bluuebunny/crossref_metadata_2025_split huggingface dataset:
1144-P: Risk of Diabetic Retinopathy in Early-Onset Type 2 Diabetes in Mexico
Authors: SILVA-TINOCO RUBÉN , CUATECONTZI-XOCHITIOTZI TERESA , CABRERA-GERARDO DOLORES , DELATORRE-SALDAÑA VIRIDIANA , CASTILLO-MARTINEZ LILIA , BERNAL-CEBALLOS FERNANDA , GUZMAN EILEEN B. , BOUCHAN-DELINO SAMUEL , RAMIREZ ANGELICA , LEÓN-GARCÍA ENRIQUE , OCHOA-MORENO JORGE , LOPEZ-ARELLANO OLIVA 
Published: May 2022

Early onset type 2 diabetes (EOD) seems to have an aggressive disease progression with a higher risk for diabetes complications at an early age. Screening for Diabetic Retinopathy (DR) is poorly executed in primary care of low-and-middle income countries. Thus, we aimed to analyze the characteristics of EOD in comparison with later-onset group. Data were obtained from the largest cohort of patients evaluated for DR within the primary care in Mexico (DIABEMPIC program) . Early and later-onset groups were defined as age of diagnosis &lt;40 and ≥40 years, respectively. DR assessment by an ophthalmologist included fundoscopy with a mydriatic camera. Proliferative DR and severe non-proliferative DR were considered as severe DR. A total of 3063 patients with T2D were included of which 9had EOD. Prevalence of DR and severe DR was significantly higher in the EOD group than in the later-onset group (p&lt;0.0001) ; however, an increase in the prevalence of DR and severe DR was observed after years of diagnosis (p&lt;0.0001) . Burden of DR at different diabetes durations are shown in Table 1. EOD was associated with increased risk of DR compared with late onset T2D (OR 2.18, 95%CI 1.85-2.57) .
In conclusion, EOD patients with regular primary care presented a higher risk of DR and of severe DR not only explained for longer disease duration. Our study enhances the need for the management of DR risk factors and proper screening of DR in patients with T2D, especially in EOD.

Disclosure
R.Silva-tinoco: n/a. E.León-garcía: None. J.Ochoa-moreno: n/a. O.Lopez-arellano: None. T.Cuatecontzi-xochitiotzi: None. D.Cabrera-gerardo: n/a. V.Delatorre-saldaña: None. L.Castillo-martinez: None. F.Bernal-ceballos: None. E.B.Guzman: None. S.Bouchan-delino: None. A.Ramirez: None.
1148-P: Risk Factor Control and Risk of Hospitalization for Heart Failure in Diabetic Patients
Authors: MA HAO , WANG XUAN , HEIANZA YORIKO , QI LU 
Published: May 2022

Both diabetes and ischemic heart disease (IHD) are important risk factors for heart failure hospitalization. We investigated the association between the degree of risk-factor control and risk of heart failure in diabetic patients with and without IHD. A total of 20,9diabetic patients from UK Biobank were included, and matched with 82,582 controls based on age, sex, the presence of IHD, and assessment center. Risk-factor control was evaluated by 3 factors: glycated hemoglobin &lt;53 mol/mol, blood pressure &lt;140/90 mm/Hg and non-HDL-cholesterol &lt;130 mg/dl. The Cox regression model was used to assess the association between the number of risk-factor control and the risk of heart failure. During a mean follow-up of 8.7 years, 1,139 incident heart failure hospitalization were documented. Higher degree of risk-factor control was significantly associated with a lower risk of heart failure in diabetic patients without IHD, but not in diabetic patients with IHD (P-interaction=0.008) . Moreover, as compared with non-diabetic controls, the diabetes-related excess risk of heart failure became diminished when all the three risk factors were under control in diabetic patients without IHD; the hazard ratio for heart failure was 1. (95%, CI, 0.85-1.49) . Our findings highlight the importance of early intervention for controlling cardiovascular risk factors in preventing heart failure, especially before the onset of IHD.

Disclosure
H.Ma: None. X.Wang: None. Y.Heianza: None. L.Qi: None.
1163-P: Prognostic Factors in Type 2 Diabetic Patients Diagnosed with COVID-in a Latin American Hospital
Authors: DULCEY SARMIENTO LUIS A. , CALTAGIRONE RAIMONDO A. , THERAN LEON JUAN S. , PARRA HECTOR MORENO , PARADA JONATHAN PINEDA , STRAUCH RAFAEL PARALES 
Published: May 2022

Background: To determine the factors associated with mortality in adult patients diagnosed with type 2 diabetes hospitalized for COVID-in a hospital of Latin America.
Methods: Prospective cohort study from June 2020-june 2021. Patients with a diagnosis of type 2 diabetes older than 18 years with a confirmed diagnosis of COVID-infection were included.
Results: A total of 813 adults were included. The mean age was 61.2 years, 575 (70.5%) were male. The most frequent comorbidities were hypertension (34.1%) and obesity (25.9%) . A total of 114 (14.0%) patients received mechanical ventilation, 38 (4.7%) were admitted to the Intensive Care Unit and 377 (46.4%) died. The requirement for ventilatory support, increased lung involvement, comorbidities and inflammatory markers were associated with mortality. Admission to the intensive care unit and the need for mechanical ventilation increased 1.39 (95% CI: 1.13 to 1.69) and 1.97 (95% CI: 1.69 to 2.29) the mortality. Those patients whose glycosylated hemoglobin on admission was greater than 10%, for every 1% increase above 10%, this increased the risk of death by 32% (RR: 1.32 95% CI: 1.25 to 1.38) .
Conclusion: The mortality found in our study was associated with age, poor control of type 2 diabetes and respiratory compromise. Ensuring a satisfactory metabolic control of the patient with type 2 diabetes would decrease complications related to COVID-infection.

Disclosure
H. Moreno Parra: None.
1175-P: Association between Equol-Producer and Type 2 Diabetes Mellitus in a Japanese Elderly Population
Authors: HAMAURA KIHO , MURAKAMI HIROSHI , TAMURA AYUMI , NISHIYA YUKI , MIZUSHIRI SATORU , DAIMON MAKOTO 
Published: May 2022

Objective: Equol (Eq) , a metabolite produced from soy isoflavone daidzein by intestinal bacteria, exhibits estrogen activity and may exert effects on glucose metabolism. Eq levels vary extensively depending on the capability for Eq production and amounts of daidzein consumed. We examined the relationship between Eq levels and type 2 diabetes mellitus.
Research Design and Methods: Among 1,395 outpatients with diabetes at our hospital, 147 subjects (age: 70-89 years) were recruited (DM group) . Also, 147 age-/sex-matched non-DM subjects were recruited from 1,113 individuals who underwent routine health examinations (non-DM group) . As the estrogenic effect of Eq becomes apparent after menopause, the subjects were age restricted. Eq producers (EqPr) were determined based on the logarithm of the ratio of urinary Eq to the concentration of daidzein with a cut-off value of −1.75.
Results: Urinary daidzein (p=0.03) and Eq concentrations (p=0.01) were significantly lower in the DM group versus the non-DM group. The proportion of EqPr differed significantly between the groups (38.8% and 53.1%, respectively; p=0.01) . However, analyses with sex-based stratification showed such difference only in women; the proportion of EqPr was 31.4% and 52.8%, respectively (p&lt;0.01) . Reversely, there were significantly fewer DM subjects among EqPr versus non-EqPr (p=0.01) . Among women, EqPr had significantly less DM than non-EqPr (p&lt;0.01) . However, such differences were not observed in men. Correlation analyses showed a significant positive correlation between urinary Eq and daidzein concentrations only in EqPr (r=0.55, p&lt;0.01) .
Conclusion: In postmenopausal women, EqPr were less diabetic; this status appears to be protective against DM. Eq levels increased in parallel with the amount of daidzein consumed in EqPr, but not in non-EqPr. Therefore, Eq supplements and/or enteric bacteria transplantation, rather than dietary intervention, may be effective in preventing DM in non-EqPr.

Disclosure
K.Hamaura: None. H.Murakami: None. A.Tamura: None. Y.Nishiya: None. S.Mizushiri: None. M.Daimon: None.
1190-P: Oral Health Status among U.S. Adults with and without Diabetes, 2020
Authors: CHO PYONE , HORA ISRAEL A. , BULLARD KAI M. , BENOIT STEPHEN R. 
Published: May 2022

To reduce the risk of gum disease, the American Diabetes Association recommends that people with diabetes brush twice and floss once daily and see the dentist twice a year. But only about two-thirds of all US adults seek dental care within a year. Regular dental checkups are more important for those with diabetes. Thus, we studied the current oral health status (visiting a dentist or a dental clinic in the past year and the number with permanent tooth loss) in US adults aged ≥ 18 years with and without diagnosed diabetes using data from the 2020 Behavioral Risk Factor Surveillance System. Both diabetes and oral health-related information were self-reported. We computed overall and state-specific age-adjusted estimates by diabetes status. In 2020, 64.4% (95% CI 64.0%-64.8%) of US adults had a dental visit within the past year. Annual dental checkups were more common among women, older people, non-Hispanic White persons, and those having higher education, better income, and health insurance. The proportion of US adults with diabetes seeing a dentist in the past year was significantly lower compared to those without diabetes (56.7% [95% CI 54.8%-58.5%] vs. 65.4% [95% CI 65.0%-65.8%]) . Both men (56.3% [95% CI 53.6%-58.9%] vs. 62.4% [95% CI 61.9%-63.0%]) and women (57.1% [95% CI 54.6%-59.6%] vs. 68.2% [95% CI 67.7%-68.8%]) with diabetes were also significantly less likely to get dental care than their counterparts. The frequency of annual dental visits among adults with diabetes also varied by state; Texas had the lowest percentage (39.8% [95% CI 32.5%-47.6%]) while Alaska had the highest (77.1% [95% CI 68.8%-83.7%]) . Adults with diabetes (34.1% [95% CI 32.4%-35.9%]) were also more likely to have a history of one or more permanent teeth removed due to tooth decay or gum disease than those without diabetes (26.5% [95% CI 26.1%-26.8%]) . Without having regular dental checkup and adequate oral hygiene, adults with diabetes are at increased risk for gum disease. These findings highlight a gap in preventive oral care among adults with diabetes.

Disclosure
P. Cho: None. I.A. Hora: None. K.M. Bullard: None.
1197-P: The Demographic and Geographic Distribution of Diabetes and Prediabetes Risk in Rural Settings
Authors: LEE DAVID C. , ARIAS CAROLINA QUINTERO , RONY MELISSA , PATEL RAHI , JENSEN ERICA , PETCU ROBERT , IMAS DANIEL M. , ELBEL BRIAN , ANTHOPOLOS REBECCCA , MCGRAW NANCY A. , THORPE LORNA 
Published: May 2022

Introduction: Evaluating diabetes prevalence and prediabetes risk in rural settings can be difficult due to sparse population coverage and limited data.
Objective: To evaluate diabetes burden and prediabetes risk in a rural county with documented poor health outcomes.
Methods: In 2021, we mailed health surveys to all households in Sullivan County, a rural county with the second-worst health outcomes of all counties in New York State. We included questions on demographics, medical history, and the American Diabetes Association’s Prediabetes Risk Test in our survey. A score of 5 points or higher on this test is considered high risk for having prediabetes. To help mitigate non-response bias, statistical raking was performed using age, sex, race/ethnicity, and health insurance strata. We analyzed diabetes prevalence and prediabetes risk by demographic characteristics. We also used geospatial analysis within the county to assess for clustering of diagnosed diabetes cases and elevated prediabetes risk scores.
Results: Of 4,725 survey responses analyzed, the adjusted diabetes prevalence in our sample was 14% compared to the 20BRFSS estimate of 8.6% for Sullivan County. In this rural area, diabetes prevalence was notably higher among non-Hispanic Black (23%) and Hispanic (16%) residents compared to non-Hispanic White (13%) residents. Prediabetes risk scores were elevated among 41% of respondents without a history of diabetes. Nearest neighbor analyses revealed that hotspots of diagnosed diabetes and high prediabetes risk scores were primarily located in more urban areas of this rural county.
Conclusion: Our mailed health survey to all residents in Sullivan county demonstrated higher diabetes prevalence compared to modelled BRFSS estimates that are based on a small telephone sample. Our results suggest the need for better diabetes surveillance in rural communities, which may benefit from interventions specifically tailored for improving glycemic control among rural residents.

Disclosure
D.C.Lee: None. N.A.Mcgraw: None. L.Thorpe: None. C.Quintero arias: None. M.Rony: None. R.Patel: None. E.Jensen: None. R.Petcu: None. D.M.Imas: None. B.Elbel: None. R.Anthopolos: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK124400)
1214-P: Use of American Heart Association’s “Life's Simple 7” as a Predictor for Initiation of Dialysis
Authors: OSAWA TAEKO , FUJIHARA KAZUYA , YAMADA MAYUKO H. , YAGUCHI YUTA , SATO TAKAAKI , KITAZAWA MASARU , MATSUBAYASHI YASUHIRO , YAMADA TAKAHO , SONE HIROHITO 
Published: May 2022

In 2016, to help achieve the goal of avoiding heart failure and preserving cardiac structure and function, the American Heart Association (AHA) designated Life’s Simple 7 as risk factors that can be addressed through lifestyle changes: smoking, weight, physical activity, diet, cholesterol, blood pressure (BP) , and blood glucose. Although most of these factors are also risk factors for the progression of kidney disease, the association between Life’s Simple 7 and risk of dialysis is unknown. We investigated the impact of 6 factors on the initiation of dialysis based on the AHA’s 7 factors using a nationwide claims database involving 294,647 participants during 2008-16. Multivariate Cox regression model identified risks of starting dialysis. Hazard ratios (HRs) were compared among 7 groups who had 0 to 6 of the following risk factors adjusted by age and sex: BMI ≥25, systolic BP (SBP) ≥140 mmHg, LDL-cholesterol ≥140 mg/dl, diabetes mellitus (DM) , no regular exercise, and smoking. Compared with SBP &lt;140 mmHg, HR for starting dialysis in those with SBP ≥140 mmHg was 3.30 (2.49-4.34) . Compared with DM-, HR for starting dialysis in those with DM+ was 6.50 (4.89-8.65) . In comparison with no risk factors, HRs for starting dialysis for those who had 3, 4, 5, or 6 risk factors were 2.20 (1.17-4.09) , 5.30 (2.80-10.0) , 11.2 (5.47-23.1) , and 32.5 (11.4-92.6) , respectively.
In summary, the risk of dialysis increased with worsening of risk factors derived from AHA’s Life’s Simple 7. These results indicated that factors similar to those used to predict cardiovascular disease might also be useful to predict initiation of dialysis. Use of these approaches might be helpful in clinical practice, especially in patient education.

Disclosure
T.Osawa: None. K.Fujihara: None. M.H.Yamada: None. Y.Yaguchi: None. T.Sato: None. M.Kitazawa: None. Y.Matsubayashi: None. T.Yamada: 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.

Funding
Japan Society for the Promotion of Science (18K17897) .
1218-P: Immigrant Density and Prevalence of Diabetes in American Neighborhoods
Authors: NGUYEN NGAN , BAKAL ETHAN , WANG NATALIE 
Published: May 2022

Background: The “healthy immigrant effect” suggests that despite immigrants generally demonstrating lower socioeconomic status than non-immigrants, they have lower age-related disease prevalence and mortality compared to non-immigrants. Recent evidence suggests immigrants may have higher levels of physical activity and may also influence their neighbors to decrease sedentary behavior. Drawing from the literature, we investigated the association between immigrant density with the prevalence of diabetes in neighborhoods and of both foreign-born and U.S.-born populations by ZIP code level.
Methods: In this retrospective, cross-sectional ecological study, we used data from the American Community Survey (ACS) and the CDC Behavioral Risk Factor Surveillance System (BRFSS) for 2018. We performed multiple regression to test our predictive model that appointed obesity and physical activity as possible mediators between immigrant density and diabetes.
Participants: ZIP codes with more than 16 foreign-born individuals (324out of 41692 total ZCTAs)
Results: Higher immigrant density in a neighborhood is associated with lower prevalence of diabetes (beta estimate = −0.056657; r-squared = 0.02709) ; this remains true even after adjusting for prevalence of obesity (0.038646; 0.5356) , physical activity (-0.014093; 0.7097) , and both (−0.001015; 0.7168) , with all p-values &lt; 0.001. We concluded that immigrant density is a potential protective factor of diabetes, and the relationship is mediated by the prevalence of obesity and physical activity.
Discussion: The effects may differ depending on the racial/ethnic composition of the neighborhood. A previous study has shown that living in communities with a high Hispanic concentration (&gt;=25%) was associated with an increase in body mass index (BMI) and higher odds for obesity in non-Hispanic Whites, respectively; meanwhile, the opposite effect is observed for communities with high Asian concentration. As a next step, we will disaggregate our results by race.
1223-P: CRP-Mediated Associations of the Individual and Neighborhood Stressors with T2D in the MESA Cohort
Authors: TAMURA KOSUKE , JAGANNATHAN RAM , HU LU , NEALLY SAM , BAUMER YVONNE , NARAYAN K.M. VENKAT , VACCARINO VIOLA , POWELL-WILEY TIFFANY 
Published: May 2022

There has been growing interest in examining the link between individual/neighborhood stressors with T2D. Prior studies have not tested if inflammation (CRP) may mediate the associations between multi-level stressors and T2D. This study included baseline data from the Multi-Ethnic Study of Atherosclerosis (MESA; n=5405; age=61.9±10.1y; 52% female) . T2D was defined as FPG ≥126 mg/dL or the use of diabetes drugs. Individual stressors included perceived lifetime discrimination, chronic burden, and personal safety. Neighborhood stressors included perceived problems, social cohesion, and physical activity facility density. Log transformed CRP (mg/L) was tested as the potential mediator. Linear regression models were used to test for significant indirect effects, adjusting for covariates. Twelve percent of participants (n=650) had T2D. Chronic burden and physical activity facility density were indirectly related to T2D via CRP (Table) . That is, higher chronic burden and lower density of physical activity facilities were linked to higher CRP. In turn, higher CRP was positively associated with T2D. Other stressors were neither directly nor indirectly associated with T2D. The associations between these stressors and T2D appear to be mediated by higher CRP in the MESA cohort. Future research should test the longitudinal mediating role of inflammation on the associations of stressors on T2D.

Disclosure
K.Tamura: None. R.Jagannathan: None. L.Hu: None. S.Neally: None. Y.Baumer: None. K.Narayan: n/a. V.Vaccarino: None. T.Powell-wiley: None.
1229-P: Participation of Hispanic (Hisp) and African-American (AA) Youth in an Observational Study in Diabetes
Authors: REDONDO MARIA J. , TOSUR MUSTAFA , UYSAL SERIFE , MUIR ANDREW B. , IFTEKHAR SANIA , DEEN SAIMA , PERRY DANIEL J. , HARRALL KYLIE K. , GLUECK DEBORAH H. , VEHIK KENDRA , ORAM RICHARD A. , HAGOPIAN WILLIAM , DABELEA DANA , ATKINSON MARK A. ,   RACE (DISCOVER) DIABETES STUDY IN CHILDREN OF DIVERSE ETHNICITY
Published: May 2022

Background and Aim: Suboptimal representation of race/ethnic minorities in clinical research contributes to critical gaps in our knowledge of diabetes in these populations. We aimed to evaluate the participation of AA and Hisp youth in an observational study in diabetes to assess factors impacting participation.
Methods: We studied 92 participants in the Diabetes Study in Children of Diverse Ethnicity and Race (DISCOVER) that is currently enrolling youth (age 0-yrs) with non-secondary diabetes for collection of data and blood samples. We compared racial/ethnic distribution of actual vs. target enrollment and refusal rates by race/ethnicity. We analyzed qualitative data on reasons for study refusal.
Results: The racial/ethnic distribution of participants was 60.9% Hisp, 27.2% AA, 12.0% non-Hispanic white [NHW] and 0% other, vs. enrollment targets of 35.3% Hisp, 31.8% AA, 29.9% NHW and 3% other (p=0.001) . In the population of eligible candidates, 31.1% of the children were Hisp, 18.8% AA, 42.2% NHW and 7.9% other. Refusal rates were 20.0%, 16.7%, 38.9% and 100%, respectively, for Hisp, AA, NHW and other (p=0.072) . Among those who refused, the reasons noted were no interest in research (44.4% overall, 80% in AA youth) , blood draw (29.6% overall, 42.6% in Hisp youth) , no direct benefit to the participant (11.1%) , and being too busy (18.5%) or overwhelmed by the recent diabetes diagnosis (11.1%) . NHW youth cited the first 3 reasons, with similar frequency, for refusal.
Conclusions: Refusal rates were not elevated in AA and Hisp children compared with NHW. Actual enrollment was statistically different from the target, with over-representation of Hisp youth and underrepresentation of NHW youth. Facilitators of racial/ethnic minority participation in research studies may include diverse racial/ethnic distribution in the population where the study is conducted, a trusted environment, race/ethnicity concordance with research team members, and a minimally invasive study protocol.

Disclosure
M.J. Redondo: Advisory Panel; Provention Bio, Inc. M. Tosur: Advisory Panel; Provention Bio, Inc. A.B. Muir: None. S. Iftekhar: None. S. Deen: None. D.J. Perry: None. D.H. Glueck: None. K. Vehik: None. R.A. Oram: Consultant; Janssen Research & Development, LLC. Research Support; Randox R & D. W. Hagopian: Research Support; Janssen Research & Development, LLC. D. Dabelea: None. M.A. Atkinson: None.

Funding
NIH NIDDK RDK124395