bluuebunny/crossref_metadata_2025_split huggingface dataset:
589-P: Health Disparities among People with and without Diabetes during COVID-19: An 18-Month Evaluation
Authors: MYERS BARBARA A. , KLINGENSMITH RACHEL , CASANOVA INES GONZALEZ , DE GROOT MARY 
Published: May 2022

This study describes the mental health of US adults with and without diabetes (ND) over an 18-month period of the COVID-pandemic. A 12-month web-based survey was administered in May 2020 (N = 2,176) to June 2021 and November 2021 (18MO; N = 1,192) including demographics, pandemic experiences, depression (PHQ-8) and anxiety (GAD-7) symptoms, perceived stress (PSS) , and resilience (BRS) . Mean age of 18MO Completers (55%) was 53 years (SD = 16.4) , primarily female (80%) , White (91%) , with an annual household income of ≥ $60,000 (58%) . 165 had type 2 diabetes (T2D; 14%) , 83 had prediabetes (7%) , and 56 had type 1 (T1D; 5%) . Completers were more likely to be White, educated (45% post-master’s degree) , and homeowners with fewer medical and emotional comorbidities at baseline than non-completers (all p&lt;.05) . At 18MO, mean PHQ-8 score was 5.2 (SD = 5.3; mild) , GAD-7 was 4.1 (SD = 4.8) , PSS was 13.2 (SD = 5.5) . All improved from baseline (p&lt;.001) . Ages 18-30 had the highest scores on anxiety (M = 6.1; SD = 5.4) and perceived stress (M = 16.5; SD = 8.3) compared to other age groups (p&lt;.001) . At 18MO, rates of COVID-infection (9.1%; p&lt;.001) , knowing someone with COVID- (86.7%) , loss from COVID- (40.7%) and pandemic burnout (M = 2.6, SD = 2.1) were increased. Greatest burnout was reported by women (M = 2.9, SD = 2.1) , 18-30 y.o.s (M = 3.5, SD = 2.0) and T1Ds (M = 3.5, SD = 1.7) , all p&lt;.05. Financial disparities persisted at all time points. At 18MO, women (15.98%) and Latinos (28.57%) reported difficulty paying monthly bills (p&lt;.001) . Asian/American Indian/Multiracial (23.73%) subgroup reported worsening financial situations compared to Whites (p&lt;.001) . 51-64 y.o.s reported difficulty paying bills (20.4%) , less financial optimism (13.4%) and worsening financial situation (21.45%) compared to other age groups (p&lt;.001) . Over 18 months, mental health outcomes improved slightly while gender, age, ethnic and racial disparities persisted as personal exposure to COVID-and pandemic burnout increased.

Disclosure
B.A.Myers: None. R.Klingensmith: None. I.Gonzalez casanova: None. M.De groot: None.

Funding
Indiana University Diabetes Translational Research Center
59-OR: Long-Term Sustainability and Durability of Diabetes Prevention via Nutritional Intervention
Authors: MCKENZIE AMY L. , ATHINARAYANAN SHAMINIE J. , VANTIEGHEM MICHELLE , VOLK BRITTANIE M. , ADAMS REBECCA N. , ROBERTS CAROLINE G.P. , FELL BRANDON , RATNER ROBERT E. , VOLEK JEFF , PHINNEY STEPHEN , HALLBERG SARAH 
Published: May 2022

The national Diabetes Prevention Program (nDPP) failed to translate the efficacy of the Diabetes Prevention Program (DPP) into real world effectiveness. We initiated a prevention program, previously publishing outcomes on 96 patients with prediabetes over two years with 75% retention. This single center observational trial examines the effectiveness of a very low carbohydrate intervention (VLCI) including nutritional ketosis delivered via a continuous remote care (CRC) model; here, we report sustainability and durability at 5 years. At completion of the 2-year trial, 58 of the original cohort (80%) renewed consent and 78% completed the 5 year follow-up. At baseline, all had prediabetes, with mean weight 109 kg and mean BMI 38.9 kg/m2. Using intention to treat analysis at 5 years, 22% regressed to normoglycemia, 13% progressed to diabetes, and 65% remained prediabetes. A1c remained unchanged (mean 5.9%) , and mean fasting glucose fell from 112 to 108 mg/dl (p=NS). Weight fell from 1 to 103 kg (p&lt;0.001) , with insulin resistance falling from a HOMA-IR of 6.1 to 4.7 (p&lt;0.05) . The nDPP utilizes 5% weight loss as a surrogate outcome for prevention. Forty-eight percent of the sample met that criteria at 5 years, with 19% achieving a 5-9.9% weight loss, 19% a 10-19.9% weight loss, and 10% with at least 20% weight loss. There was a 30% reduction in class 3 obesity (BMI ≥40) , contributing to a 2.7 fold increase in those now overweight (BMI 25-29.9). These results show that a VLCI delivered via CRC is sustainable in prediabetes, resulting in normalization of A1c without medication in over 20% with limited glycemic deterioration to the diabetes threshold. No other real world intervention has presented glycemic data on diabetes prevention, but only reported surrogate weight change as an outcome. Over 5 years, almost half of the cohort achieved that surrogate with significant population shifts to lower obesity classes. The promise of the DPP is met via telehealth-supported VLCI and is sustainable over the long term.

Disclosure
A.L.Mckenzie: Employee; Virta Health Corp., Stock/Shareholder; Virta Health Corp. S.Phinney: Employee; Virta Health Corp. S.Hallberg: Advisory Panel; Atkins Nutritionals Inc., Employee; Virta Health Corp., Stock/Shareholder; Virta Health Corp. S.J.Athinarayanan: Employee; Virta Health Corp. M.Vantieghem: Employee; Virta Health Corp., Stock/Shareholder; Virta Health Corp. B.M.Volk: Employee; Virta Health Corp., Stock/Shareholder; Virta Health Corp. R.N.Adams: Employee; Virta Health Corp. C.G.P.Roberts: Employee; Virta Health Corp., Stock/Shareholder; Virta Health Corp. B.Fell: Employee; Virta Health Corp., Stock/Shareholder; Virta Health Corp. R.E.Ratner: Employee; Virta Health Corp. J.Volek: Advisory Panel; Abbott Diagnostics, Simply Good Foods, Stock/Shareholder; Virta Health Corp.
591-P: Green Diabetes: What Do People with Diabetes Think about Packaging Waste and Sustainability?
Authors: HEINEMANN LUTZ , EHRMANN DOMINIC , ROOS TIMM , HERMANNS NORBERT , KULZER BERNHARD 
Published: May 2022

Aims: More and more people with diabetes (PwD) are paying attention to the waste associated with new technologies and want more sustainable concepts for waste prevention and a positive ecological footprint. So far, there are little results on the importance people with diabetes attach to the issue of sustainability and environmental compatibility. In an online survey, we wanted to determine the extent of these wishes and ecological needs of PwD.
Methods: PwD in Germany were asked via online surveys (2.417 PwD; 47.5% female, 57.8% type 1 diabetes (T1D) , 20.7% type 2 diabetes (T2D) , 19.0% parents of children with diabetes; Ø 47.7 years) .
Results: For more than half of all respondents, the topic of packaging waste is important (54.5%) , two out of three respondents say they would like to see more reusable utensils in diabetes therapy (67.1%) . However, the amount of packaging waste in diabetes technologies does not seem to be a decision criterion for most PwD when selecting modern technologies - this is only significant for 15% (TSD 21,9%) . Overall, there were only slight differences between the groups of PwD.
Conclusions: Ecological aspects are becoming increasingly important in diabetes therapy: most PwD are concerned about the issue of packaging waste in diabetes technologies and would like to see more recyclable utensils for their diabetes therapy. Although the number of respondents who consider the amount of packaging waste to be a decisive criterion for the choice of a diabetes technology is low - among people with type 2 diabetes, however, this is already around one in five persons.

Disclosure
L.Heinemann: Board Member; Lifecare, Inc., Consultant; Becton, Dickinson and Company, Roche Diabetes Care, Stock/Shareholder; Profil Institut für Stoffwechselforschung GmbH, Science Consulting in Diabetes GmbH. D.Ehrmann: Advisory Panel; Dexcom, Inc., Consultant; mySugr, Roche Diabetes Care, Speaker's Bureau; Berlin-Chemie AG, Dexcom, Inc. T.Roos: None. N.Hermanns: Advisory Panel; Abbott Diabetes, Research Support; Becton, Dickinson and Company, Roche Diagnostics, Speaker's Bureau; Berlin-Chemie AG, Novo Nordisk, Sanofi. B.Kulzer: Advisory Panel; Bayer AG, Bayer AG, Becton, Dickinson and Company, Becton, Dickinson and Company, Berlin-Chemie AG, Berlin-Chemie AG, Dexcom, Inc., Dexcom, Inc., Insulet Corporation, Novo Nordisk, Roche Diabetes Care, Sanofi, Sanofi-Aventis Deutschland GmbH, Research Support; Novo Nordisk, Roche Diabetes Care.
592-P: Living with Type 1 Diabetes (T1DM) as an Older Adult: A Qualitative Study Examining Experiences and Attitudes about Continuous Glucose Monitoring (CGM)
Authors: KAHKOSKA ANNA , CRISTELLO ANGELICA , SMITH CAMBRAY , THOMAS SHARITA R. , BATSIS JOHN , MAYER-DAVIS ELIZABETH J. , KOSOROK MICHAEL R. , PRATLEY RICHARD E. , WEINSTOCK RUTH S. , YOUNG LAURA A. , LICH KRISTEN HASSMILLER 
Published: May 2022

There is a growing population of adults over the age of 65 years with T1DM, but their lived experiences have not been well-characterized, especially in the context of evolving advances in self-management technology. We conducted focus groups with adults 65+ yrs with T1DM to characterize their perspectives surrounding T1DM and its management, focusing on CGM experiences. Participants were recruited from a US academic medical center and encouraged to bring a caregiver. Focus groups were stratified by CGM use, facilitated by standardized questions, audiotaped and transcribed. A team-based, inductive coding approach using ATLAS.ti identified themes. There were 33 adults (mean age 73.3±4.3 years [range 66-85]; 55% women, 82% non-Hispanic white, 12% non-CGM users, 83% pump users, 12% caregivers) . Five CGM-related themes were identified from all participants, including adoption challenges and complex clinical and psychosocial effects (Table) . Caregiver participants emphasized increased security with CGM use. Patient participants expressed a prevalent “survivor” mentality and a desire for increased peer support and strategies to minimize intrusiveness of T1DM management. Findings reinforce that older adults’ experiences with T1DM and CGM necessitate individualized psychosocial and tactical support for management and adoption of new technology.

Disclosure
A.Kahkoska: None. L.A.Young: Research Support; Bayer AG, Boehringer Ingelheim International GmbH, Dexcom, Inc., Eli Lilly and Company, Novo Nordisk, vTv Therapeutics. K.Hassmiller lich: None. A.Cristello: None. C.Smith: None. S.R.Thomas: None. J.Batsis: None. E.J.Mayer-davis: None. M.R.Kosorok: n/a. R.E.Pratley: Other Relationship; Bayer AG, Corcept Therapeutics, Dexcom, Inc., Hanmi Pharm. Co., Ltd., Merck & Co., Inc., Metavention, Novo Nordisk, Pfizer Inc., Poxel SA, Sanofi, Scohia Pharma Inc., Sun Pharmaceutical Industries Ltd. R.S.Weinstock: Research Support; Boehringer Ingelheim International GmbH, Dexcom, Inc., Diasome, Eli Lilly and Company, Insulet Corporation, Kowa Pharmaceuticals America, Inc., Medtronic, Novo Nordisk, Tandem Diabetes Care, Inc., Tolerion, Inc.

Funding
ARK is supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant KL2TR002490. The project was supported by UL1TR002489 from the Clinical and Translational Science Award program of the Division of Research Resources, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
598-P: Discussion Recall in Diabetes Care Visits with Young Adults with T1 Diabetes
Authors: MONAGHAN MAUREEN , BRYANT BREANA , WANG CHRISTINE H. , STREISAND RANDI 
Published: May 2022

Introduction: Engagement in and recall of clinical discussions is a key component of patient-centered care. We evaluated frequency and agreement on discussion topics between young adults (YAs) with type 1 diabetes (T1D) and their health care provider (HCP) .
Methods: 52 YAs (51.9% female; 48.1% non-Hispanic White (NHW) ; M age = 20.6±1.1 yrs; M T1D duration = 10.9±4.7 yrs; M A1c = 8.2±1.8%) and 9 HCPs (5 MDs; 4 NPs; 100% female) enrolled in a randomized trial to improve health communication skills in YAs preparing for adult T1D care. At baseline, YAs reported demographic information; after the baseline clinic visit, YAs and HCPs separately completed a checklist of topics discussed and rated satisfaction with the visit. Topic frequency and agreement between YAs and HCPs were calculated. Independent samples t-tests and correlations evaluated associations among demographic and clinical characteristics, discussion topics, and agreement.
Results: YAs and HCPs had adequate agreement (M = 76.4%; Table 1) . Agreement was not associated with YA gender, age, T1D duration, A1c, or overall visit satisfaction. YAs of color had significantly higher agreement with HCPs than NHW YAs (81.4% vs. 70.8%; t (50) =2.3, p&lt;.05) .
Conclusions: Results highlight YA engagement and frequency of developmentally important topics in routine T1D visits. Communication plans may improve frequency of topics raised and recall, and will be evaluated in future research.

Disclosure
M.Monaghan: Employee; National Institute of Diabetes and Digestive and Kidney Diseases, Research Support; American Diabetes Association. B.Bryant: None. C.H.Wang: None. R.Streisand: None.

Funding
American Diabetes Association (1-18-ACE-27) ;
600-P: Examining Beliefs about Type 2 Diabetes Medications: A Multidimensional Approach
Authors: ASMAN ARIELLE G. , PHILLIPS LEIGH A. , WALKER ELIZABETH A. , PAPPALARDO LINDSEY D. , GONZALEZ JEFFREY S. 
Published: May 2022

Background: Beliefs about type 2 diabetes (T2D) medications predict treatment adherence; yet, factors that influence these beliefs are poorly understood. Further, prior studies reduce the complex interplay between beliefs about treatment necessity and medication-related concerns to a single dimension by using a difference score. This study examined correlates of T2D medication beliefs and modeled the multidimensional associations of beliefs and adherence.
Methods: Participants were 812 primarily disadvantaged and ethnic minority adults with T2D (Female = 56.9%; Latino = 86.5%; Mean [SD] Age and A1C = 59.2 [10.8], 9.3 [1.8], respectively) recruited for a self-management trial. Informed by the Common Sense Model and prior research, relations of patient- and illness-related factors with medication beliefs (Horne, Weinman, Hankins, 1999) were examined using linear regression. Confirmatory and exploratory polynomial regression examined associations of medication beliefs and self-reported adherence.
Results: Hispanic ethnicity (p &lt; .01) , insulin use (p &lt; .05) , greater number of medications (p &lt; .05) , and lower levels of education (p &lt; .05) were associated with stronger necessity beliefs. Lower income (p &lt; .05) and Hispanic ethnicity (p &lt; .01) were associated with greater concerns. Adherence was lowest among those with strong concerns and weak necessity beliefs. Non-reciprocal effects were also observed, which could not have been assessed using a difference score. Patients with ambivalent beliefs had lower adherence than those with indifferent beliefs.
Discussion: Indicators of lower SES were associated with concerns about T2D medications. Increased disease severity and Hispanic ethnicity were associated with stronger necessity beliefs. However, Hispanics also reported more concerns about their medications. Results further support use of polynomial regression to assess medication beliefs and adherence. Addressing concerns, in particular, may enhance T2D medication adherence.

Disclosure
A.G.Asman: None. L.A.Phillips: None. E.A.Walker: None. L.D.Pappalardo: None. J.S.Gonzalez: Consultant; Virta Health Corp.

Funding
National Institutes of Health (R18 DK098742) Einstein–Mount Sinai Diabetes Research Center (P30 DK020541) New York Regional Center for Diabetes Translation Research (P30 DK111022) J.S.G. is supported by National Institutes of Health (RDK104845, RDK121298, RDK121896)
607-P: Gender Differences in the Relationship between Financial Barriers and Emergency Department Visits due to Diabetes
Authors: AKINBOBOYE OLAITAN J. , EGEDE LEONARD E. , THORGERSON ABIGAIL , WILLIAMS JONI S. 
Published: May 2022

Background: This study assessed gender differences in the relationship between financial barriers and Emergency Department (ED) visits due to diabetes in a sample of adults with diabetes.
Methods: Data from 1,278 patients (weighted=3,500,000) in the 2014 Health Center Patient Survey (HCPS) were analyzed. Financial barrier was measured by summing ‘yes’ responses from the following questions: “In the last 12 months, were you unable to get medical care, tests, or treatments you or a doctor believed necessary?.” and “In the last 12 months, were you unable to get prescription medicines you or a doctor believed necessary?.” ED visits due to diabetes were measured using the question: “In the past 12 months, have you been in the hospital or visited an emergency room because of diabetes?”. Logistic regression was used to assess the association between financial barriers and ED visits due to diabetes by gender.
Results: There was a statistically significant relationship between financial barriers and ED visits due to diabetes among men. In the adjusted model, the odds of ED visits due to diabetes was 5.66 times higher in men with one or more financial barrier than in men with no financial barrier (OR= 5.66, p=0.002) . Among women, financial barriers were not significantly associated with ED visits due to diabetes in the adjusted model.
Conclusions: Our study shows that financial barriers drive ED visits due to diabetes among men but not women. Policy interventions should be developed to target vulnerable groups with diabetes, and future studies should elucidate the mechanisms responsible for the differences observed in this study.

Disclosure
O.J.Akinboboye: None. L.E.Egede: None. A.Thorgerson: None. J.S.Williams: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases K24Dk093699 (PI: Leonard E. Egede, MD, MS) , R01DK118038 (PI: Leonard E. Egede, MD, MS) , and R01DK120861 (PI: Leonard E. Egede, MD, MS) and R21DK123720 (PI: Joni S. Williams, MD, MPH) .
609-P: Virtual Peer Groups (VPG) for Adolescents and Young Adults (AYA) with Type 1 Diabetes (T1D) : Patient-Reported Importance of Specific Features
Authors: BISNO DANIEL I. , PYATAK ELIZABETH , REID MARK W. , FOX D. STEVEN , FOGEL JENNIFER L. , SALCEDO-RODRIGUEZ ELIZABETH , FLORES GARCIA JAQUELIN J. , SANCHEZ ALEJANDRA TORRES , RAYMOND JENNIFER 
Published: May 2022

Background: VPG have been shown to improve psychosocial well-being in AYA with T1D, but it is unknown what aspects of VPG are most or least valued.
Methods: CoYoT1 to California is a 15 month randomized controlled trial for patients ages 16-25 with T1D. AYA received Usual Care (n=28) or CoYoT1 Care (n=40) , which consisted of patient-centered provider visits and bimonthly VPG led by a YA with T1D. VPG were AYA-driven discussions focused on topics pertinent to AYA with T1D, emphasizing problem-solving and emotional support. At study end, VPG participants responded to a survey about their preferences for intervention features.
Results: CoYoT1 Care patients were 40% female, 53% Latinx, and 72% publicly insured; and they attended 1.9 VPG each on average. AYA who attended at least one VPG participated in 4.1 VPG on average. The average session had 4.5 AYA present; each topic was covered by 9.6 AYA on average. Most survey respondents (75%) reported VPG were extremely or very valuable in supporting their T1D care. Seeing peers use diabetes technology and being supported by same-aged peers with T1D increased VPG value the most. Larger group size and not feeling comfortable sharing decreased value the most.
Conclusion: Peer interactions may support unmet needs of AYA with T1D from diverse backgrounds. Further work will help optimize the design of VPG based on patient preferences.

Disclosure
D.I.Bisno: None. E.Pyatak: Research Support; Abbott Diabetes. M.W.Reid: None. D.Fox: None. J.L.Fogel: None. E.Salcedo-rodriguez: None. J.J.Flores garcia: None. A.Torres sanchez: None. J.Raymond: None.

Funding
The Donaghue Foundation
611-P: Do Social Needs Impact Quality of Life among Adult Medicaid Beneficiaries with Type 2 Diabetes?
Authors: MCQUEEN AMY , BROWN DEREK , VERDECIAS NIKO , KREUTER MATTHEW 
Published: May 2022

Treatment trials increasingly include quality of life (QoL) measures to compliment clinical outcomes. Most QoL studies focus on clinical correlates. The growing appreciation for social determinants of health warrant examining how they impact QoL. This analysis of a preliminary baseline sample of 296 Medicaid beneficiaries with type 2 diabetes from an ongoing intervention trial examined the influence of social needs on aggregate and subscale T-scores of the SF12v2 QoL measure individually and controlling for covariates. We assessed 12 social needs (e.g., food, housing, utilities) and receipt of 9 resources (e.g., food stamps, WIC) . Participants rated having 22 chronic conditions and their impact (when applicable) on daily activity (1=not at all; 5=a lot) . Participants were female (76.7%) , White (29.1%) , Black (65.9%) , age M=51.8 (SD=9.3) , had M=2.7 social needs (SD=1.7) and M=1.3 (SD=1.2) resources. Including diabetes, participants reported M=7.4 chronic conditions (SD=3.0) with moderate impact M=23.0 (SD=14.4) . Mean QoL T-scores were all below the norm (50) except vitality (M=51.9, SD=11.4) . Sum needs were associated with aggregate mental health (r= -.13, p=.032) and 3 of 4 subscales: vitality (r= .16, p=.007) , role emotional (r= -.18, p=.002) , and social functioning (r= -.23, &lt;.001) . For physical health, social needs were only associated with the pain subscale (r= -.17, p=.004) . Although the influence of social needs remained statistically significant for some subscales when controlling for chronic conditions, needs were most consistently associated with social functioning even when controlling for comorbidity impact, age, race, sex, and resources. We found few strong associations between social needs and SF12 scores, which may be due in part to limitations in how QoL is defined and measured and the distal causal pathway between social needs and functioning. Future analyses will examine changes in QoL over time and differences by treatment group and social needs.

Disclosure
A.Mcqueen: None. D.Brown: None. N.Verdecias: None. M.Kreuter: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK115916-01)