals and staff from participating clinics. A trained member of the study team used a semi-structured interview guide to collect qualitative data from clinical staff. A total of 6 individuals were interviewed from two clinics. Key themes included close-knit relationships between clinical staff and their patients with diabetes, lack of resources for patients in rural communities, and ongoing need for DSMES programs available through primary care clinics - particularly for patients with newly-diagnosed diabetes. Practice staff reflections on the R-D1D program were positive. Interviewees appreciated having a program offered to both English and Spanish-speaking patients to address disparities among their patient population. Staff reported patients appreciated meeting as a group - in a supportive setting - and enjoyed having access to a professional class made for them and offered to them. Changes recommended included setting the intervention date in advance, offering a program overview at a staff meeting to ensure all team members were aware of the program and felt comfortable discussing it with patients, and offering the class in the requested language. R-D1D will undergo iterations, as guided by these interviews, in the next phase of this research.

Disclosure
K.Curcija: None. G.Latendresse: None. T.Oser: Advisory Panel; Cecelia Health, Dexcom, Inc. M.L.Litchman: None. B.Kwan: None. L.K.Zittleman: None. J.Neuberger: None. C.Sutter: None. E.Iacob: None. S.J.Gonzalez: None.

Funding
National Institute of Nursing Research 1R56NR019466-01
53-OR: Diabetes Stigma and Clinical Outcomes in Adolescents and Young Adults: The SEARCH for Diabetes in Youth Study
Authors: EITEL KELSEY B. , ROBERTS ALISSA J. , DAGOSTINO RALPH , BELL RONNY A. , BELLATORRE ANNA , BARRETT CATHERINE E. , CRISTELLO ANGELICA , DABELEA DANA , DOLAN LAWRENCE M. , JENSEN ELIZABETH T. , LIESE ANGELA D. , MARCOVINA SANTICA M. , MAYER-DAVIS ELIZABETH J. , REYNOLDS KRISTI , PIHOKER CATHERINE 
Published: May 2022

We examined the association between diabetes stigma and glycemic control, treatment regimen, and acute and chronic complications in adolescents and young adults (AYAs) with type 1 (T1D) and type 2 diabetes (T2D) in the SEARCH for Diabetes in Youth Study, 2016-2019. A 5-question survey assessed frequency of perceived stigma experience, from which we created a total stigma score. We used multivariable linear modeling, stratified by T1D and T2D, to examine the association of diabetes stigma with clinical factors, adjusting for sociodemographic, clinic site, duration of diabetes, health insurance type, treatment regimen, and HbA1c. Of 16respondents, 78% had T1D, 56% were female, and 48% were non-Hispanic White. Mean (SD) age at study visit was 21.7 (5.1) years (range - 24.9 years) . Mean (SD) HbA1c was 9.2% (2.3) . Higher stigma scores were associated with female sex and higher HbA1c (both p &lt;0.01, table) . No statistically significant association between stigma score and insulin pump or continuous glucose monitor use was observed. In participants with T2D, higher stigma scores were associated with insulin use (p = 0.04) . Independent of HbA1c, higher stigma scores were associated with acute complications for AYAs with T1D and chronic complications for AYAs with T1D and T2D (table) . Diabetes stigma in AYAs is associated with worse diabetes outcomes and therefore is important to address in diabetes care.

Disclosure
K.B.Eitel: None. E.T.Jensen: Consultant; Regeneron Pharmaceuticals Inc. A.D.Liese: None. S.M.Marcovina: None. E.J.Mayer-davis: None. K.Reynolds: Research Support; Amgen Inc., Merck & Co., Inc., Novartis Pharmaceuticals Corporation. C.Pihoker: None. A.J.Roberts: None. R.Dagostino: Consultant; Aetion, Inc., AstraZeneca, Biogen, Bristol-Myers Squibb Company, Daiichi Sankyo, Merck & Co., Inc. R.A.Bell: None. A.Bellatorre: None. C.E.Barrett: None. A.Cristello: None. D.Dabelea: None. L.M.Dolan: None.

Funding
The SEARCH for Diabetes in Youth Cohort Study (1R01DK127208-01, 1UC4DK108173) is funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases and supported by the Centers for Disease Control and Prevention.
566-P: Development and Evaluation of Pharmacotherapy Decision Support Technology for Type 2 Diabetes Mellitus
Authors: TARUMI SHINJI , TAKEUCHI WATARU , CHALKIDIS GEORGE , BAN HIDEYUKI , KAWAMOTO KENSAKU 
Published: May 2022

Background and Objectives: The established treatment target for most patients with type 2 diabetes mellitus (T2DM) is controlling HbA1c levels to less than 7%; however, about half of patients fail to achieve this target. In order to support optimal prescription selection, we have been developing a prescription selection support system that predicts expected outcomes by treatment options. In this presentation, we report a novel analytical method named Treatment Pathway Based Estimation (TPGE) , which predicts the probability of achieving a treatment goal, such as HbA1c less than 7% in 3 months, using a treatment pathway graph built from the data.
Methods: The TPGE model was built and evaluated using EHR data from 27,9 patients with T2DM. TPGE was compared with a conventional machine learning approach, gradient boosting decision tree (GBT) , across two dimensions. First, the prediction error of the probability of achieving treatment was evaluated by the Brier Score. Second, the characteristics of the prescriptions recommended with the highest probability were investigated, referring to the prescriptions actually prescribed by clinicians.
Results: TPGE achieved a prediction error of 0.158, which is lower than the prediction error of 0.162 of GBT. In addition, the calibration error was 0.002 (84.6% reduction) , much lower than that of GBT (0.013) . A prescription to add two or more drugs was selected by clinicians for 0.7% of cases. GBT recommended that prescription for 42.2 % of cases, while TPGE recommended for 1.4%, which was closer to the clinicians’ decision.
In summary, the superiority of TPGE over GBT was confirmed.
Conclusion: We have developed a pharmacotherapy decision support technology for T2DM to help clinicians and patients select the optimal prescription.

Disclosure
S.Tarumi: None. W.Takeuchi: None. G.Chalkidis: Employee; Hitachi, Ltd. H.Ban: None. K.Kawamoto: Consultant; Korean Society of Medical Informatics, NORC at the University of Chicago, Pfizer Inc., RTI International, Security Risk Solutions, Other Relationship; MD Aware, Research Support; Hitachi, Ltd., Pfizer Inc.
567-P: A Weight Management Program Tailored for Adults with Type 2 Diabetes: Effects on Glycemic Control
Authors: APOLZAN JOHN W. , LAROSE JESSICA G. , ANTON STEPHEN D. , BEYL ROBBIE A. , GREENWAY FRANK L. , WICKHAM EDMOND P. , LANOYE AUTUMN , HARRIS MELISSA N. , KAUFMAN ADAM , BULLARD TIFFANY , FOSTER GARY D. , CARDEL MICHELLE 
Published: May 2022

Background: Clinical weight loss interventions improve glycemic control in adults with type 2 diabetes (T2D) , but are costly and have limited accessibility. The objective of this trial was to test the efficacy of a diabetes-tailored widely available weight management program (WW, formerly Weight Watchers) on glycemic control in adults with T2D.
Methods: This was a prospective 24-week single arm, three-site clinical trial. Participants (n= 136) had T2D, a baseline HbA1c between 7-11%, and a BMI between 27-50 kg/m2. All participants received the 24-wk intervention, which consisted of the WW digital + workshop program tailored for people with T2D, and included weekly virtual workshops and use of the WW App. Assessments occurred at baseline, wk 12 (83.8% retention) , and wk 24 (83.1%) . Primary outcome was change in HbA1c at 24 weeks. Secondary endpoints were changes in body weight and the Diabetes Distress Scale (DDS) . Generalized linear effects models were used for statistical analysis (MAR) and used an intent-to-treat analysis.
Results: Participants were 56.8 ± 0.8 y (Mean ± SEM) , 80.2% Female, 62.2% non-Hispanic white. Baseline BMI was 36.2±0.6 kg/m2. Baseline HbA1c, weight, and total DDS score were 7.9±0.1%, 104.3±1.8 kg, and 2.2±0.1, respectively. HbA1c decreased 0.6±0.1% at wk 12 and 0.8±0.1% at wk 24 (both p &lt;.0001) . Body weight decreased 4.6±0.5% at wk 12 and 5.7±0.5% at wk 24 (both p &lt;.0001) . Total DDS score decreased 0.2±0.1 at wk 12 and 0.3±0.1 at wk 24 (both p &lt;.0001) .
Conclusions: The widely available WW program, modified for those with T2D, had favorable and clinically meaningful effects on glycemic control, body weight, and diabetes distress at 12 and 24 weeks.

Disclosure
J.W.Apolzan: Research Support; Mizkan Holdings, LLC , WW International, Inc. T.Bullard: Employee; WW International, Inc. G.D.Foster: Employee; WW International, Inc. M.Cardel: Employee; WW International, Inc. J.G.Larose: Research Support; WW International, Inc. S.D.Anton: None. R.A.Beyl: None. F.L.Greenway: Advisory Panel; General Nutrition Corporation, Jenny Craig, NovMeta Pharma, Nutraceutical Corporation, Pfizer Inc., Plensat, UR Labs, Consultant; Basic Research, Dr. Reddy’s Laboratories Ltd., Energesis, Gedeon Richter, Jazz Pharmaceuticals, Rejuvenate Bio, Other Relationship; Academic Technology Ventures, Inc., Melior Discoveries, Stock/Shareholder; Energesis, Ketogenic Health Systems, NovMeta Pharma, Plensat, Rejuvenate Bio, Slim Health Nutrition, UR Labs. E.P.Wickham: Board Member; American Board on Obesity Medicine, Research Support; National Institutes of Health, WW International, Inc. A.Lanoye: Research Support; WW International, Inc. M.N.Harris: None. A.Kaufman: Employee; WW International.

Funding
WW International, Inc.
568-P: Predictors of Engagement and Adherence in a Text Messaging Diabetes Intervention for Hispanics
Authors: CLARK TAYLOR , FORTMANN ADDIE L. , PHILIS-TSIMIKAS ATHENA , SAVIN KIMBERLY L. , SANDOVAL HALEY , SPIERLING BAGSIC SAMANTHA R. , GALLO LINDA 
Published: May 2022

Mobile health delivery of diabetes self-management education and support (DSME/S) can reduce barriers among racial/ethnic minority populations (e.g., Hispanics) , but little is known about how participant characteristics shape adherence and engagement with mHealth interventions. The current study examined this using data from Dulce Digital-Me, a randomized trial that tested an adaptive mHealth DSME/S intervention among 3Hispanic adults with poorly managed type 2 diabetes from a Federally Qualified Health Center in San Diego, CA. In addition to core educational content, participants in three intervention arms received text messages with ecological momentary assessment (EMA) of health behaviors and prompts to check their blood glucose (BG) over 24 weeks. Linear regression models examined associations of age, sex, diabetes duration, health literacy (Single Item Literacy Scale) , and diabetes distress (Diabetes Distress Scale-17) at baseline with the percentage of EMA and BG checks completed, controlling for study arm. Average participant age was 52.6 years ± 11.5; 70% were female. Younger age (B=-.88) , longer diabetes duration (B=.51) , lower health literacy (B=-4.7) , and lower diabetes distress (B=-6.7) predicted significantly higher EMA completion, while only lower distress (B=-4.5) predicted higher BG check completion (all ps&lt;.05) . Follow-up analyses revealed that those with moderate distress tended to have higher completion rates than those with low or high diabetes distress. Overall, these results were in line with prior research in predominantly non-Hispanic samples, with the exception of health literacy, where we typically see a positive association with mHealth engagement. This finding may reflect that our intervention content was written for populations of lower literacy levels. Future qualitative research should expand on these findings to explore who adheres to and engages most with mHealth DSME/S.

Disclosure
T.Clark: None. A.L.Fortmann: Consultant; Ascensia Diabetes Care, Employee; Dexcom, Inc. A.Philis-tsimikas: Advisory Panel; Bayer AG, Novo Nordisk, Research Support; Lilly Diabetes, National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk, Viking Therapeutics. K.L.Savin: None. H.Sandoval: None. S.R.Spierling bagsic: None. L.Gallo: None.

Funding
National Institutes of Health (NCT03130699)