bluuebunny/crossref_metadata_2025_split huggingface dataset:
103-LB: Comparison of Two Hyperglycemia Correction Scales in Hospitalized Patients with Diabetes Mellitus Type 2—CAPADOCIA 2 Trial
Authors: YEPES CARLOS A. , MORA JAVIER M. , MOSCOSO EVELYN , RODRÍGUEZ JORGE ALEJANDRO R. , LEÓN LAURA A. , GOMEZ JAVIER , BURITICÁ NATHALIE 
Published: May 2022

Introduction: We evaluated the efficacy and safety of the recommended scheme by international guideline in 2012 (2012’s scheme) in comparison with a less aggressive scheme (2019’s scheme) proposed by Umpierrez et al.
Methods: A non-blinded randomized clinical study was conducted in which two short-time insulin schemes for hyperglycemic control (2012’s vs. 2019’s) were compared in hospitalized patients of Hospital Universitario Clínica San Rafael (HUCSR) in Bogotá Colombia in a period between october 2019 and february 2022.
Results: Totally, 91 patients joined the trial. There were no statically significant difference between the demographic characteristics and outcomes.
Conclusions: The two schemes are equally safe and efficient in our population and can be used interchangeably.

Disclosure
C. A. Yepes: Speaker’s Bureau; Medtronic, Novo Nordisk, Sanofi. J. M. Mora: None. E. Moscoso: None. J. R. Rodríguez: None. L. A. León: None. J. Gomez: None. N. Buriticá: None.
1030-P: Glycemic Control Two Years after Diagnosis in Children with Type 1 Diabetes In Kuwait
Authors: ALQAISI TAIBAH , ALSABER AHMAD R. , ALKANDARI HESSA , AL-ABDULRAZZAQ DALIA 
Published: May 2022

Type 1 diabetes (T1D) in children is linked to a high risk of developing microvascular and macrovascular complications. HbA1c is an indicator for assessing long-term glycemic outcomes and a modifiable risk factor directly related to diabetes complications. The study aim was to describe glycemic outcomes of children with T1D at baseline and over a 2-year follow-up period post diagnosis as well as identify factors associated with optimal glycemic control. This retrospective cross-sectional study included patients (aged ≤14) with T1D registered in the Childhood Onset Diabetes electronic Registry (CODeR) between 2011-2017. Baseline data was retrieved through CODeR and follow-up data was retrieved by medical chart review. Optimal glycemic control was defined as HbA1c &lt;7.5% per the International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines at the follow-up period. ANOVA, chi-square, and logistics regression analysis was used. A total of 799 patients (53% females) were included at baseline. Mean (SD) age at diagnosis was 7.70 (3.10) and mean (SD) HbA1c was 11.3% (2.3) . HbA1c was significantly different between females and males at baseline (11.6% vs. 10.9%; p&lt;0.001) . In the follow-up period, 580 patients were included. Most patients achieved sub-optimal or high-risk compared to optimal glycemic control at follow-up (n=503, mean HbA1c 9.8% vs. n=77, mean HbA1c 6.9%; p&lt;0.001) . Patients on CSII therapy were more likely to have better glycemic outcomes than patients on MDI therapy (OR = 4.86, 95% CI [1.66-14.2], p=0.004) . Height z-score was associated with poor glycemic control (OR = 1.24, 95% CI [1.017-1.515], p=0.034) . Most patients did not meet the glycemic control target defined by ISPAD, signaling a significant challenge faced by children with T1D in Kuwait. However, this study highlights the importance of making CSII therapy accessible. Individualized glycemic control goals may be needed to enhance diabetes management and care early at diagnosis.

Disclosure
T.Alqaisi: None. A.R.Alsaber: None. H.Alkandari: None. D.Al-abdulrazzaq: None.
1033-P: An Interactive Capacity Planning Dashboard for Algorithm-Enabled Telemedicine-Based Diabetes Care
Authors: CHANG ANNETTE , GAO MICHAEL Z. , FERSTAD JOHANNES , MAAHS DAVID M. , PRAHALAD PRIYA , JOHARI RAMESH , SCHEINKER DAVID 
Published: May 2022

We previously showed that the use of a tool for remote analysis of continuous glucose monitor data, Timely Interventions for Diabetes Excellence (TIDE) , was associated with improved glucose management for patients with type 1 diabetes. To facilitate the deployment of TIDE at two partner institutions, we developed an operational planning tool.
We designed an interactive dashboard to match capacity and demand with a variety of operational, population, and workforce parameters. To improve the dashboard’s accessibility, simplicity, and interpretability, we performed iterative design based on feedback from users and two partner institutions. We set parameter values based on the first deployment of TIDE and conducted sensitivity analyses of the capacity-demand match.
The dashboard (Figure 1) contains seven modifiable parameters; generates a table illustrating the match between capacity and demand; displays a timeseries plot of capacity and demand; and calculates three alternative capacity plans that satisfy annual patient demand. It is available online (www.bit.ly/surf-tide) . Small absolute reductions in per-patient review time produced the most significant changes in clinic capacity.
We developed an interactive dashboard that facilitates data-driven operational planning for clinics seeking to deploy algorithm-enabled telemedicine-based diabetes care.
Figure 1. Capacity Planning Dashboard

Disclosure
A.Chang: None. M.Z.Gao: None. J.Ferstad: None. D.M.Maahs: Advisory Panel; Abbott Diabetes, Eli Lilly and Company, Medtronic, Novo Nordisk, Sanofi, Consultant; Aditx Therapeutics, Inc., Biospex. P.Prahalad: None. R.Johari: None. D.Scheinker: None.

Funding
NIH R18DK122422
104-OR: Association of Neighborhood Deprivation and Gestational Diabetes Mellitus
Authors: LIU EMILY F. , SRIDHAR SNEHA B. , FERRARA ASSIAMIRA , GREENBERG MARA , HEDDERSON MONIQUE M. 
Published: May 2022

A more comprehensive understanding of gestational diabetes mellitus (GDM) risk factors is needed given its increasing incidence and association with adverse maternal and fetal outcomes. Physical and social environments may play an important role in GDM because of their relationship to known risk factors such as physical activity, diet, and other lifestyle behaviors. We used logistic regression to examine the relationship between neighborhood deprivation index (NDI) , a composite score employing US Census indicators of education, income and poverty, employment, housing, and occupation, and GDM in a large and racially diverse cohort of livebirths between 20 and 2018 (n = 167,287) in Kaiser Permanente Northern California. GDM was defined by the Carpenter and Coustan criteria. Overall, 12,238 (7.4%) of pregnancies had GDM. When stratified by quartiles of NDI, GDM prevalence increased with neighborhood deprivation -- from 2,674 (6.5%) in the least deprived quartile to 3,432 (8.3%) in the most deprived quartile. Adjusted model results showed increased GDM risk as higher neighborhood deprivation quartiles were compared to the least deprived quartile (Table 1) . The test for linear trend was statistically significant (p≤0.05) .
In conclusion, additional emphasis should be placed on social determinants of health prior and during pregnancy when evaluating GDM risk and working towards health equity in maternal and fetal outcomes.

Disclosure
E.F.Liu: None. S.B.Sridhar: None. A.Ferrara: n/a. M.Greenberg: None. M.M.Hedderson: None.

Funding
Kaiser Permanente Health Policy and Disparities Research Program grant
1047-P: To Assess the Physiological Changes of Glucose Metabolism Associated with Increased BMI in Pregnancy
Authors: LINDER TINA , EPPEL DANIEL , MONOD CÉCILE , KOTZAERIDI GRAMMATA , TURA ANDREA , GÖBL CHRISTIAN S. 
Published: May 2022

Background: Maternal overweight is a risk factor for Gestational Diabetes Mellitus (GDM) . However, there is emerging evidence that increased maternal BMI has considerable impact on the development of large for gestational age (LGA) offspring even in women who do not develop GDM, possibly related to subtle impairments in glucose metabolism. This study aims to assess physiological changes associated with increased BMI.
Methods: 21 women with overweight and 21 normal weight controls were included in this explorative study and received a metabolic assessment at early pregnancy (13.3 weeks) (Visit 1) , including a 60 min frequently sampled intravenous glucose tolerance test (FSIGT) . An OGTT was performed between 24 and 28 weeks of gestation (Visit 2) in women who remained normal glucose tolerant.
Results: At V1 mothers with overweight showed significantly elevated fasting glucose and HbA1c values, a well as impaired insulin sensitivity at fasting condition and dynamically assessed during the FSIGT, whereby the Calculated Insulin Sensitivity index (CSI) was lower in the overweight group as compared to normal weight controls (3.5 vs. 6.7 10-4⋅[μU/mL]-1⋅min-1, p=0.025) . The Disposition Index (DI) as a parameter of β-cell function was significantly decreased in mothers with overweight. Likewise, maternal BMI was inversely related to fasting (rho=0.56, p=0.005) and dynamically assessed insulin sensitivity (rho=0.51, p=0.014) as well as the DI (rho=0.51, p=0.014) and the AUC of glucose (rho=0.66, p&lt;0.001) and C-Peptide (rho=0.46, p=0.020) during the OGTT in mothers who remained normal glucose tolerant during pregnancy at V2.
Conclusions: Increased maternal BMI is associated to insulin resistance and impaired β-cell function already at early pregnancy. We also observed that maternal BMI was associated with impaired glucose metabolism and especially elevated glucose levels during the OGTT at mid gestation in women who did not develop GDM and remained normal glucose tolerant.

Disclosure
T.Linder: None. D.Eppel: None. C.Monod: None. G.Kotzaeridi: None. A.Tura: None. C.S.Göbl: Research Support; Dexcom, Inc., Sanofi.
1049-P: Outcomes for Macrosomic Births by Maternal Diabetes Status
Authors: FITCH KATHERINE , HERSH ALYSSA R. , GARG BHARTI , VALENT AMY M. 
Published: May 2022

Objective: To determine obstetric outcomes by birthweight (BW) among individuals with and without diabetes mellitus (gestational or pre-existing diabetes) in pregnancy.
Study Design: Retrospective cohort study of singleton, non-anomalous, live births in the U.S. from 2012-2018 registered in the National Vital Statistics System. Infants weighing &gt; 3,000g at 37-42 week gestation were included. BW was stratified into four categories: 3,000-3,999g, 4,000-4,499g, 4,500-4,999g and ≥5,000g. Association of BW with outcomes was examined among women with and without diabetes mellitus (DM) . Chi-squared and multivariable logistic regression analyses were performed for statistical comparisons.
Results: Of 18,397,3deliveries included in this analysis, 6.3% had DM. Higher BW were associated with higher odds of cesarean delivery, maternal blood transfusion, anal sphincter injury, APGAR &lt;7 at 5 minutes, NICU admission, and assisted ventilation. At ≥5,000g, there were higher odds of neonatal seizures and death. Although findings among pregnant persons without DM were similar, the strength of association for most adverse perinatal outcomes was greater among persons with DM.
Conclusion: Fetal macrosomia is associated with significant adverse perinatal outcomes, with even greater odds among deliveries impacted by maternal DM. Prenatal intervention studies to optimize pregnancy health are necessary to improve perinatal outcomes.

Disclosure
K.Fitch: None. A.R.Hersh: None. B.Garg: None. A.M.Valent: None.
1054-P: Dietary Fat Intake Is Not Associated with Increased Insulin Resistance among Pregnant Women
Authors: ROSENBERG EMILY A. , SEELY ELLEN W. , THAWEETHAI TANAYOTT , JAMES KAITLYN , YU CHU , CALLAHAN MICHAEL J. , NELSON STACEY , POWE CAMILLE E. 
Published: May 2022

Background: Dietary modification in gestational diabetes (GDM) has focused on restricting carbohydrates. Some research suggests that increased dietary fat intake, which often occurs with carbohydrate restriction, may worsen insulin resistance in women with GDM. We tested for a relationship between dietary fat intake and insulin sensitivity in pregnant women.
Methods: Pregnant women in the late 2nd trimester, (median [IQR] =26 [25-27] weeks’ gestation) completed a 75 g oral glucose tolerance test (OGTT) and a validated self-administered 24-hr dietary recall. We tested for an association between fat intake the day before the OGTT and insulin sensitivity (inverse of insulin resistance, measured using Matsuda index) using linear regression, adjusting for age, race, education, parity, BMI, gestational age, carbohydrate intake, and caloric intake. We also tested for associations with insulin secretion (measured using Stumvoll 1st phase estimate, with adjustment for insulin sensitivity) , and fasting, 1-hr and 2-hr OGTT glucose (mg/dl) .
Results: Pregnant women (N=120, age 34 [31-36]) consumed 82 g of fat [62-101], 235 g of carbohydrate [195-298] and 78 g of protein [61-100] during a 24-hr period. Carbohydrate and fat intake were inversely related after adjusting for total caloric intake (0.3 fewer g of carbohydrate per additional g of fat, P &lt;0.001) . We found no association between fat intake and insulin sensitivity (β=0.07, P=0.14) . There was no association between fat intake and insulin secretion (β=2.21, P=0.62) or OGTT glucose (fasting: β=0.03, P=0.67, 1-hr: β=-0.36, P=0.26, 2-hr: β=0.01, P=0.98) .
Conclusion: Our results suggest that dietary fat intake does not increase insulin resistance in pregnant women. This may have implications for dietary recommendations in women with GDM.

Disclosure
E.A.Rosenberg: None. E.W.Seely: None. T.Thaweethai: None. K.James: None. C.Yu: None. M.J.Callahan: None. S.Nelson: None. C.E.Powe: None.

Funding
National Institutes of Health (1F32DK126343-01A1) ,Nation Institutes of Health (K23DK113218) , and the Robert Wood Johnson Foundation’s Harold Amos Medical Faculty Development Program
1055-P: Low Rate of Preconception Counseling and Near Absence of Contraception Provision by Endocrinologists for Women with Diabetes
Authors: JEFFERS REBECCA , SAYRES LAUREN , ABUSHAMAT LAYLA , NIELSEN CHLOE , ZAMAN ADNIN , BARBOUR LINDA (LYNN) A. 
Published: May 2022

Preconception counseling for reproductive-age women with type 1 and type 2 DM improves maternal-fetal outcomes. Endocrinologists are in a unique position to provide such important counseling and contraception or applicable referrals. In response to an increasing number of women referred to our prenatal clinic with poor glycemic control and unplanned pregnancies, we instituted a quality improvement initiative to improve preconception care at our academic center. We conducted a chart review of 96 women of reproductive age with at least one in-person visit for DM from July 2020-Oct 2021. Patients who were pregnant or had undergone sterilization were excluded. Fifty patients (mean age 34.5+/-6.7 yrs) met inclusion criteria. Of these, 66% had T1DM, 32% had T2DM and 26% had a HgbA1c ≤6.5%, recommended for pregnancy. Each woman had a mean of 2.1+/-1.2 visits with an endocrinology provider during these 15 mos. Only 4% had contraception specifically documented during a visit, although medical staff or other providers had documented contraception use in 56% of cases. No women received a contraception prescription. Endocrinologists did not document provision of preconception counseling to any of these women, although 14% had previously undergone counseling with a maternal fetal medicine provider. No women were referred to an OB-Gyn provider. Our data suggest that endocrinology providers infrequently provide preconception or contraception counseling or referrals for women with diabetes and underscores the striking need for a QI initiative. To this end, we are implementing a multifaceted intervention to educate providers on key aspects of preconception counseling and contraception provision, facilitate specialist referrals, simplify documentation, and provide patient education materials. We will assess the efficacy of our intervention with the ultimate goal of improving outcomes for this rapidly growing population of women with diabetes and their offspring.

Disclosure
R.Jeffers: None. L.Sayres: None. L.Abushamat: None. C.Nielsen: None. A.Zaman: None. L.A.Barbour: None.
1056-P: Reported Pregnancy Outcomes with Insulin Glargine 100 U/mL (Gla-100) and 300 U/mL (Gla-300) : Post-Marketing Survey of Pharmacovigilance Data
Authors: WESTERBACKA JUKKA , BASSOLE CAROLINE , DUVERNE MARIELLE , DODER ZORAN , SCHOEPPER HEIKE 
Published: May 2022

Background: Good metabolic control during pregnancy is crucial for people with diabetes to prevent adverse events associated with hyperglycemia. Gla-300, a long-acting basal insulin (BI) analog, provides similar glycemic control and less hypoglycemia versus the first-generation BI Gla-100. We examined real-life safety of insulin glargine use in pregnancy.
Methods: Cumulative searches of the Sanofi global pharmacovigilance database for Gla-100/Gla-300 exposures in pregnancy were performed using Medical Dictionary for Regulatory Activities terms, from database initiation to March 9, 2021.
Results: Searches found 4936 (2370 solicited, 2566 unsolicited; 71 countries) exposures to Gla-100 and 246 (66 solicited, 180 unsolicited; 44 countries) for Gla-300 (Table) . Cumulative exposure was 89 million and 7.9 million person-years for Gla-100 and Gla-300, respectively. Congenital, familial, and genetic anomalies were rare (2.6% Gla-100; 2.0% Gla-300) , in line with general population rates (3-5%) . Spontaneous abortion rates were low (3.0% Gla-100; 2.8% Gla-300) , which is also in line with the general population (˜10%) .
Conclusion: Rates of congenital anomalies and spontaneous abortions for Gla-100 and Gla-300 were consistent with the general population. The results indicate no safety issues with insulin glargine use during pregnancy.

Disclosure
J.Westerbacka: Employee; Sanofi, Stock/Shareholder; Sanofi. C.Bassole: Employee; Sanofi. M.Duverne: Employee; Sanofi. Z.Doder: None. H.Schoepper: None.

Funding
Sanofi
1063-P: Social Risks and Health-Related Quality of Life in Women Who Have Experienced Gestational Diabetes
Authors: WALKER SHANNON L. , WALKER REBEKAH J. , HAWKS LAURA , MOSLEY-JOHNSON ELISE , NAGAVALLY SNEHA , EGEDE LEONARD E. 
Published: May 2022

Objective: To examine the relationship between social risk factors (housing instability and food insecurity) on health-related quality of life (HRQoL) in women with a previous diagnosis of gestational diabetes mellitus (GDM) .
Methods: Cross-sectional data on women aged 18 and older from the Behavioral Risk Factor Surveillance System (2014, 2015, 2017) were analyzed. GDM was defined by self-reported diagnosis of diabetes only during pregnancy. Social risks were defined by experiences of housing instability or food insecurity within the previous year. Linear regression was run to evaluate the association between social risks and HRQoL controlling for sociodemographic confounders. Interaction terms between each social risk factor and race/ethnicity were tested for each outcome but were not significant, thus the analysis was not stratified.
Results: Among the total study sample (weighted N=3,080,442) of adult women with a prior GDM diagnosis, 14.8% and 12.6% reported recent housing instability and food insecurity, respectively. Among women with prior GDM, housing instability was associated with reduced self-rated general health status (-0.36; 95%CI -0.53, -0.19) and increased days of poor mental health (4.81; 95%CI 1.23, 8.39) . Food insecurity was associated with reduced self-rated general health status (-0.43, 95%CI -0.59, -0.27) and increased days of poor mental health (5.29; 95%CI 1.95, 8.64) .
Conclusion: Our findings indicate an inverse association between food insecurity and housing instability and self-rated general health status and mental health functioning among women with a prior GDM diagnosis. There was no differential relationship by race/ethnicity. These findings highlight the importance of interventions which address social risks to improve quality of life in women with a prior GDM diagnosis.

Disclosure
S.L.Walker: None. R.J.Walker: None. L.Hawks: None. E.Mosley-johnson: None. S.Nagavally: None. L.E.Egede: None.

Funding
American Diabetes Association (1-19-JDF-075) ; National Institute of Diabetes and Digestive Kidney Disease (K24DK093699, R01DK118038, R01DK120861, PI: Egede) , the National Institute for Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker)
1066-P: Association of T2D Subgroups with MCI/Dementia
Authors: BANCKS MICHAEL , LOVATO JAMES , BALASUBRAMANYAM ASHOK , CODAY MACE , JOHNSON KAREN C. , MUNSHI MEDHA , REBELLO CANDIDA J. , WAGENKNECHT LYNNE E. , ESPELAND MARK 
Published: May 2022

Objectives: To assess whether T2D subgroups are associated with MCI/dementia, and whether the Action for Health in Diabetes (Look AHEAD) intensive lifestyle intervention (ILI) differs in prevention of MCI/dementia by T2D subgroup.
Methods: Included 3760 participants (73% of original cohort after death and attrition) with T2D and overweight/obesity randomized to years of ILI or diabetes support and education. We characterized T2D subgroups at randomization using k-means clustering methods and data on age of T2D diagnosis, BMI, waist circumference, and HbA1c. We estimated marginal probabilities for prevalent MCI/dementia 10-13 years post-randomization by T2D subgroup with adjustment for cohort attrition and covariates (Table) and assessed for differential effects of ILI on MCI/dementia by T2D subgroup.
Results: T2D subgroups were characterized by (1) older and (2) younger age at T2D onset, (3) high HbA1c, and (4) severe obesity (Table) . Prevalence of MCI/dementia was 8.4% and differed by T2D subgroup. After adjustment, rate of MCI/dementia was highest for the severe obesity and lowest for the younger onset subgroups. There were no differences in MCI/dementia rates between intervention arms for any T2D subgroup (interaction p-value=0.84) .
Conclusions: T2D subgroups differ in rate of MCI/dementia, with the highest rate for a subgroup of participants with severe obesity. Lifestyle intervention did not modify rate of MCI/dementia in any T2D subgroup.

Disclosure
M.Bancks: None. J.Lovato: None. A.Balasubramanyam: None. M.Coday: None. K.C.Johnson: None. M.Munshi: Consultant; Sanofi. C.J.Rebello: None. L.E.Wagenknecht: None. M.Espeland: None.