bluuebunny/crossref_metadata_2025_split huggingface dataset:
322-OR: ECG-Derived QRS-T Angle Is an Independent Predictor of Sudden Cardiac Death in Patients with Type 2 Diabetes: From the SURDIAGENE Prospective Study
Authors: GARCIA RODRIGUE , TAVERNIER MARINE , GAND ELISE , DE KEIZER JOE , ALOS BENJAMIN , BOULETI CLAIRE , DEGAND BRUNO , HADJADJ SAMY , SAULNIER PIERRE-JEAN ,   THE SURDIAGENE STUDY GROUP
Published: May 2022

Diabetes is associated with a high risk of sudden cardiac death (SCD) but the risk of non-SCD is even higher. We aimed to assess cardiac electrical markers for predicting SCD in patients with T2D.
SURDIAGENE is a French prospective cohort of T2D patients. Baseline 12-lead ECG of 1285 (64±years; 43% female) patients were concordantly evaluated by 2 cardiologists to measure 15 ECG-derived markers. Causes of death were adjudicated by an independent committee. The primary outcome was SCD which was defined as a sudden, natural, and unexpected death, with preceding duration of symptoms &lt;24 hours for witnessed cases and &lt;1 hour witnessed cases. Bonferroni-adjusted cause-specific Cox proportional hazards and Fine and Gray competing-risk models were performed to identify independent predictors (adjustment for age, sex, HbA1c, NT-proBNP, eGFR, ACR, history of myocardial infarction, diuretic, and insulin) . At baseline, mean diabetes duration was 14±years and mean HbA1c 7.8±1.6%. During a median follow up of 7.4 years, 446 deaths occurred including 83 (18.6%) SCD. In univariate analysis, R wave voltage ≥mm in aVL lead, corrected QT interval and QRS-T angle ≥90° were associated with SCD risk at the Bonferroni-adjusted level of significance (P &lt; 0.0033) . Using competing-risk multivariate analysis, QRS-T angle ≥90° only was significantly associated with a higher risk of SCD (sHR 1.63 [1.01-2.62]; P=0.045) but interestingly not with non-SCD (sHR 1.02 [0.78-1.33], P=0.87) . Discrimination of SCD prediction model was improved by QRS-T angle beyond multivariate Cox model parameters (C-statistic improved from 0.798 to 0.805, P&lt;0.0001) .
ECG-derived QRS-T angle is an independent predictor of SCD in patients with T2D and improves SCD-risk model prediction accuracy.

Disclosure
R.Garcia: Other Relationship; Abbott, Boston Scientific Corporation, Medtronic, Microport. The surdiagene study group: n/a. M.Tavernier: None. E.Gand: None. J.De keizer: None. B.Alos: None. C.Bouleti: Consultant; AstraZeneca, Novartis Pharmaceuticals Corporation, Research Support; Pfizer Inc. B.Degand: None. S.Hadjadj: Consultant; Abbott Diabetes, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novartis AG, Novo Nordisk, Sanofi, Servier Laboratories, Valbiotis, Other Relationship; Janssen Pharmaceuticals, Inc. P.Saulnier: Consultant; Grünenthal Group, Research Support; AstraZeneca, Novo Nordisk, Sanofi.
335-OR: Dapiglutide, a Once-Weekly GLP-1R/GLP-2R Dual Agonist, Was Safe and Well Tolerated and Showed Dose-Dependent Body Weight Loss over Four Weeks in Healthy Subjects
Authors: OLSEN MINNA B. , HÖVELMANN ULRIKE , GRIFFIN JON , KNUDSEN KIM M. , ERIKSSON PER-OLOF , AGERSNAP MIKKEL A. 
Published: May 2022

Dapiglutide is a first-in-class peptide with dual activity on the GLP-1 and GLP-2 receptors and with potential to treat several metabolic/gastrointestinal (GI) diseases. In a multiple ascending dose cohort trial, 40 healthy subjects (mean BMI 24.6 kg/m2) received once weekly s.c. injections of dapiglutide (1, 2.25, 3.5 or 6 mg) or placebo for 4 weeks. There were no serious or severe adverse events (AEs) and no withdrawals. The most frequent related AEs reported were GI disorders and metabolism and nutrition disorders similar to marketed GLP-1RAs. No subject developed anti-drug antibodies. The pharmacokinetics (PK) showed dose proportionality with a low inter-subject variability and a mean half-life of 123-129 hours across the 4 dose cohorts. Dose-response was shown for plasma glucose, insulin, triglycerides, and gastric emptying after a mixed meal test. Mean body weight loss was 0.1%, 0.5%, 2.4% and 4.5% after 4 weeks of treatment in each cohort (fig 1) . Multiple doses of dapiglutide were well-tolerated and the safety profile is similar to GLP-1 and GLP-2 receptor agonists. The PK results support that dapiglutide is suitable for once-weekly dosing. The clinical potential of dapiglutide as a novel treatment for obesity and NASH should be explored in trials of longer duration.

Disclosure
M.B.Olsen: Employee; Zealand Pharma A/S, Stock/Shareholder; Novo Nordisk A/S, Zealand Pharma A/S. U.Hövelmann: None. J.Griffin: Employee; Zealand Pharma A/S, Stock/Shareholder; Zealand Pharma A/S. K.M.Knudsen: Employee; Zealand Pharma A/S. P.Eriksson: Employee; Zealand Pharma A/S. M.A.Agersnap: Employee; Zealand Pharma A/S.
356-OR: DNA Methylation Suggests Accelerated Biological Age and Specific Biomarkers Correlate with the Speed of Aging in Diabetes Mellitus
Authors: CORTEZ BRIANA N. , PAN HUI , AGUAYO-MAZZUCATO CRISTINA 
Published: May 2022

Type 2 Diabetes (T2D) correlates with increased biological age (BA) as indicated by clinical biomarkers. Chronological age (CA) is the total years lived, while BA depicts cellular level changes. Our prior data showed that BA was accelerated in Type 1 Diabetes (T1D) and T2D with a large spread of individual BA within these groups. It is unknown whether accelerated age in diabetes mellitus (DM) is also seen at the DNA methylation (DNAm) level, the gold standard to determine BA, and which variables regulate the speed of aging in individuals. We hypothesized that DNAm would reflect accelerated aging in tissues from people with T2D and that specific biomarkers would associate with the speed of aging. The DNAm Phenotypic Age Clock was used to determine BA and showed accelerated aging in whole blood (p=0.01) and pancreatic islets (p=0.03) from people with T2D. Linear regression was used to find associations between biomarkers and speed of aging using the NHANES 2017-18 and ACCORD Trial cohorts. Avoidance of fried foods (p=0.02) and fat intake (p=0.01) , and vigorous activity (p=0.001) correlated with decreased BA in T2D. Biomarkers associated with slower aging (BA&lt;5 years from CA) were higher albumin (p&lt;0.04) , lower globulin (p=5.7x10-5) , lower blood pressure (p&lt;0.005) , higher hemoglobin (p&lt;0.03) and older age at DM diagnosis (p=0.04) . Faster aging (BA&gt;5 years from CA) was associated with higher total and LDL-cholesterol (p&lt;0.003) , pulse (p=0.002) , platelet count (p&lt;0.03) , glycohemoglobin (p&lt;3.6x10-5) and fasting glucose (p&lt;0.04) , and lower self-perception of health (p=0.005) . Normal aging (BA within 5 years of CA) associated with greater ferritin (p=0.03) and moderate-intensity activity at work (p=0.005) .
In conclusion, DNAm of blood and islets from people with T2D age faster than those without. Further analysis of specific variables associated with the speed of aging will identify crucial intervention nodes to alter the aging speed in a population with DM.

Disclosure
B.N.Cortez: None. H.Pan: n/a. C.Aguayo-mazzucato: Consultant; eGenesis.
389-P: A Six-Month Periodic Fasting Reduces Microalbuminuria and Improves Metabolic Control in Patients with Type 2 Diabetes and Diabetic Nephropathy: A Randomized Controlled Study
Authors: SULAJ ALBA , KOPF STEFAN , RAUCHHAUPT EKATERINA V. , KLIEMANK ELISABETH , BRUNE MAIK , KENDER ZOLTAN , BARTL HANNELORE , GARCIA-CORTIZO FABIOLA , KLEPAC KATARINA , HAN ZHE , KUMAR VARUN , LONGO VALTER , TELEMAN AURELIO , OKUN JUERGEN G. , MORGENSTERN JAKOB , FLEMING THOMAS H. , SZENDROEDI JULIA M. , HERZIG STEPHAN 
Published: May 2022

Aim: To assess whether periodic fasting reduces albuminuria and activates nephropathy-driven pathways in patients with type 2 diabetes and diabetic nephropathy.
Methods: Forty patients with type 2 diabetes (HbA1c 7.8±0.2% [62.1±2.3 mmol/mol]) and increased albumin-to-creatinine ratio (ACR) were randomized to fasting-mimicking diet (FMD) (n=21) or Mediterranean diet (n=19) for six months with three-month follow-up. Primary endpoint was the difference of the change in ACR from baseline to after six months between groups. Subgroup analysis for patients with micro- versus macroalbuminuria at baseline was performed. Secondary endpoints comprised HOMA-IR, circulating markers of dicarbonyl detoxification (MG-H1, glyoxalase-1 and hydroxyacetone) , lipid oxidation (acylcarnitines AC) , DNA-damage/repair, (yH2Ax) and senescence (suPAR) . Comparison was done by ANCOVA adjusted for age, sex, weight loss and baseline values of the respective outcome.
Results: Difference of change in ACR between FMD and control group after six months was 110.3mg/g (95% CI 99.2, 121.5mg/g; P=0.45) in all patients, -30.3mg/g (95% CI -35.7, -24.9mg/g; P≤0.05] in patients with microalbuminuria, and 434.0mg/g (95% CI 404.7, 463.4mg/g; P=0.23) in those with macroalbuminuria at baseline. FMD led to change in HOMA-IR of -3,8 (95% CI -5,6, -2.0; P≤0.05) and in suPAR of -156.6pg/ml (95% CI -172.9, -140.4pg/ml; P≤0.05) after six months, while no change was observed in markers of dicarbonyl detoxification or DNA-damage/repair. Change in AC profile was related to patient responsiveness to ACR improvement. At follow-up only HOMA-IR reduction (-1.9 [95% CI -3.7, -0.1], P≤0.05) was sustained.
Conclusions: When accompanied by intensive diabetes care, FMD improves microalbuminuria, HOMA-IR and suPAR. Lack of changes in markers of dicarbonyl detoxification and DNA-damage/repair might explain the relapse of albuminuria at follow-up.

Disclosure
A.Sulaj: None. Z.Han: None. V.Kumar: None. V.Longo: Stock/Shareholder; L-Nutra Inc. A.Teleman: None. J.G.Okun: None. J.Morgenstern: None. T.H.Fleming: None. J.M.Szendroedi: Consultant; Boehringer Ingelheim International GmbH. S.Herzig: None. S.Kopf: Board Member; Novo Nordisk, Speaker's Bureau; AstraZeneca, Recordati S.p.A. E.V.Rauchhaupt: None. E.Kliemank: None. M.Brune: None. Z.Kender: None. H.Bartl: None. F.Garcia-cortizo: None. K.Klepac: None.

Funding
German Research Foundation DFG (236360313 and 255156212) German Center for Diabetes Research DZD (82DZD07C2G)
40-OR: 4T Study: Tighter Glucose Target Settings with Early CGM Initiation Further Improves A1C in Youth with T1D
Authors: PRAHALAD PRIYA , DING VICTORIA , ZAHARIEVA DESSI P. , ADDALA ANANTA , BISHOP FRANZISKA K. , SCHEINKER DAVID , JOHARI RAMESH , DESAI MANISHA , HOOD KOREY K. , MAAHS DAVID M. ,   4T STUDY GROUP
Published: May 2022

In the Pilot 4T study (diagnosed July 2018 to May 2020, A1c target &lt;7.5%, n=135) , early CGM initiation and remote patient monitoring (RPM) was associated with lower A1c. We hypothesized that tightening A1c targets to &lt;7% would further lower A1c.
All youth with newly diagnosed T1D from June 2020 to December 2021 were offered CGM initiation in the first month of diagnosis and RPM (4T cohort, n=115) . We compared A1c outcomes in the 4T cohort with the Pilot 4T cohort and the Historical cohort who were not offered early CGM (diagnosed 2014-2016, n=272) . We visualized population-based A1c trajectories using locally estimated scatter plot smoothing (LOESS, Fig) .
Mean A1c at diagnosis was similar in the 4T and Pilot 4T cohorts (12.3% v 12.2%) and higher than the Historical cohort (10.7%) . The median age of diagnosis was 11.2 years [7.1, 14], 53% male, 35% non-Hispanic White, and 65% with private insurance in the 4T cohort. CGM initiation occurred within 30 days of diagnosis in 98.3% of youth. At 3, 6, and 9 months post-diagnosis, those in the 4T cohort had LOESS-based mean A1c differences of 0.33%, 0.36%, and 0.42% lower than the Pilot 4T cohort and 0.39%, 0.62%, and 0.96% lower than the Historical cohort.
Early CGM initiation and RPM combined with tighter glucose targets was associated with a lower A1c compared to historical cohorts. These data support implementation of the 4T program with tight target setting in youth with T1D.

Disclosure
P.Prahalad: None. D.M.Maahs: Advisory Panel; Abbott Diabetes, Eli Lilly and Company, Medtronic, Novo Nordisk, Sanofi, Consultant; Aditx Therapeutics, Inc., Biospex. 4t study group: n/a. V.Ding: 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. F.K.Bishop: None. D.Scheinker: None. R.Johari: None. M.Desai: None. K.K.Hood: Consultant; Cecelia Health, Havas Health, Insulet Corporation, LifeScan Diabetes Institute.

Funding
Stanford Diabetes Research Center (P30DK116074) and R18DK122422; Dexcom; Lucile Packard Children’s Hospital Auxiliaries Endowment
428-P: Type 2 Diabetes Mellitus and Congestive Heart Failure in Women Are Mutually Independent Predictors of Nonalcoholic Fatty Liver Disease
Authors: MAECHLER MAXIMILIAN , SPRENGER LUKAS , MADER ARTHUR , LARCHER BARBARA , VONBANK ALEXANDER , LEIHERER ANDREAS , MUENDLEIN AXEL , DREXEL HEINZ , SAELY CHRISTOPH H. 
Published: May 2022

Nonalcoholic fatty liver disease (NAFLD) is associated with both type 2 diabetes mellitus (T2DM) and congestive heart failure (CHF) , and T2DM is highly prevalent in CHF patients, in particular among women. However, the single and joint associations of T2DM and CHF with NAFLD in women have not been investigated yet. This issue therefore is addressed in the present study.
We investigated 76 female patients with CHF and 321 female controls who did not have signs or symptoms of CHF and in whom significant coronary artery disease was ruled out angiographically. The presence of NAFLD was determined using the validated fatty liver index (FLI) .
The prevalence of T2DM was 39.5% in women with CHF and 22.1% in controls (p=0.002) . FLI values and prevalence rates of NAFLD (FLI≥60) in non-CHF women without T2DM were 43±28 and 31.6%, respectively. They were significantly higher in non-CHF, but T2DM patients (65±28, p&lt;0.0 and 64.8%, p&lt;0.001, respectively) , in CHF patients without T2DM (67±25, p&lt;0.0 and 63.0%, p=0.002, respectively) and in CHF patients with T2DM (66±31, p&lt;0.0 and 66.7%, p&lt;0.001, respectively) . In multivariate analysis of covariance, T2DM and CHF proved to be mutually independent predictors of FLI after adjustment for age, sex, BMI, LDL-C, history of smoking and hypertension and use of statins (F=7.25; p=0.0 and F=46.89; p&lt;0.001, respectively) ; concordantly, T2DM and CHF independently predicted the presence of NAFLD in logistic regression analyses, with adjusted odds ratios of 3.22 [1.38-7.50]; p=0.0 and 21.71 [6.58-71.59]; p&lt;0.001, respectively.
We conclude that CHF and T2DM are mutually independent predictors of NAFLD in women.

Disclosure
M.Maechler: None. L.Sprenger: None. A.Mader: None. B.Larcher: None. A.Vonbank: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None. C.H.Saely: None.
458-P: Inflammatory Markers and Cardiovascular Autonomic Neuropathy in Type 1 Diabetes
Authors: ANG LYNN , GUNARATNAM SEJAL V.G. , HUANG YIYUAN , MIZOKAMI-STOUT KARA R. , MARTIN CATHERINE , REISS JACOB , BURANT AARON , VASBINDER ALEXI , LAUNIUS CHRISTOPHER , ZHAO LILI , FELDMAN EVA L. , HAYEK SALIM , POP-BUSUI RODICA 
Published: May 2022

Objective: We aimed to assess the role of chronic inflammation in the pathogenesis of cardiovascular autonomic neuropathy (CAN) , a serious complication of type 1 diabetes (T1D) .
Methods: We leveraged an ongoing randomized, placebo-controlled clinical trial targeting inflammation with salsalate in individuals with T1D, to measure a panel of 40 inflammatory markers (Figure) in baseline samples. Measures of CAN included standardized cardiovascular autonomic reflex tests (CARTs) (E/I, Valsalva, 30/15 ratios) and indices of heart rate variability (HRV) . We used Spearman-rank to assess the correlations between inflammatory markers and CAN measures, and linear regression to adjust for age and hemoglobin A1c.
Results: The Figure displays the correlation between biomarkers and CAN measures in 58 T1D participants (mean age 51 ± 13 years, and HbA1c 8.4 ± 1.8%) . Amongst all biomarkers, we noted a singular negative correlation between soluble urokinase plasminogen activator receptor (suPAR) and measures of CAN, which remained significant in multivariable analysis (E/I ratio p=0.005, Valsalva p=0.037, RFA p=0.019, LFA p=0.023) .
Conclusion: Amongst a large panel of inflammatory markers, we found suPAR to have a notable association with CAN. SuPAR is an immune-mediated signaling glycoprotein which levels are strong predictors of risk in patients with diabetes, thus its role in CAN warrants further exploration.

Disclosure
L.Ang: None. L.Zhao: None. E.L.Feldman: None. S.Hayek: n/a. R.Pop-busui: Advisory Panel; Averitas Pharma, Inc., Boehringer Ingelheim International GmbH, Nevro Corp., Novo Nordisk, Reata Pharmaceuticals, Inc., Regenacy Pharmaceuticals, Inc. S.V.G.Gunaratnam: None. Y.Huang: None. K.R.Mizokami-stout: None. C.Martin: Advisory Panel; Nevro Corp. J.Reiss: n/a. A.Burant: None. A.Vasbinder: None. C.Launius: None.

Funding
NIH/NIDDK-1-R01-DK-107956-01
480-P: Correlation of Tg/HDL Ratio and Liver Fibrosis in People with Diabetes in a Tertiary Care Center in India
Authors: TEWARI AJOY , TEWARI VINEETA , TEWARI JAY , SABOO BHARAT , SHRIVASTAVA ABHISHEK , DARIYA S S. , CHAVDA VIPUL , HASNANI DHRUVI , INAMDAR ANIKET V. , CHOUDHURY RUPAM 
Published: May 2022

Introduction: As per the recent International Diabetes Federation (IDF) atlas, there are 537million adults living with diabetes. Indians with the same body mass index (BMI) have higher central adiposity and insulin resistance compared to Caucasians. High insulin resistance in people with diabetes predisposes them to Nonalcoholic Fatty Liver Disease (NAFLD) . TG/HDL ratio is emerging as a sensitive marker of insulin resistance. Liver stiffness measurements predict advanced fibrosis in people with diabetes. The current study aims to correlate TG/HDL ratio and liver stiffness measurements using fibro scans in people with diabetes.
Material and Methods: A total of 181 people with diabetes coming for the first time at our center underwent liver stiffness measurements using fibro scans after taking consent, people on prior lipid-lowering therapy and thiazolidinedione therapy were excluded from the study.
Results: Median stiffness ranged from 2.3kpa to 34.8kpa (median of 8.0kpa) , TG/ HDL ratio values ranged from 0.5-29.3 (median of 4.5) . Median stiffness, correlated with TG/HDL ratio correlation coefficient, was 0.2 (p 0.01) . Further 26.5% subjects had advanced fibrosis (Liver stiffness measurement (LSM) &gt;9.1) , 23.7% of male subjects and 30% of female subjects had advanced fibrosis. Males and females with LSM &gt;9.1 had high TG/ HDL ratio, mean 4.9 in males (range 2.5-13.7) and 4.9 in females (range 1.0-17) . These values were much higher than TG/HDL values of 0.9 and 1.2 used in females and males respectively, as cutoffs to predict insulin resistance.
Discussion: Previous studies have correlated TG/HDL ratio with NAFLD in nondiabetic individuals using ultrasonography. Fibro scan is a more sensitive and specific modality to screen for NAFLD. Median stiffness predicts liver fibrosis. There is a high incidence of advanced fibrosis in the index study, which correlated with TG/HDL ratio. All male and female subjects with advanced fibrosis had a high TG/HDL ratio.

Disclosure
A.Tewari: None. R.Choudhury: None. V.Tewari: None. J.Tewari: None. B.Saboo: None. A.Shrivastava: None. S.S.Dariya: None. V.Chavda: None. D.Hasnani: None. A.V.Inamdar: None.
531-P: Continuous Glucose Monitoring Placement during Physical Activity
Authors: THRASHER BRAD J. , DYESS RYAN J. , MCKAY TIM E. , WINTERGERST KUPPER A. 
Published: May 2022

Objectives: Individuals living with type 1 diabetes (T1D) are encouraged to participate in physical activity (PA) . It is vital that technology used to manage diabetes, such as a continuous glucose monitor (CGM) , provides reliable results during and after exercise. Currently, the Dexcom G6 CGM is approved to be inserted on the abdomen or upper buttock. The following study compared various location sites to assess reliability of those differing locations during times of moderate intensity PA.
Methods: Thirty adolescents and young adults (age 13-20 years, µ=14.3 years) with T1D performed moderate intensity PA on a treadmill. Intensity was determined by Karvonen heart rate reserve formula. The PA consisted of walking/jogging for 40 minutes, with a 10-minute break occurring at the halfway point. Dexcom G6 CGM and glucometer measurements were collected and analyzed every minutes during and after exercise. Dexcom locations included arm, abdomen, thigh, and upper buttock. Analysis of accuracy metrics included mean absolute relative difference (MARD) and clinical reliability was assessed by Clarke Error Grid Analysis.
Results: Analysis of CGM location sites revealed that CGMs placed on the arm and buttocks, statistically, had a worse MARD in comparison to abdomen. The CGM being placed on the buttocks increased the MARD by a ratio of 2.15 when compared to the abdomen. Additionally, we found that individuals who wore the CGM on their buttocks had an increased risk of having glucoses in Zone D of the Clarke Error Grid in comparison to those wearing it on the abdomen.
Conclusions: The results suggest that CGM location does matter during and after exercise, with the abdomen providing the most reliable results. Furthermore, we found that CGM placement on the buttocks may lead to failure to detect dysglycemia during exercise. We hypothesize this may be due to interstitial fluid changes in actively exercising muscles which alter the accuracy during exercise. However, additional research in this area is needed to support this theory.

Disclosure
B.J.Thrasher: None. R.J.Dyess: None. T.E.Mckay: None. K.A.Wintergerst: None.
59-LB: Outcomes of an Employer-Sponsored Virtual Type 2 Diabetes (T2D) Reversal Program in Working-Age Adults
Authors: CHEN ZHEN , BIRSE CHARLES E. , ARELLANO ANDRE R. , FRAGALA MAREN S. , MCPHAUL MICHAEL J. , BARE LANCE A. 
Published: May 2022

Objective: To evaluate short-term outcomes of an employer-sponsored virtual T2D reversal program, conducted through medically supervised nutritional intervention and provider-led telehealth, in working-age adults.
Methods: This pre-post study included 119 employees with T2D and high HbA1c and/or high spending on T2D prescriptions who enrolled in the T2D reversal program October 15, 2020-January 27, 2021. HbA1c, fasting glucose (FG) , body weight, body index mass (BMI) , and waist circumference pre- and post-enrollment were assessed from annual employer-sponsored wellness screening conducted 2019-2021, independently of the T2D reversal program. Program prescriptions (insulin, DPP4, GLP1, meglitinide, sulfonylurea, TZD, SGLT2) were compared pre vs. post (Table footnote 1) . Pharmacy spending for these prescriptions was estimated from a third-party claims database.
Results: The program retention rate was 82% at 6 months and 67% at 1 year. Mean levels of all outcome measures declined significantly from pre to post (Table) . The number of prescriptions decreased for 47 (39.5%) of the 119 participants and increased for 3 (2.5%) . For 89 individuals participating for 6 months or more, average monthly prescription spending declined 18% (to $449 from $547) during the first 6 months after enrollment (vs. the prior 12 months) .
Conclusions: A virtual T2D reversal program helped lower HbA1c, FG, body weight, BMI, and waist circumference in employees with diabetes while reducing prescriptions and pharmacy spending.

Disclosure
Z. Chen: Employee; Quest Diagnostics, Stock/Shareholder; Quest Diagnostics. C. E. Birse: Employee; Quest Diagnostics. A. R. Arellano: Employee; Quest Diagnostics. M. S. Fragala: Employee; Quest Diagnostics, Stock/Shareholder; Quest Diagnostics. M. J. Mcphaul: Employee; Quest Diagnostics. L. A. Bare: Employee; Quest Diagnostics.