bluuebunny/crossref_metadata_2025_split huggingface dataset:
702-P: Short-Period CGM Data Are More Useful than HbA1c for Treatment Adjustment in Type 2 Diabetes Patients
Authors: TOTOMIROVA TZVETELINA , ARNAUDOVA MILA 
Published: May 2022

Current recommendations for type 2 diabetes treatment are based on targeting HbA1c depending on different factors. HbA1c reflects recent 8-12 weeks glucose control, but amount of data show HbA1c insufficiencies. Continuous glucose monitoring (CGM) is used for insulin dose adjustment but also for control assessment and treatment determination. In our study we compare seven-day non-real time CGM data and HbA1c to find out which is more appropriate for determining drug prescription in patients with type 2 diabetes. Our study includes 85 patients with type 2 diabetes (35 women, 50 men; age 43.93±10.87 years, disease duration 21.91±6.years) , on different treatment regimens (31 on oral therapy, 33 treated with premixed insulin, 21 on multiple insulin injections) . Patients performed Non-Real Time Continuous Glucose Monitoring by using iProTM for seven days and HbA1c was measured at the end of this period. No difference in HbA1c level was found in three observed groups. HbA1c showed moderate negative correlation to percentage of time within the limits (r1=-0.48; r2= -0.654; r3= -0.674) . Based on HbA1c assessment 34.84% of type 2 patients on oral medications, 36.36% of patients on premixed insulin and 19.05% of type 2 patients on multiple daily injection are with good control. CGM defined 54.84% of type 2 patients on oral medication, 18.27% of patients on premixed insulin and 17.80% of type 2 patients on intensified regimen as well controlled. CGM was more precise than HbA1c in defining patients with good control (p&lt;0.05) . HbA1c shows bad correlation with overall glucose excursion (r1=-0.096, r2=0.200, r3=0.377) . No difference was found between studied groups in regard to CGM percentage of time spent above and below the limits and to AUC above upper limit. We conclude that CGM data give more precise information than HbA1c about glucose control and are more useful for defining treatment adjustment. Even performing CGM for short period helps physician to choose the most appropriate drug.

Disclosure
T.Totomirova: n/a. M.Arnaudova: None.
705-P: CGM Attitudes and Adoption among People with Type 2 Diabetes Using One Drop
Authors: SEARS LINDSAY , IMRISEK STEVEN D. , HOY-ROSAS JAMILLAH R. , LAVAYSSE LINDSEY M. , LEE MATTHEW , CHAPMAN MATTHEW R. , DACHIS JEFF 
Published: May 2022

Background: Despite research establishing the strong benefits of continuous glucose monitors (CGMs) in the management of diabetes, adoption remains low among people with type 2 diabetes (T2D) . The present mixed-method study describes CGM attitudes and use among people with T2D.
Method: Members with T2D with a paid subscription to One Drop completed a survey about One Drop and their health. Qualitative reasons for and against CGM adoption were coded and reported with descriptive statistics.
Results: Of the 171 respondents, 55% were male, 70% were White, 86% were non-Hispanic and average age was 55.4 (SD=11.7) . Approximately 92% of members reported logging their blood sugar daily or weekly, 96% of members found One Drop’s health logging features helpful, and 95% found the glucose analysis and reports helpful. Most members were familiar with CGM devices (90%) , and of that group, 83% had never tried one. Most of those familiar with CGMs were also open to CGM adoption (N=107; 79%) . Reasons for openness included valuing continuous feedback (28) , relief from fingersticks (15) , convenience (12) and improved diabetes management (12) , while a subset expressed concerns about insurance coverage and costs (12) . Those not open to CGM adoption (N=29) cited a lack of need (9) , lack of familiarity (4) , inconvenience (3) , pain/size of devices (3) and costs (2) .
Conclusion: Despite their established benefit, CGM adoption among people with T2D is concerningly low. While awareness and interest in CGM adoption is high, costs are a concern, and there is a subset that would benefit from more education and exposure. Advancements in device technology, reimbursement policy as well as interventions to increase health knowledge and motivation are warranted to better meet the needs and preferences of people with T2D.

Disclosure
L.Sears: Employee; One Drop. S.D.Imrisek: Employee; One Drop. J.R.Hoy-rosas: None. L.M.Lavaysse: Employee; One Drop. M.Lee: Employee; One Drop. M.R.Chapman: Employee; One Drop. J.Dachis: Board Member; One Drop, Employee; One Drop, Stock/Shareholder; One Drop.
706-P: CGM Disruption: A Common Phenomenon
Authors: CEDENO ANDREA , KRUTILOVA PETRA , MARKOV ALEXANDER , MCGILL JANET B. , MCKEE ALEXIS M. 
Published: May 2022

Background: Advances in diabetes technology have led to reliance on continuous glucose monitors (CGM) for glycemic management. Insufficient wear time due to device malfunction, insertion problems, displacement or removal for imaging, medical procedures or hospitalization is common. Prescription practices that provide an exact number of sensors without redundancy fail to account for the realities of CGM use. The aim of this study is to characterize CGM disruption rates and consequences.
Methods: A RedCap survey was completed by adults from a university based diabetes center with T1D or T2D who utilize CGM.
Results: Of 262 surveys sent, 76 were completed. Participants had mean age 54, T1D 69%, female 72%, White 97%, and mean duration of diabetes 28 years. 100% used CGM (85.1% Dexcom, 9.5% Freestyle Libre, 5.4% Medtronic) , 61% insulin pump, and 41% HCL systems. The percent of participants reporting ≥1 CGM disruption events in 1 year: device malfunction (85.1%) , insertion problems (63.0%) , displacement (56.8%) ; removal for imaging (44.6%) , surgery/procedures (13.7%) and hospitalization (4.1%) . Adverse glycemic events attributed to disruption of CGM including hyperglycemia and hypoglycemia occurred ≥1 time in 55.4% and 45.9% of the participants respectively (Figure) .
Conclusion: Loss of CGM use prior to the anticipated change date is common. Lack of redundancy of CGM supplies contributes to disruptions in care and adverse glycemic events.

Disclosure
A.Cedeno: None. P.Krutilova: None. A.Markov: None. J.B.Mcgill: Advisory Panel; Gilead Sciences, Inc., Lilly Diabetes, MannKind Corporation, Novo Nordisk A/S, Provention Bio, Inc., Salix Pharmaceuticals, Consultant; Bayer AG, Boehringer Ingelheim International GmbH, Research Support; Dexcom, Inc., Novo Nordisk. A.M.Mckee: Consultant; Medtronic.
720-P: Change in Body Weight from Baseline with Tirzepatide: Sex Subgroup Analysis of the SURPASS Studies
Authors: PLAT ARIAN W. , RASOULI NEDA , PELESHOK JENNIFER , SAPIN HELENE , WILDING JOHN 
Published: May 2022

Five Phase 3 SURPASS trials have shown robust efficacy of novel dual GIP/GLP-1 receptor agonist, tirzepatide, in glycaemic control and body weight (BW) loss in adults with Type 2 Diabetes (T2D) . A key secondary endpoint investigated the effect of tirzepatide (5, 10, and 15 mg) versus placebo or active comparators on mean BW change from baseline to endpoint. To determine whether weight-lowering effects of tirzepatide depend on the sex of study participants, we conducted a post-hoc subgroup analysis of SURPASS (S) -1 to -5 trials. BW change in the sex subgroups was assessed in patients while on treatment without rescue medication (efficacy estimand) in the modified intention-to-treat (mITT) population, defined as all randomized patients who received at least one dose of study drug. All tirzepatide doses significantly reduced BW compared to placebo or active comparators regardless of the sex of study participants (S-1 to -5 p&lt;0.001) . The most frequent AEs were mild-to-moderate, GI-related, and occurred during the dose-escalation period.

Disclosure
A.W.Plat: None. N.Rasouli: Advisory Panel; Eli Lilly and Company, Novo Nordisk, Sanofi, Research Support; Allergan, Eli Lilly and Company, Novo Nordisk. J.Peleshok: Employee; Eli Lilly and Company, Eli Lilly and Company. H.Sapin: Employee; Eli Lilly and Company. J.Wilding: Advisory Panel; Alnylam Pharmaceuticals, Inc., AstraZeneca, Eli Lilly and Company, Mundipharma, Novo Nordisk A/S, Rhythm Pharmaceuticals, Inc., Sanofi, Research Support; AstraZeneca, Speaker's Bureau; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk A/S, Takeda Pharmaceutical Company Limited.

Funding
Eli Lilly and Company
727-P: Glycemic Effect of Tirzepatide by Duration of Diabetes
Authors: DE BLOCK CHRISTOPHE , MATHIEU CHANTAL , SAPIN HELENE , KILJANSKI JACEK I. , PELESHOK JENNIFER 
Published: May 2022

Results of SURPASS-1 through -5 trials have shown robust efficacy of novel dual GIP/GLP-1 receptor agonist tirzepatide (TZP) in people with type 2 diabetes. To understand whether glucose-lowering effect of tirzepatide depends on the duration of diabetes we conducted a subgroup analysis within each of the 5 Phase 3 trials. The primary endpoint of the 5 SURPASS clinical trials was mean change from baseline in HbA1c for 5mg, 10mg, and 15mg to 40 or 52 weeks against various comparators in adults with type 2 diabetes. This subgroup analysis of the 5 trials assessed whether mean change of HbA1c from baseline in the overall population were consistent when assessed by baseline duration of diabetes category (≤5 years, 5 to years, &gt;years) in patients while they were on-treatment and without rescue medication (efficacy estimand) . For all 5 studies, analysis of change from baseline in HbA1c at 40 or 52 weeks for all 3 duration of diabetes subgroups were consistent with primary study results, with the treatment differences favoring all 3 doses of TZP compared with placebo or active comparator (Figure) . The most frequent adverse events were mild-to-moderate, gastrointestinal-related and occurred during the dose-escalation period. In conclusion, these results suggest that TZP was effective for mean change from baseline Hba1c for patients regardless of baseline duration of diabetes consistent with the overall patient population across the 5 SURPASS studies.

Disclosure
C.De block: Advisory Panel; Abbott Diagnostics, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk, Research Support; Indigo Diabetes, Speaker's Bureau; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk. C.Mathieu: Advisory Panel; Abbott, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Imcyse, Insulet Corporation, Medtronic, Novo Nordisk, Sanofi, Zealand Pharma A/S, Speaker's Bureau; AstraZeneca. H.Sapin: Employee; Eli Lilly and Company. J.I.Kiljanski: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. J.Peleshok: Employee; Eli Lilly and Company, Eli Lilly and Company.
730-P: Effectiveness of iGlarLixi (Insulin Glargine-Lixisenatide) in People with Type 2 Diabetes According to the Time of Administration through the Day
Authors: HALUZIK MARTIN , SEUFERT JOCHEN , GUJA CRISTIAN , BONNEMAIRE MIREILLE , BIGOT GREGORY , TOURNAY MATHILDE , KIS JANOS T. , FREEMANTLE NICK 
Published: May 2022

Pre-Breakfast iGlarLixi efficacy and safety were demonstrated in several randomized controlled trials. Whether time of administration could impact effectiveness in real life clinical practice is unknown. In the European REALI pooled database, we analyzed patient-level data of 1303 people with type 2 diabetes (T2D) treated with iGlarLixi for 24 weeks. Of these, 33% had the injection pre-Breakfast, 20% pre-Lunch, 31% pre-Dinner, while 16% switched time of injection. Overall, baseline characteristics were similar among groups with mean±SD age of 61±9.0 years, BMI 32.2±5.5 kg/m2, and median diabetes duration of 9 years. People with T2D previously used 1 oral glucose-lowering agent (57%) or ≥2 (43%) . A total of 590 people (45%) were insulin pretreated for a median duration of 2.5 years. Mean±SD HbA1c improved from 9.1±1.4% at Baseline to 7.7±1.2% at Week 24, with a least square mean decrease of 1.4% [95% CI: -1.50;-1.36], and most notable reduction in the pre-Breakfast group as shown in Figure 1. Mean±SD fasting plasma glucose decreased by 50.0±54.2 mg/dL and body weight by 1.8±6.6 kg at Week 24 with no difference between groups. Hypoglycemia reports were low in all groups.This analysis confirms the effectiveness of iGlarLixi at all administration times; pre-Breakfast may be preferable when there is a choice.

Disclosure
M.Haluzik: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi, Speaker's Bureau; Abbott Diabetes, AstraZeneca, Lilly Diabetes, Novartis AG. J.Seufert: Advisory Panel; Abbott, Sanofi-Aventis Deutschland GmbH, Research Support; Boehringer Ingelheim International GmbH, Speaker's Bureau; Abbott Diabetes, AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Lilly, Novo Nordisk, Sanofi-Aventis Deutschland GmbH. C.Guja: Speaker's Bureau; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier Laboratories. M.Bonnemaire: Employee; Sanofi. G.Bigot: None. M.Tournay: None. J.T.Kis: Speaker's Bureau; 77 Elektronika Kft., AstraZeneca, Boehringer Ingelheim International GmbH, EGIS Pharmaceuticals, Lilly Diabetes, Novo Nordisk, Sanofi. N.Freemantle: Consultant; Novo Nordisk, Research Support; Aimmune, ALK-Abelló A/S, Allergan, AstraZeneca, Ipsen Biopharmaceuticals, Inc., Novartis Pharmaceuticals Corporation, Sanofi, Vertex Pharmaceuticals Incorporated, Speaker's Bureau; Abbott.

Funding
Sanofi
731-P: Metabolite Biomarkers and Cardiovascular Events in REWIND: A Post Hoc Analysis
Authors: PIRRO VALENTINA , PARE GUILLAUME , LEE SHUN FU , COLHOUN HELEN M. , LIN YANZHU , WILSON JONATHAN M. , QIAN HUI-RONG , HOOVER ANASTASIA , DUFFIN KEVIN L. , GERSTEIN HERTZEL C. 
Published: May 2022

Dulaglutide (DU) reduced the risk of CV outcomes compared with placebo (PL) in the REWIND trial (NCT01394952) , with a MACE-3 (major adverse CV events) hazard ratio of 0.88 over 5.4 years. Participants were ≥50 years of age with T2D, A1C ≤9.5%, BMI ≥23 kg/m2, and CV risk and received either DU (1.5 mg weekly) or PL. This post-hoc analysis explored the hypothesized relationship between metabolite biomarkers and MACE-3 in a nested case-control substudy comprising 600 MACE cases and 6non-MACE REWIND participants. A total of 135 plasma metabolites were measured by targeted metabolomics using mass spectrometry. Biomarkers significantly associated with DU were first identified in analyses that adjusted for 135 multiple comparisons (discovery approach) . Predefined clusters of the remainder based on non-REWIND data were then assessed using principal component analyses (hypothesis testing) . DU was associated with 2-year changes in 2-hydroxybutyric acid, threonine, acylcarnitines and homocitrulline; of these, only the acylcarnitines were linked with MACE (Table) . In the literature, higher levels of acylcarnitines are associated with CV events. These analyses suggest that DU-associated reductions in acylcarnitines are associated with its MACE benefit.

Disclosure
V.Pirro: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. H.C.Gerstein: Advisory Panel; Abbott, Eli Lilly and Company, Hanmi Pharm. Co., Ltd., Novo Nordisk, Pfizer Inc., Sanofi, Viatris Inc., Consultant; Kowa Company, Ltd., Other Relationship; DKSH, Eli Lilly and Company, Sanofi, Zuellig Pharma Holdings Pte. Ltd., Research Support; AstraZeneca, Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk, Sanofi. G.Pare: Advisory Panel; Amgen Inc., Bayer AG, Sanofi, Research Support; Bayer AG. S.Lee: None. H.M.Colhoun: Advisory Panel; Bayer AG, Eli Lilly and Company, Novo Nordisk, Consultant; AstraZeneca, Research Support; AstraZeneca, Stock/Shareholder; Bayer AG, Roche Pharmaceuticals. Y.Lin: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. J.M.Wilson: Employee; Eli Lilly and Company. H.Qian: Employee; Eli Lilly and Company, Stock/Shareholder; Apple, Eli Lilly and Company. A.Hoover: Employee; Eli Lilly and Company. K.L.Duffin: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company, Pfizer Inc.

Funding
Eli Lilly and Company
767-P: Changes in Ambulatory Glucose Profile (AGP) in Patients with Type 1 Diabetes Mellitus after Switching from Sensor-Augmented Insulin Pump Therapy to a Do-it-Yourself Artificial Pancreas System: A Retrospective Data Analysis of Real-World Data
Authors: MUELLER-KORBSCH MICHAEL , FRUEHWALD LISA , KIETAIBL ANTONIA-THERESE 
Published: May 2022

Background: Many patients with type 1 diabetes mellitus are switching from sensor-augmented insulin pump therapy to an artificial pancreas system for various reasons. Since there are no suitable approved Automated Insulin Delivery -AID system in Austria, open-source systems are increasingly being used. The question arises, how does glycemic control change after switching?
Methods: This monocentric retrospective data analysis from 20to 2021 will compare sensor-augmented pump therapy with the open-source AID system using AGP profiles from 25 patients with type 1 diabetes mellitus. The AGP are generated from sensor data 4 weeks with pump therapy AGP1 and 4 weeks with open-source AID system AGP2. AGP is generated with Dexcom application.
Results: Comparing AGP1 and 2 shows a significant reduction of mean glucose from 143mg/dl to 125mg/dl and glucose variability from 50mg/dl to 40mg/dl. The time in target range can be increased from 74% to 84% without changing the time in hypoglycemia. Time in hyperglycemia above 180 and 250 mg/dl and GMI decreased significantly.
Conclusion: Open-source AID system can achieve an improvement in glycemic control. In this data analysis, the open-source AID systems can be considered safe due to the lack of increase in hypoglycemia.

Disclosure
M. Mueller-Korbsch: Research Support; Dexcom, Inc.
779-P: Announced Meals at Will with the MINIMED Advanced Hybrid Closed-Loop
Authors: MINSKY NOGA , HIRSH MAYA LARON , SHALIT ROY , COHEN OHAD , KURTZ NATALIE , ROY ANIRBAN , GROSMAN BENYAMIN , TIROSH AMIR 
Published: May 2022

Background: We compared glycemic outcomes and participant experience during MiniMed™ 780G Advanced Hybrid Closed Loop (AHCL) system use while announcing all meals vs. announcing meals at will.
Methods: Participants with T1DM used the AHCL system at home during two 90 days phases in which they were given instructions first to announce all meals (AM) , and next, for meals containing up to 80 grams of carbohydrates, to announce meals at will (AMW) .
Results: Fourteen subjects (males, mean age 44.3±11) with T1DM were enrolled, with a baseline A1C of 6.9±1%. Table 1 summarizes glycemic indices and AHCL data, demonstrating that patients chose to bolus only slightly less during AMW compared to AM (5.5 vs. 5.2 boluses) , without resultant deterioration in glycemic indices (A1c 6.4 vs. 6.5%, TIR 78.1 vs. 78.8%, p=ns) . Subjects surveyed regarding the option not to have to bolus for all meals experienced a significant reduction in reported effort to manage diabetes (p=0.045) and 86% endorsed worrying less about their diabetes. Most (93%) preferred the AMW phase of the study.
Conclusion: The MinMed™ AHCL system is designed for optimal performance with meal announcement. Nonetheless, when meals containing &lt; 80 grams of carbohydrates are consumed with announcement of meals at will, there is a slight reduction in the number of daily boluses with no decline in glycemic control, yet markedly less diabetes related distress and improved treatment satisfaction.

Disclosure
N. Minsky: None. R. Shalit: Speaker's Bureau; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk. O. Cohen: Employee; Medtronic. N. Kurtz: Employee; Medtronic. A. Roy: Employee; Medtronic. B. Grosman: Employee; Medtronic. 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.
78-LB: Association between Daytime vs. Nighttime Mean Glucose and Time-in-Range with A1C in Adults with Type 1 Diabetes
Authors: SHAH VIRAL , VIGERS TIMOTHY B. , PYLE LAURA , AKTURK HALIS K. , KLONOFF DAVID C. 
Published: May 2022

Prior studies using frequent self-monitored blood glucose in patients with type 2 diabetes on oral medications reported that the relative contribution of fasting glucose gradually increased with increasing HbA1c levels (30% for A1c &lt;7.3% and 70% for A1c &gt;10.2%) . This has led to targeting fasting glucose first to lower A1C in uncontrolled diabetes.
Our study evaluated associations between daytime vs. nighttime mean glucose and time-in-range (TIR; 70-180 mg/dL) with A1C in adults with type 1 diabetes (T1D) (n=340) using Dexcom G6 continuous glucose monitoring (CGM) for at least 6 months. The last 2 weeks of CGM mean glucose and TIR were correlated with four A1C categories (&lt;7%, 7- &lt;8%, 8-&lt;9%, 9-&lt;10%, and &gt;10%) .
With increasing A1C, there was increased mean sensor glucose and reduced TIR for daytime and nighttime (p&lt;0.001 for both) . However, there was no difference in daytime vs. nighttime in TIR (p=0.08) or mean glucose (p=0.42) within four A1C groups. The results were similar when TIR target was changed to 70-140 mg/dL.
Our results suggest influence of mean glucose and TIR on A1C is similar during daytime and nighttime in T1D adults. Thus, either postprandial glucose reduction or fasting glucose reduction strategies should be equivalent in lowering A1C. Our results explain the basis for the benefits of the established use of equal doses of basal and bolus insulin for all A1C levels in these patients.

Disclosure
V. Shah: Advisory Panel; Medscape, Sanofi, Consultant; Dexcom, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk. T. B. Vigers: None. L. Pyle: None. H. K. Akturk: Research Support; Dexcom, Inc., Eli Lilly and Company, REMD Biotherapeutics. D. C. Klonoff: Consultant; AI Health, Dexcom, Inc., Eli Lilly and Company, EOFlow Co., Ltd., Fractyl Health, Inc., Integrity, Lifecare, Inc., Medtronic, Novo Nordisk, Rockley Photonics, Samsung, Thirdwayv Inc., Employee; Diabetes Technology Society.