bluuebunny/crossref_metadata_2025_split huggingface dataset:
1147-P: Trends in Diabetes-Related Foot Disease Hospitalization, Revascularization, and Amputations in Australia 20to 2019
Authors: QUIGLEY MATTHEW , MORTON JEDIDIAH I. , LAZZARINI PETER A. , SHAW JONATHAN E. , MAGLIANO DIANNA J. 
Published: May 2022

Hospitalization for diabetes-related foot disease adds considerable burden for people living with diabetes and often leads to lower extremity amputation. We evaluated trends in the incidence of foot disease related hospital admission, revascularization and amputation procedures among people with type 1 and type 2 diabetes in Australia from 2010-2019. We included 70,766 people with type 1, and 1.1 million people with type 2 diabetes from the Australian diabetes registry (55% male) . We linked the diabetes registry to hospital admissions data to obtain the number of hospital admissions for foot disease, revascularization and amputation procedures. We estimated the annual incidence rates, using people with diabetes as the denominator, and evaluated trends over time with Joinpoint regression. In type 1 diabetes, rates of admission for foot disease and revascularization increased, while amputation rates were relatively stable (Table) . In type 2 diabetes, rates of foot disease admission and revascularization increased. While above the knee amputations decreased, below the knee amputations were stable, and foot and toe amputations increased. Average annual percent changes were generally higher for men than women (i.e. men showed greater increases or less of a decrease over time) . These findings highlight the importance of improving management of diabetes-related foot disease.

Disclosure
M.Quigley: None. J.I.Morton: None. P.A.Lazzarini: None. J.E.Shaw: Advisory Panel; Abbott Diagnostics, AstraZeneca, Eli Lilly and Company, Pfizer Inc., Roche Diagnostics, Research Support; AstraZeneca, Boehringer Ingelheim International GmbH, Speaker's Bureau; AstraZeneca, Eli Lilly and Company, Novo Nordisk, Sanofi. D.J.Magliano: None.

Funding
MQ is supported by an Australian Government Research Training Program (RTP) Scholarship. JIM is supported by an Australian Government Research Training Program (RTP) Scholarship and Monash Graduate Excellence Scholarship. PAL is supported by a National Health and Medical Research Council Early Career Fellowship. JES is supported by a National Health and Medical Research Council Investigator Grant. DJM is supported by a National Health and Medical Research Council Senior Research Fellowship. This work is partially supported by the Victorian Government’s Operational Infrastructure Support Program.
1152-P: Achieving Diabetic Management Targets in People with Type 1 Diabetes
Authors: VARKEVISSER RITA D.M. , BIRNIE ERWIN , VOLLENBROCK CHARLOTTE E. , MUL DICK , VAN DIJK PR , VAN DER KLAUW MELANIE M. , VEEZE HENDRIK J. , AANSTOOT HENK-JAN , WOLFFENBUTTEL BRUCE H. 
Published: May 2022

Background: Optimal diabetes care and risk factor management are important to delay micro- and macrovascular complications in individuals with type 1 diabetes (T1D) . Ongoing improvement of management strategies requires the evaluation of target achievement and identification of determinants in individuals who do (or do not) achieve these targets.
Methods: Cross-sectional data were collected from individuals with T1D visiting Diabeter and the University Medical Center Groningen, the Netherlands, in 2018. Targets were defined as HbA1c &lt;7%, LDL-c &lt;2.6mmol/l (no CVD present) or &lt;1.8mmol/l (CVD present) , or blood pressure (BP) &lt;140/90mmHg. Determinants between individuals who did (or did not) achieve targets were compared by presence of CVD.
Results: Data from 1,737 individuals were available. Mean age was 27 [IQR 22-43] years and 50% female. Mean HbA1c was 63 mmol/mol (7.9%) , LDL-c was 2.67mmol/l, and BP 131/76mmHg. In individuals with CVD, 24%, 33%, and 46% achieved HbA1c, LDL-c, and BP targets respectively. In individuals without CVD these percentages were, 29%, 54%, and 77%, respectively. Individuals with CVD who did or did not achieve HbA1c targets did not differ significantly. Individuals who achieved LDL-c targets had a longer diabetes duration (42 vs. 37 years, p=0.03) , lower eGFR (eGFR 56 vs. 70 ml/min/kg2) and were prescribed more lipid lowering medication (94% vs. 77%, p=0.05) . Individuals who achieved BP targets were younger (58 vs. 62 years, p=0.05) . In comparison, individuals without CVD who achieved HbA1c targets differed in age (28 vs. 25 years, p=&lt;.001) , sex (45% vs. 53% female, p=0.02) , and insulin pump use (60% vs 52%, p=0.01) amongst others. Those who achieved LDL-c targets had lower BMI (24.1 vs. 26.1kg/m2, p=&lt;.001) . BP targets were achieved by younger individuals with less microvascular complications (14% vs. 33%, p=&lt;.001) .
Conclusions: Opportunities for improvement diabetes management exist for the achievement of glycaemic, lipid and BP targets but differ between individuals with and without CVD.

Disclosure
R.D.M.Varkevisser: None. E.Birnie: None. C.E.Vollenbrock: None. D.Mul: None. P.Van dijk: None. M.M.Van der klauw: Advisory Panel; Pfizer Inc. H.J.Veeze: Employee; Medtronic. H.Aanstoot: Consultant; Lilly Diabetes, Medtronic. B.H.Wolffenbuttel: Advisory Panel; Novo Nordisk A/S, Other Relationship; Novo Nordisk.
1164-P: The Prevalence of Comorbidities among People with Obesity with and without Prediabetes
Authors: FORD JANET , LAGE MAUREEN J. , BOYE KRISTINA , BAE JAY P. , TERRELL KENDRA A. , BUNCK MATHIJS C. 
Published: May 2022

Objective: Obesity and prediabetes are widespread in the U.S., with an estimated 42% of adults living with obesity and 35% living with prediabetes. This research examines the prevalence of comorbidities among people with obesity with or without prediabetes over a 5-year period.
Methods: This observational study uses Optum® Market Clarity deidentified data from 2007-2020. For adults with obesity and prediabetes, the index date was defined as the first date where the person was identified with both obesity (BMI ≥ 30 kg/m2) and prediabetes (5.7% ≤ A1c &lt; 6.5%) while for adults with obesity without prediabetes (obesity only) , the index date was defined as the first date with BMI ≥ 30 kg/m2. All patients were required to be continuously insured from 1 year prior through 5 years post index date. For both cohorts, patients were excluded if there was any prior evidence of diabetes and in the obesity only cohort individuals were excluded if identified with prediabetes in the pre-period. Prevalence rates and 95% CIs were calculated for comorbidities for each 365-day period post index date and over the entire 5-year post-period.
Results: There were 22,423 individuals with obesity and prediabetes (mean age = 58.5 years; 42.2% male) and 902,975 individuals with obesity only (mean age = 51.7 years; 46.1% male) . The mortality rate after 5 years was 16.7% for adults with obesity and prediabetes and 9.9% for adults with obesity only (p&lt;0.05) . Five years post index date, the prevalence of T2D was 28.8% for people with obesity and prediabetes and 11.9% for people with obesity only (p&lt;0.05) . Prevalence rates for heart failure (4.3% v 2.2%) , atherosclerotic cardiovascular disease (16.2% v 6.9%) , and obstructive sleep apnea (2.2% v 1.0%) were significantly higher for adults with obesity and prediabetes compared to adults with obesity without prediabetes (all p&lt;0.05) .
Conclusion: Findings indicate that the presence of prediabetes contributes to the development of additional morbidity and mortality in adults with obesity over time.

Disclosure
J.Ford: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. M.J.Lage: Consultant; Eli Lilly and Company. K.Boye: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. J.P.Bae: None. K.A.Terrell: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. M.C.Bunck: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company.
1166-P: Distinct Phenotypes of Multiorgan Abnormalities in Long COVID and Type 2 Diabetes Identified by Multiparametric Magnetic Resonance Imaging
Authors: EICHERT NICOLE , TELFORD ALISON , ROCA-FERNANDEZ ADRIANA , HAMID AZLINDA , THOMAIDES-BREARS HELENA B. , DENNIS ANDREA , BANERJEE RAJARSHI , ALI SARAH , THANABALASINGHAM GAYA , KEMP GRAHAM , CUTHBERTSON DANIEL , BANERJEE AMITAVA 
Published: May 2022

Introduction: Both long COVID and Type 2 Diabetes (T2D) are multi-system conditions requiring multi-organ assessment to monitor organ health and detect co-morbidities earlier. Here, we defined multi-organ abnormalities in both patient groups with a rapid, non-contrast MRI scan.
Methods: We recruited 135 long COVID patients (NCT04369807) and 135 T2D patients (NCT04114682) . MRI data were acquired for organ-specific measures of size, fat deposition and fibroinflammation (CoverScan®, Perspectum Ltd.) . Reference values were based on 92 controls and published literature.
Results: There was a high prevalence of organ abnormality in both patient groups (Figure, left) , including increased fat deposition (steatosis) in liver, pancreas, and kidney (Figure, right) . 35% of T2D patients had clustering of abnormalities involving at least 2 organs, compared to 23% in long COVID. Abnormalities affecting the liver and renomegaly were more common in T2D than in long COVID. Considering only obese patients, liver fibroinflammation, hepatomegaly, and renomegaly remained significantly more prevalent in T2D than in long COVID.
Conclusion: Multi-organ MRI assessment can enrich the current blunt assessment of multi-system abnormalities in diverse disease states to inform earlier intervention and treatments.

Disclosure
N.Eichert: Employee; Perspectum Ltd. G.Kemp: None. D.Cuthbertson: Other Relationship; AstraZeneca, Novo Nordisk. A.Banerjee: Research Support; AstraZeneca. A.Telford: Employee; Perspectum Ltd. A.Roca-fernandez: Employee; Perspectum Ltd. A.Hamid: None. H.B.Thomaides-brears: Employee; Perspectum Ltd, Stock/Shareholder; Perspectum Ltd. A.Dennis: Employee; Perspectum Ltd. R.Banerjee: Employee; Perspectum Ltd., Other Relationship; Perspectum Ltd., Stock/Shareholder; Perspectum Ltd. S.Ali: Other Relationship; NICE committee for diabetes. G.Thanabalasingham: Speaker's Bureau; Boehringer Ingelheim International GmbH.

Funding
EU RADIcAL grant, Innovate UK
117-LB: Glucokinase Activator Restores Glucose Sensitivity and Early-Phase Insulin Secretion in T2DM Patient—A Post Hoc Analysis of Dorzagliatin
Authors: FENG LINGGE , GUO QUANLE , CHEN CHUNXIANG , LIU XIANG , CHEN LI , YANG WENYING 
Published: May 2022

Background: Insulinogenic index (IGI) and disposition index (DI) measures patient’s early phase insulin secretion ability and glucose sensitivity. Pervious clinical trials of dorzagliatin have showed excellent effect on glycemic control and good safety profile in Chinese T2DM patients. This post-hoc analysis was focused on evaluating the correlation between glycemic control and the restoration effect of glucokinase activator on β-cell function.
Method: The analysis has involved two phase III clinical trials of dorzagliatin, monotherapy (SEED) (NCT03173391) and metformin add-on (DAWN) (NCT03141073) , respectively. The change of HOMA2-IR, IGI and DI from baseline to 24 weeks were analyzed. Correlation between glycemic control status and patient’s early phase insulin secretion ability as well as glucose sensitivity were further demonstrated by logistic regression analysis with IGI, DI, HOMA2-IR and other characteristics.
Results: Totally 726 patients were included in the final analysis set, with 241 patients from SEED cohort and 485 patients from DAWN. After 24 weeks treatment, two cohorts showed the consistent result of IGI and DI improvement. Nevertheless, The improvement of IGI and DI for HbA1c controlled group (HbA1c &lt;7%) were significantly higher than HbA1c uncontrolled group (HbA1c ≥ 7%) . The result was also consistent across different disease course groups in DAWN cohort considering the relatively longer disease course. Logistic regression analysis revealed that both the improvement of IGI and DI were independent influential factor of patient’s HbA1c controlled status after treatment of dorzagliatin.
Conclusion: The post hoc analysis demonstrated the beneficial effect of dorzagliatin on early insulin secretion ability and glucose sensitivity on T2DM patients. The HbA1c control status were significantly affected by improvement of early insulin secretion ability and glucose sensitivity both for drug naïve patients and metformin tolerated patient.

Disclosure
L. Feng: Employee; Hua Medicine. Q. Guo: None. C. Chen: Employee; Hua Medicine. X. Liu: Employee; Hua Medicine. L. Chen: Employee; Hua Medicine. W. Yang: Advisory Panel; Hua Medicine.

Funding
Hua Medicine
1183-P: Effects of an Early Postpartum Lifestyle Intervention on Long-Term Risk of Diabetes in Women with Gestational Diabetes Mellitus
Authors: HU GANG , LIU HUIKUN , LENG JUNHONG , WANG LEISHEN , ZHANG SHUANG , LI WEIQIN , LI WEI , QI LU , YU ZHIJIE , YANG XILIN , TUOMILEHTO JAAKKO 
Published: May 2022

Few randomized controlled trials (RCT) that have thus far been published have not unequivocally found that early postpartum lifestyle intervention can prevent or delay the onset of type 2 diabetes in women with prior gestational diabetes mellitus (GDM) . The aim of the present large-scale, long-term RCT was to assess whether an early postpartum lifestyle intervention can reduce or delay type 2 diabetes risk in women with prior GDM in the Tianjin Gestational Diabetes Mellitus Prevention Program in China. A total of 1180 women who were diagnosed with GDM from 20to 20were randomly assigned to either a 4-year lifestyle intervention (n = 586) or a control group (n = 594) . Major elements of the intervention included six face-to-face meetings with study dietitians in the first year, and two additional sessions and two telephone calls in each subsequent year. The mean follow-up was 4.5 years. During the trial, overweight women with GDM in the intervention group compared with the control group were more likely to lose weight. The incidence of diabetes was 0.87 and 1.46 per 100 person-years in the lifestyle intervention and control groups, respectively; the lifestyle intervention reduced the incidence by 45 percent (P = 0.023) . An early postpartum healthy lifestyle management markedly reduced the incidence of diabetes among women with prior GDM.

Disclosure
G.Hu: None. X.Yang: None. J.Tuomilehto: Stock/Shareholder; Orion Pharma. H.Liu: None. J.Leng: None. L.Wang: None. S.Zhang: None. W.Li: None. W.Li: None. L.Qi: None. Z.Yu: None.

Funding
This study is supported by the grant from European Foundation for the Study of Diabetes (EFSD) /Chinese Diabetes Society (CDS) /Lilly program for Collaborative Research between China and Europe. Dr. Hu is partly supported by the grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100790) and the National Institute of General Medical Sciences (U54GM104940) of the National Institutes of Health.
1187-P: Distinct Islet Autoantibody Profiles in Hispanic Youth at Type 1 Diabetes Onset
Authors: SIMMONS KIMBER M. , VIGERS TIMOTHY B. , PYLE LAURA , YOUNGKIN ERIN M. , BASCHAL ERIN E. , MCDANIEL KRISTEN , YU LIPING , MICHELS AARON W. 
Published: May 2022

The incidence of type 1 diabetes continues to increase, most notably in American Hispanic (HIS) youth. Type 1 diabetes autoimmunity has not been fully characterized in HIS youth. Determining the prevalence of islet autoantibody positivity in HIS youth may improve understanding of T1D immunopathogenesis and potentially impact treatment. We determined the prevalence of islet autoantibodies directed against glutamic acid decarboxylase 65 (GADA) , insulinoma antigen-2 (IA-2A) , insulin (IAA) and zinc transporter 8 (ZnT8A) using fluid-phase radiobinding assays from stored sera in HIS youth (n=378) and in age/sex matched (9.4±4.0y, 48% male) non-Hispanic white (NHW) youth (n=378) with recent onset diabetes from our large diabetes center in Colorado. Of note, BMI was significantly lower in HIS youth (17±3.6 kg/m2) compared to NHW youth (20.0±7.1) (p=0.01) . HIS youth with type 1 diabetes had a higher rate of positivity for GADA and IA-2A when compared to NHW youth with type 1 diabetes (p&lt;0.01, Figure) . HIS youth were also more likely to have 3 or more islet autoantibodies present at diagnosis compared to NHW youth (p=0.01) . Investigating the phenotype of diabetes in diverse racial and ethnic groups with type 1 diabetes provides an opportunity to further dissect the heterogeneity that exists within diabetes in youth.

Disclosure
K.M.Simmons: Advisory Panel; Provention Bio, Inc., Consultant; Dexcom, Inc. T.B.Vigers: None. L.Pyle: None. E.M.Youngkin: None. E.E.Baschal: None. K.Mcdaniel: None. L.Yu: None. A.W.Michels: Employee; ImmunoMolecular Therapeutics, Stock/Shareholder; ImmunoMolecular Therapeutics.

Funding
National Institutes of Health (K12DK094712)
1193-P: Natural History of Type 2 Diabetes in South Asians: Arrow of Time
Authors: NARAYAN K.M. VENKAT , KONDAL DIMPLE , STAIMEZ LISA R. , ANJANA RANJIT MOHAN , GUJRAL UNJALI , DEEPA MOHAN , PATEL SHIVANI A. , ALI MOHAMMED K. , PRABHAKARAN DORAIRAJ , CHANG HOWARD H. , TANDON NIKHIL , MOHAN VISWANATHAN 
Published: May 2022

Background: People of South Asian ancestry are at high risk for type 2 diabetes, but the time to disease progression in this population is not fully understood.
Methods: We analyzed data from 2714 adults aged ≥20 years, enrolled in the Chennai site of the prospective Cardiometabolic risk reduction in South Asia (CARRS) study. Participants had 75g OGTT and HbA1c measurements. We defined normal glucose tolerance (NGT) , isolated impaired fasting glucose (iIFG) , impaired glucose tolerance (IGT) , and diabetes based on ADA criteria. We constructed continuous chain Markov models to estimate the transition through multiple states (NGT -&gt; iIFG -&gt; diabetes; NGT -&gt; IGT -&gt; diabetes) . The annual and five-year transition probability among states was estimated based on transition intensity.
Results: Participants were, on average, 38.4 (range 20-89) years old, and 40.1% were male. Prevalence of iIFG and IGT was 16.9% and 7.3%, respectively. Over 5 years of follow up, the progression rates were: NGT to iIFG, 36.3 (95% CI: 32.5, 40.5) per 1,000 person-years (PYR) , NGT to IGT, 27.4 (95% CI: 24.1, 31.1) per 1,000 PYR, iIFG to diabetes 47.3 (95% CI: 40.4, 55.4) per 1,000 PYR, and IGT to diabetes 77.1 (95% CI: 65.1, 91.3) per 1,000 PYR. The estimated annual probability of remaining as NGT, iIFG, and IGT were 95.2% (94.7%, 95.8%) , 87.3% (85.5%, 89.0%) ;%) , and 81.9% (79.6%, 84.3%) %) , respectively. Assuming unidirectional transition, the annual probability of conversion from NGT to iIFG, and iIFG to diabetes were 4.5% (3.9%, 4.9%) , and 12.7% (10.9%, 14.5%) , respectively; and NGT to IGT, and IGT to diabetes were 3.8% (3.3%, 4.2%) and 18.1% (15.7%, 20.3%) . The estimated mean sojourn time (years) in each state were: NGT 20.5 (18.2, 23.2) , iIFG 7.4 (6.4, 8.6) , and IGT 5.0 (4.4, 5.8) , respectively.
Conclusion: The course to diabetes in South Asians is rapid once prediabetes sets in, allowing a window of only 5-7.4 years to implement proven prevention. Innovative prevention efforts in normoglycemic people may be needed to prevent prediabetes in the first place.

Disclosure
K.Narayan: n/a. H.H.Chang: None. N.Tandon: None. V.Mohan: None. D.Kondal: None. L.R.Staimez: None. R.Anjana: None. U.Gujral: None. M.Deepa: None. S.A.Patel: Research Support; Johnson & Johnson. M.K.Ali: Advisory Panel; Bayer AG, Research Support; Merck & Co., Inc. D.Prabhakaran: None.

Funding
The National Heart, Lung, and Blood Institute (NHLBI) , National Institutes of Health (HHSN268200900026C)
12-LB: A Prediction Model on Incident End-Stage Kidney Disease (ESKD) among Individuals with Type 2 Diabetes (T2D) and Chronic Kidney Disease (CKD)
Authors: LIN YILU , SHAO HUI , ANDERSON AMANDA H. , FONSECA VIVIAN , BATUMAN VECIHI , SHI LIZHENG 
Published: May 2022

Diabetes is the leading cause of ESKD, a costly and disabling condition that often results in premature death. This study aimed to predict incident ESKD among individuals with T2D comorbid with CKD. The ACCORD clinical trial data were split into a training set and a validation set by a ratio of 7:3. A dynamic time-varying Cox model was fit to predict the development of incident ESKD. Significant predictors were identified from a list of candidate variables, including demographic characteristics, physical exam results, laboratory results, medical history, drug information, and healthcare utilization. Model performance was evaluated by Brier score and C statistics. Confidence intervals (CI) were calculated using a bootstrap method. Decomposition analysis was conducted to assess the variable importance. Patient-level data of HARMONY Outcome clinical trial was used for external validation. A total of 6,982 diabetes patients with CKD at baseline were used for model development, with a median follow-up of 4 years and 312 ESKD events. The significant predictors for the ESKD risk model were female, race, smoking status, age at T2D diagnosis, SBP, HR, HbA1c, estimated glomerular filtration rate (eGFR) , urine albumin-creatinine ratio (UACR) , retinopathy event happened in last year, antihypertensive drug use, and an interaction term between SBP and female. The model demonstrated good performance in discrimination (C-statistics 0.764 [95% CI 0.763-0.811]) and calibration (Brier Score 0.0083 [95% CI 0.0063-0.0108]) . The top 3 most important predictors in the prediction model were eGFR, retinopathy event, and UACR. There were 2,954 patients with CKD extracted from HARMONY Outcome with 545 ESKD events and a median follow-up of 2 years. Acceptable discrimination (C-statistics: 0.701 [95% CI 0.665-0.716]) and calibration (Brier Score: 0.0794 [95% CI 0.0733-0.1022]) were demonstrated in the external data. The dynamic risk prediction of incident ESKD among individuals with T2D can be used to support better disease management to lower the risk of developing ESKD.

Disclosure
Y. Lin: None. H. Shao: Board Member; BRAVO4HEALTH, LLC. A. H. Anderson: None. V. Fonseca: Consultant; Abbott, Asahi Kasei Corporation, Bayer AG, Novo Nordisk, Sanofi, Research Support; Fractyl Health, Inc., Jaguar Gene Therapy, Stock/Shareholder; Abbott, Amgen Inc., BRAVO4Health, Mellitus Health. V. Batuman: None. L. Shi: None.