bluuebunny/crossref_metadata_2025_split huggingface dataset:
539-P: Evaluation of a Comprehensive Physical Fitness Index to Predict Future Prediabetes and Metabolic Syndrome (MetS)
Authors: SATO TAKAAKI , FUJIHARA KAZUYA , YAMADA MAYUKO H. , CHO KAORI , YAGUCHI YUTA , YAMAMOTO MASAHIKO , KITAZAWA MASARU , ISHIGURO HAJIME , OSAWA TAEKO , YAMADA TAKAHO , KATO KIMINORI , SONE HIROHITO 
Published: May 2022

Muscle strength, balance, and flexibility has been associated with the development of type 2 diabetes and atherosclerosis, but little is known whether the physical score (PS) , which integrates these physical fitness indices, can predict future metabolic diseases. We investigated the longitudinal relationship between baseline and changes in PS and future prediabetes and MetS. Analyzed were 5620 men aged 30 to 69 y without MetS who underwent physical fitness tests. Principal component analysis was performed on the correlation matrix of the physical fitness test results according to age. PS was defined as the first principal component score. Associations between PS values at the start of observation (year 0) , change in the PS one year later (year 1) and the onset of prediabetes and MetS at the end of observation (years 4 or 5) were examined by Cox hazard regression analysis. The same analysis was performed for the 3812 men without prediabetes at baseline. No significant difference was found for the development of prediabetes, but a significant difference was found for development of MetS. The hazard ratio for the development of MetS was 1.30 (1.18,1.44) for every 1 decrease in the PS in year 0 and 1.35 (1.13,1.60) for every 1 decrease in the change in PS from year 0 to year 1. PS was a simple and non-invasive indicator to predict MetS.

Disclosure
T. Sato: None. K. Fujihara: None. M. Yamamoto: None. M. Kitazawa: None. H. Ishiguro: None. T. Osawa: None. H. Sone: Research Support; Astellas Pharma Inc., Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Novo Nordisk, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Takeda Pharmaceutical Company Limited.
542-P: Determinants of Objectively Measured Physical Activity in Chinese Immigrants in the U.S. with Prior Gestational Diabetes
Authors: HUANG SHUYUAN , ASH GARRETT I. , NAM SOOHYUN , JEON SANGCHOON , MCMAHON ERIN , WHITTEMORE ROBIN 
Published: May 2022

Background: Women with prior gestational diabetes (GD) have times the risk of developing type 2 diabetes (T2D) as women without prior GD. Chinese immigrants in the US are disproportionately affected by GD and T2D. Physical activity (PA) is a modifiable lifestyle strategy to reduce the risk of T2D. The aim of this study was to identify health beliefs, cultural, and psychosocial determinants of objectively-measured PA among Chinese immigrants in the US with prior GD.
Methods: We conducted a cross-sectional study among 1Chinese immigrants with prior GD (6 months to 5 years postpartum) across the US, recruited primarily via WeChat. PA was measured by GT9X+ hip accelerometers for 7 consecutive days. Validated questionnaires in English and Chinese were used to assess health beliefs, cultural, and psychosocial characteristics. Descriptive, bivariate, and multiple regression analyses were performed to identify factors associated with PA levels.
Results: The mean age of participants was 34.3±3.7 years, and mean body mass index was 21.7±2.6 kg/m2. Mean daily steps were 5912±2139. Only 28% met the PA guidelines of ≥150 minutes of moderate- to vigorous- physical activity (MVPA) per week. The duration of MVPA per week was 86 [IQR 39- 152] minutes. Participants had an average of 9.2±1.4 hours of sedentary time per day, which was about 64.7±7.8% of the total wear time. In the final adjusted model, participants who had higher acculturative stress [-0.25 (SE=0.14) , p=.006], were not living with parents [-0.21 (SE=0.22) , p=.020], had no knowledge of PA guidelines [-0.18 (SE=0.17) , p=.039], and had an annual household income of &lt; $60K [-0.21 (SE=0.23) , p=.025] were had fewer MVPA minutes per week.
Conclusion and implication: Strategies are needed to increase MVPA among this high-risk group, including decreasing acculturative stress and increasing knowledge of PA guidelines. The findings from this study will inform the development of culturally-sensitive interventions.

Disclosure
S.Huang: None. G.I.Ash: None. S.Nam: None. S.Jeon: None. E.Mcmahon: None. R.Whittemore: None.

Funding
Connecticut Nurses’ Foundation Scholarship Award
550-P: A Randomized Trial of Low-Carbohydrate Diet on Hemoglobin A1c among Individuals with Elevated Hemoglobin A1c
Authors: DORANS KIRSTEN S. , BAZZANO LYDIA A. , QI LU , HE HUA , CHEN JING , APPEL LAWRENCE J. , HU FRANK , SAMET JONATHAN , MILLS KATHERINE T. , O'BRIEN MATTHEW J. , UWAIFO GABRIEL I. , HE JIANG 
Published: May 2022

Background: Low-carbohydrate diets decrease hemoglobin A1c among patients with type 2 diabetes mellitus. However, evidence on effects of low-carbohydrate diets on hemoglobin A1c among individuals with prediabetes is limited.
Methods: We conducted a randomized parallel-group trial of 150 adults aged 40-70 years with untreated hemoglobin A1c from 6.0-6.9%. Participants were assigned to a healthy low-carbohydrate diet (target &lt;40 grams net carbohydrates months 1-3; &lt;60 grams months 3-6) or usual diet. The low-carbohydrate arm received regular dietary counseling. Data on hemoglobin A1c and other metabolic risk factors were collected at 0, 3, and 6 months.
Results: Mean age was 59 years; 72% were female and 59% were Black. 95% completed the study. Participants in the low-carbohydrate arm had significantly greater 6-month decrease in hemoglobin A1c (net difference, -0.23% [95% CI, -0.32 to -0.14%]) , fasting plasma glucose (net difference, -10.3 mg/dL [95% CI, -15.7 to -4.9 mg/dL]) , and body weight (net difference, -5.9 kg [95% CI, -7.2 to -4.7 kg]) compared with usual diet arm. At 6 months, 53% in the low-carbohydrate arm and 32% in the usual diet arm had hemoglobin A1c &lt;6.0% (p=0.01) .
Conclusion: A healthy low-carbohydrate diet led to improvements in glycemic and other cardiometabolic outcomes in adults with elevated hemoglobin A1c and could be recommended for prevention of type 2 diabetes mellitus.

Disclosure
K.S.Dorans: None. M.J.O'brien: None. G.I.Uwaifo: None. J.He: None. L.A.Bazzano: None. L.Qi: None. H.He: None. J.Chen: None. L.J.Appel: n/a. F.Hu: None. J.Samet: None. K.T.Mills: None.

Funding
National Institute of General Medical Sciences (1P20GM109036-01A1) . The California Walnut Commission (Folsom, CA) supported the study by providing walnuts. Shakes and bars were donated by The Simply Good Foods Company (Denver, CO) . Sugar replacement samples were provided by Swerve LLC (New Orleans, LA) .
551-P: Effects of a Plant-Based Intensive Lifestyle Intervention in Adults with Type 2 Diabetes: A Randomized Controlled Trial
Authors: HANICK CODY , PETERSON COURTNEY M. , SABATÉ JOAN , DAVIS BRENDA C. , SPENCE JAMIE W. , KELLY JOHN 
Published: May 2022

Background: The Republic of the Marshall Islands (RMI) has the highest rate of type 2 diabetes (T2D) in the world. Lifestyle interventions, including plant-based diets and exercise, have been shown to effectively manage T2D.
Objective: We therefore conducted the largest plant-based lifestyle intervention in adults with T2D. The goal of this study was to determine whether a plant-based lifestyle intervention is more effective than the standard of care for treating type 2 diabetes.
Methods: We conducted a parallel-arm randomized clinical trial in Majuro, RMI. Adults with T2D were randomized to either standard of diabetes care (SOC) or a plant-based lifestyle intervention (PB+Ex) for 24 weeks. The first 12 weeks of the intervention involved the provision of plant-rich meals, counselling, cooking classes, and group exercise sessions, which gradually decreased in frequency over the 12-week period. Thereafter, from Weeks 13-24, participants in the PB+Ex group were instructed to continue the lifestyle intervention on their own. The primary outcome was change in HbA1c. Secondary outcomes included fasting glucose, insulin, blood pressure, lipids, and medication use. Outcome data was collected at five time points and analyzed using linear mixed models.
Results: One hundred thirty-eight adults with T2D started the intervention (mean ± SD; age: 54.3 ± 8.6 years, HbA1c: 10.3 ± 2.1%; 50.7% female) . PB+Ex reduced HbA1c by 1.3 ± 0.3% (lsmean ± SEM; p&lt;0.001) and 0.7 ± 0.3% (p=0.01) at weeks 12 and 24, respectively, compared to SOC. PB+Ex also decreased BMI at weeks 12 and 24 (both -1.1 kg/m2; p&lt;0.001) . Additionally, PB+Ex reduced C-reactive protein and waist circumference compared to SOC. Additional analyses on other fasting cardiometabolic endpoints and medication changes are underway.
Conclusions: A plant-based intensive lifestyle intervention with exercise is more effective at improving glycemic control, BMI, and inflammatory markers than the standard of diabetes care.

Disclosure
C.Hanick: None. C.M.Peterson: None. J.Sabaté: None. B.C.Davis: None. J.W.Spence: None. J.Kelly: None.

Funding
Department of the Army (W81XWH-05-1-0547)
554-P: Complex Meal Handling with Advanced Hybrid Closed-Loop (AHCL) System
Authors: HIRSH MAYA LARON , SHALIT ROY , SHALEM SHIRAN , COHEN OHAD , KURTZ NATALIE , ROY ANIRBAN , GROSMAN BENYAMIN , CUKIERMAN-YAFFE TALI , TIROSH AMIR 
Published: May 2022

Background and Aims: Meal management is a major challenge for people with type 1 diabetes (PWD) . We aimed to explore 3 approaches to complex meal planning, from a most comprehensive scheme in open loop (OL) to a simplified, carbohydrate (CHO) counting-free scheme when using the MiniMed™ 780G system AHCL.
Methods: Participants (N=13, mean age 46.8±12.8 years and baseline A1C of 6.1±1.2%) consumed a high fat, high protein, meal using 3 types of insulin boluses;1) OL utilizing the dual-wave bolus and elaborate CHO counting;2) AHCL with accurate CHO amount;3) AHCL with a predefined bolus and no CHO counting,
Results: No significant differences in TIR and 5-hour iAUC were observed between the 3 bolus groups (P=0.401, P=0.526, respectively) There were no significant differences in other glucose metrics. (Table 1)
Conclusion: Our results indicate that glycemic control following a complex meal challenge is similar when using AHCL with or without accurate CHO counting and with less tendency for hypoglycemia when compared with the most elaborate meal management in OL. Thus, the current burden of meal management for PWD during OL system use is alleviated with AHCL.

Disclosure
M.Laron hirsh: None. R.Shalit: Speaker's Bureau; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk. S.Shalem: None. O.Cohen: Employee; Medtronic. N.Kurtz: Employee; Medtronic. A.Roy: Employee; Medtronic. B.Grosman: Employee; Medtronic. T.Cukierman-yaffe: Research Support; European Association for the Study of Diabetes, Medtronic, Merck Sharp & Dohme Corp., Novo Nordisk, Speaker's Bureau; AstraZeneca, Eli Lilly and Company, Medtronic, Merck Sharp & Dohme Corp., Novo Nordisk, Sanofi. A.Tirosh: Advisory Panel; Abbott Diagnostics, AstraZeneca, Boehringer Ingelheim International GmbH, Merck & Co., Inc., Novo Nordisk, Sanofi, Consultant; Bayer AG, DreaMed Diabetes, Ltd., Research Support; Medtronic, Speaker's Bureau; Eli Lilly and Company.
56-LB: Racial/Ethnic Differences in the Use of Blood Pressure–Lowering Drugs Associated with Different Risk levels of Type 2 Diabetes among U.S. Adults without Diabetes
Authors: SHAO HUI , ALKHUZAM KHALID , GUO JINGCHUAN , JIAO TIANZE , SMITH STEVEN M. , ZHANG PING , GREGG EDWARD W. 
Published: May 2022

Understanding differences in risk factors can assist in identifying means to reduce racial/ethnic disparities in type 2 diabetes (T2D) prevalence. Different types of blood pressure (BP) lowering drugs are associated with different levels of T2D risk. This study examined the utilization of BP-lowering drugs among US adults aged 18 and over without diabetes with diagnosed hypertension by racial/ethnic group. We used self-report or ICD-10 diagnostic codes to identify our study population using the 2016-2019 Medical Expenditure Panel Survey. The high T2D risk drugs included beta-blockers and diuretics and the low-risk drugs were ACEI and ARBs. We calculated the percentage of high-risk and low-risk drug use in non-Hispanic Black (NHB) , non-Hispanic White (NHW) , Hispanic, and Asian persons. Logistic regression was used to compare the uses of two drug types across different racial/ethnic groups, controlling for demographics, history of cardiovascular and renal diseases, insurance, duration of hypertension, and general health measurements. We have identified 18,283 individuals, with a mean age of 60.7 and 52.4% were females. Compared with NHB, NHW persons (adjusted odds ratio (aOR) :0.90, 95% CI: 0.58-0.98) , Hispanic (aOR:0.62, 95% CI: 0.56-0.70) , and Asian (aOR:0.54, 95% CI: 0.46-0.64) persons were less likely to receive high-risk drugs. Meanwhile, NHW (aOR: 1.19, 95% CI: 1.09-1.29) , Hispanic (aOR:1.14, 95% CI: 1.03-1.27) , and Asian (aOR:1.19, 95% CI: 1.02-1.40) persons were more likely to use low-risk drugs than NHB persons (all p&lt;0.05) . The highest use of high-risk BP-lowering drugs and the lowest use of low-risk BP-lowering drugs by NHB persons could increase their risks of T2D and contribute to disparities in T2D prevalence between NHB and other racial/ethnic groups. Future studies can quantify the effect of the BP-lowering drug choices on T2D disparities.

Disclosure
H. Shao: Board Member; BRAVO4HEALTH, LLC. K. Alkhuzam: None. J. Guo: None. T. Jiao: None. S. M. Smith: None. P. Zhang: None. E. W. Gregg: None.
575-P: Screening, Selecting, and Training Peers to Deliver Mental Health Support via a Virtual Care Platform to Adults with Type 1 Diabetes Living in Rural and Remote Communities
Authors: TANG TRICIA S. , YIP KAI WAI , MOORE LAUREN , KLEIN GERRI 
Published: May 2022

Introduction: While the diabetes distress (DD) experience is unique for adults with type 1 diabetes (T1D) compared to those with type 2 diabetes (T2D) , DD interventions involving peer support have focused largely on the T2D population. This study describes the process of screening, selecting, and training peers to provide mental health support to adults with T1D living in geographically marginalized settings.
Methods: Peer Supporter (PS) candidates (n=65) underwent a two-component screening process involving an online personality assessment and a semi-structured interview. Individuals who passed participated in a 6-hour Zoom-based Peer Supporter Training (PST) consisting of three parts: (1) identifying internal motivation, boosting resilience, and expressing empathy; (2) exercising mindfulness, sitting with difficult emotions, and exploring DD; and (3) practicing active listening, avoiding advice giving (including clinical) . Candidates were assigned a standardized patient (SP) with T1D and invited to complete a 5-day peer support trial. To graduate successfully, trainees needed to score ≥ 4 of a 5-point Likert scale for each of 8 competencies criteria.
Results: Of the 65 participants screened, 52 participated in PST. For the 5-day trial, candidates facilitated a values exercise and explored the SP’s DD profile. Mean scores for the 8 competency domains were: listening actively (4.55) ; no passing judgment (4.67) ; asking open-ended questions (4.12) ; making reflections (4.5) ; expressing empathy (4.42) ; sitting with strong emotions (4.44) ; avoiding advice giving (4.38) ; and deferring medical questions (4.58) . Forty-six of 52 participants graduated successfully.
Conclusions: A rigorous process is feasible for screening, selecting and training peers to deliver mental health support to adults with T1D. The next step is to examine the impact of this peer support intervention on DD outcomes.

Disclosure
T.S.Tang: None. K.Yip: None. L.Moore: None. G.Klein: None.

Funding
Juvenile Diabetes Research Foundation (2-SRA-2020-986-S-B)
579-P: Diabetes-Related Distress Is Inversely Associated with Weight Loss with Lifestyle Intervention in T2D
Authors: VAKHARIA JANAKI , WEXLER DEBORAH J. , THAWEETHAI TANAYOTT , YU CHU , DELAHANTY LINDA M. 
Published: May 2022

Measures of depression (e.g., PHQ-8) and diabetes-related distress (e.g., Problem Areas In Diabetes, or PAID) are associated with diabetes self-care and adherence to lifestyle regimens in patients with T2D. The REAL HEALTH-Diabetes trial evaluated a Look-AHEAD adapted group lifestyle intervention (LI) . We sought to determine baseline characteristics that were associated with achieving ≥5% weight loss during the first year of the intervention. Participants were randomly assigned to receive LI either in-person (IP, n = 69) or by telephone (Tele, n =72) . At baseline, 12.9% had a PHQ-8 score of ≥ 10, indicating current depression, and 50.4% had a baseline PAID score of ≥ 40, indicating severe emotional distress. At 6 months and 12 months, 46.8% and 45.7% achieved ≥ 5% weight loss (Table 1) . Participants who achieved ≥ 5% weight loss at 6 and 12 months had lower mean baseline PAID scores than non-achievers (35 vs. 44, P=0.021 at 6 months; 35 vs. 43, P=0.036 at 12 months) . Achievers also had lower mean baseline PHQ-8 scores compared to non-achievers, but this difference was not statistically significant (4.0 vs. 5.1, P=0.596 at 6 months; 3.8 vs. 5.1, P=0.842 at 12 months) . We found that diabetes distress was more common than depression, and that baseline levels of diabetes-related distress were inversely associated with achievement of ≥ 5% weight loss at 6 and 12 months of LI.

Disclosure
J.Vakharia: None. D.J.Wexler: Other Relationship; Elsevier, Novo Nordisk, UpToDate. T.Thaweethai: None. C.Yu: None. L.M.Delahanty: Advisory Panel; Lilly Diabetes, Omada Health, Inc., WW International, Inc., ZOE Limited, Stock/Shareholder; Jana Care Inc., Omada Health, Inc., ZOE Limited.

Funding
T32 DK007028
580-P: Clinical and Psychological Differences in Depression in Distressed Teens with Type 1 Diabetes (T1D)
Authors: SCOTT SAMANTHA R. , O'DONNELL MAEVE B. , ZHOU CHUAN , MALIK FAISAL , PIHOKER CATHERINE , DESALVO DANIEL , BRADFORD MIRANDA , ROSENBERG ABBY , HILLIARD MARISA E. , YI-FRAZIER JOYCE 
Published: May 2022

Introduction: Teens with T1D are at risk for depression and diabetes distress. While diabetes distress is typically more predictive of A1C, less is known about teens experiencing both concerns. In teens with T1D with elevated diabetes distress, we explored clinical and psychological differences between those with or without depression.
Methods: At baseline of a psychosocial intervention trial, teens (N=173) with PAID-T scores ≥30 (elevated diabetes distress) reported demographics and Patient Reported Outcomes (PROs) of depression, general/T1D resilience, diabetes quality of life (QoL) , and family conflict. A1C and pump use were extracted from medical records. Using Fisher’s exact, X-square, and Wilcoxon rank sum tests, we compared demographics, pump use, A1C, and PROs by depression status (clinical cutoff of PHQ-8 ≥10) .
Results: Distressed teens with depression (34%) were more likely to be female and have unemployed caregivers. Compared to participants without depression, distressed teens with depression reported lower resilience and QoL and higher distress and family conflict. There were no differences in mean HbA1c or insulin pump use.
Conclusions: Screening for depression is an important clinical initiative-teens with general and T1D-specific mood concerns are at risk for multiple psychosocial challenges that may warrant intervention and may be impacted by social determinants of health.

Disclosure
S.R.Scott: None. J.Yi-frazier: None. M.B.O'donnell: None. C.Zhou: None. F.Malik: n/a. C.Pihoker: None. D.Desalvo: Consultant; Dexcom, Inc., Insulet Corporation, Research Support; Insulet Corporation. M.Bradford: None. A.Rosenberg: None. M.E.Hilliard: None.

Funding
NIH 1R01DK121224-01
601-P: Participation in Diabefly Program and Significant Reduction in Diabetes Distress and Improvement in Motivation and Attitude towards Changing Health among People with Type 2 Diabetes
Authors: VERMA NEHA , LATHIA TEJAL , VASAN PALLAVI , GUPTA NISHUL , VERMA RITIKA , KALRA SANJAY , PADSALGE MAHESH V. , METHIL VINOD , SINGAL ARBINDER K. , SAMUDRA KIRTI 
Published: May 2022

Introduction: Diabetes distress is a unique, often hidden, emotional burden and worry that an individual experiences while managing diabetes. Enhanced motivation and willingness are important components of one’s ability to manage the increasing demands of diabetes. Aim of this study is to analyse the effectiveness of digital therapeutics programs in providing evidence-based care that can help in better management of diabetes through long-term behaviour change.
Methods: This study was conducted with 100 participants diagnosed with type 2 DM across India. They were enrolled in the Diabefly® digital therapeutics program for 90 days. Highly customized virtual stress management and behaviour therapy sessions were given to each participant along with nutrition and fitness sessions. Various digital interventions were shared at regular intervals. Initial and final assessment was done using Diabetes Distress Scale and Motivation and Attitude towards Changing Health. t - test was used to analyse the data.
Results: Motivation levels among participants improved significantly by 9.39% from a baseline score of 33.70±4.24 to 37.42±4.50 (p=0.001) . Distress levels among participants decreased significantly by 24.21% from a baseline score of 1.90±0.77 to 1.35±0.45 (p=0.001) . Participants from joint families have higher interpersonal distress as compared to nuclear families (p=0.008) . Participants having diabetes for more than 5 years have higher physician distress (p=0.001) and interpersonal distress (p=0.005) as compared to newly diagnosed ones. Participants who are on insulin along with medications have higher physician distress (p=0.031) and interpersonal distress (p=0.020) in comparison to those who are just on medication or not on any medication.
Conclusion: Remote behavioural interventions as part of a comprehensive 90 days Diabefly® program can be very effective in managing diabetes adequately.

Disclosure
N.Verma: Employee; Fitterfly HealthTech Private Limited. K.Samudra: None. T.Lathia: Advisory Panel; Abbott, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Novartis Pharmaceuticals Corporation, Novo Nordisk, Sanofi. P.Vasan: Employee; Fitterfly Health Tech Pvt Ltd. N.Gupta: Employee; Fitterfly HealthTech Pvt Ltd. R.Verma: Employee; Fitterfly Healthtech Pvt Ltd, Wellthy Therapeutics Pvt Ltd. S.Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. M.V.Padsalge: None. V.Methil: None. A.K.Singal: Other Relationship; Fitterfly Healthtech Pvt Ltd.