bluuebunny/crossref_metadata_2025_split huggingface dataset:
1179-P: Secular Trends in Dietary Intake Over a Five-Year Period in People with Type 2 Diabetes in Japan: Japan Diabetes Complications Study (JDCS)
Authors: HORIKAWA CHIKA , AIDA REI , KAMADA CHIEMI , FUJIHARA KAZUYA , TANAKA SHIRO , ARAKI ATSUSHI , YOSHIMURA YUKIO , AKANUMA YASUO , SONE HIROHITO 
Published: May 2022

To provide effective medical nutrition therapy (MNT) , it is necessary to consider dietary intake, which can change over time. This longitudinal study analyzed changes in the dietary intakes of Japanese patients with type 2 diabetes over a 5-year period. The JDCS is a nationwide study of Japanese patients with type 2 diabetes conducted in 1996. Participants were aged 40-70 years from outpatient clinics in 59 universities and general hospitals. Analyzed were 922 responders to a dietary survey assessed by the Food Frequency Questionnaire based on food groups at baseline and 5 years after registration. Paired samples t-test was used for analysis. Over a 5-year period, patients with type 2 diabetes maintained almost the same body mass index (BMI) (baseline: 22.9±3.0; 5 years later: 22.8±3.0 kg/m2) . Differences in energy intake, fat-to-energy ratio, and carbohydrate-to-energy ratio were small although significant. Neither the mean intake of fiber nor salt met the required intake for MNT for persons with diabetes both at baseline and after 5 years. As for food groups, there was a significant decrease in intakes of vegetables, seaweed, soybeans/soy products, and milk/dairy products. Details are shown in the Table. Results showed that Japanese patients with type 2 diabetes need to pay special attention to dietary fiber intake and salt intake on an ongoing basis.

Disclosure
C.Horikawa: None. R.Aida: None. C.Kamada: None. K.Fujihara: None. S.Tanaka: None. A.Araki: None. Y.Yoshimura: None. Y.Akanuma: 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 (19H04028)
118-LB: The Antipsychotic D2 Receptor Antagonist Diphenylbutylpiperidines Improve Glycemia in Experimental Obesity by Inhibiting Succinyl-CoA—3-Ketoacid CoA transferase
Authors: TABATABAEI DAKHILI SEYED AMIRHOSSEIN , ABOU FARRAJ RABIH , GREENWELL AMANDA A. , SAED CHRISTINA T. , YANG KUNYAN , GOPAL KESHAV , CHAN JORDAN S.F. , LEE CRYSTAL , EATON FARAH , VELAZQUEZ CARLOS A. , CRAWFORD PETER A. , GLOVER MARK , AL BATRAN RAMI , USSHER JOHN R. 
Published: May 2022

Purpose: Despite significant progress in understanding the pathogenesis of type 2 diabetes (T2D) , it remains difficult to manage, hence, new therapeutic options are required. We previously observed that elevated skeletal muscle succinyl CoA:3-ketoacid CoA transferase (SCOT) activity, the rate-limiting enzyme of ketone (KB) oxidation, contributes to obesity-induced hyperglycemia. Moreover, we identified that the antipsychotic agent, pimozide, is a SCOT inhibitor with glucose-lowering actions. In silico molecular modeling determined that a wide range of DPBPs can theoretically inhibit SCOT activity, therefore, we determined whether the DPBP drug class could be repurposed for the treatment of T2D.
Methods: 8-week-old male wild-type and muscle-specific/brain-specific SCOT knockout (SCOTMuscleKO, SCOTBrainKO) mice were subjected to experimental obesity via consumption of a high fat, high sugar diet for 12-weeks. Lean control mice received a low fat, low sugar diet. At 8-weeks, lean and obese mice were treated with DPBPs (penfluridol, fluspirilene, pimozide (10mg/kg)) once every 2 days via oral gavage for 14-days, following which circulating KB levels and glucose homeostasis were assessed. To rule out a contribution of the canonical actions of DPBPs as dopamine 2 (D2) receptor antagonists to DPBP-mediated glucose-lowering, obese mice were treated with the structurally unrelated D2 receptor antagonist, lurasidone (10 mg/kg) .
Results: All tested DPBPs improved glucose homeostasis in obese mice through a mechanism dependent on the inhibition of both brain and muscle SCOT activity. Treatment with lurasidone failed to improve glycemia in obese mice, thus consistent with a SCOT-dependent mechanism of action.
Conclusions: Our findings suggest all DPBPs have glucose-lowering actions and therefore may have clinical utility in being repurposed for the treatment of T2D.

Disclosure
S. Tabatabaei dakhili: None. C. A. Velazquez: None. P. A. Crawford: Advisory Panel; Abbott Diabetes, Johnson & Johnson Global Services. M. Glover: None. R. Al batran: None. J. R. Ussher: None. R. Abou farraj: None. A. A. Greenwell: None. C. T. Saed: None. K. Yang: None. K. Gopal: None. J. S. F. Chan: None. C. Lee: None. F. Eaton: None.

Funding
Canadian Institutes of HealthResearch
1180-P: Diet Quality and ABC Goals among U.S. Adults with Diabetes: 2013–2018
Authors: CHEN YU , SIEGEL KAREN R. , BULLARD KAI M. , ROLKA DEBORAH B. 
Published: May 2022

A healthy diet can help attain hemoglobin HbA1c (A1C) , blood pressure (BP) , and cholesterol goals (ABC goals) in people with diabetes. We examined the association of diet quality with achievement of ABC goals (defined as A1C&lt;8%, BP &lt;140/90 mmHg, non-HDL cholesterol &lt;130 mg/dL, and meeting all three goals) among adults with diabetes. Our analysis included non-pregnant adults aged ≥18 years with a self-reported diabetes diagnosis who had complete data on the 24-hour dietary recalls in the 2013-2018 National Health and Nutrition Examination Surveys. We used the Healthy Eating Index-2015 (HEI-2015) to measure diet quality. Overall, the median HEI-2015 among adults with diabetes was 51.1 points; a score larger than the median was positively associated with achievement of the A1C goal (Figure) . After adjusting for age, sex, race/ethnicity, education, marital status, health status, health insurance status, and smoking status using logistic regressions, we found that an interquartile increase in HEI-2015 (from 43.0 to 60.2 points) was significantly associated with 4.5 percentage points larger probability (74.3% compared with 78.8%, p=0.02) of meeting the A1C goal. No significant associations were found between HEI-2015 and achievement of BP, cholesterol, or combined ABC goals. Public health efforts to improve dietary quality among people with diabetes may help to increase the proportion of individuals with diabetes who achieve A1C goals.

Disclosure
K.R. Siegel: None. K.M. Bullard: None. D.B. Rolka: None.
1182-P: Is Prediabetes Awareness Associated with Leisure-Time Physical Activity and Dietary Behaviors?
Authors: SIEGEL KAREN R. , PAVKOV MEDA E. , BENOIT STEPHEN R. , IMPERATORE GIUSEPPINA , BULLARD KAI M. 
Published: May 2022

Lifestyle modification –healthy diet and physical activity– can help prevent or delay type 2 diabetes in adults with prediabetes (preDM) . However, 84% of US adults with preDM are unaware they have it. Whether preDM status awareness is associated with leisure-time physical activity (LTPA) levels and dietary intake is unknown. Using data from US adults without DM ≥18 y from the National Health and Nutrition Examination Surveys 2013-2018, we classified preDM as ‘aware’ (self-report of preDM and 5.7%≤A1c&lt;6.5%, n=456) , ‘unaware’ (no self-report; 5.7%≤A1c&lt;6.5%, n=2,223) , and ‘normoglycemic’ (A1c&lt;5.7% but self-reported as preDM, n=191) . We calculated means or medians for LTPA (self-reported minutes of moderate to vigorous physical activity per week) , dietary intake (total calories, fruit, vegetables, whole grains, added sugars, processed meat, unprocessed red meat from one day of 24-h recall data) , and the Healthy Eating Index (HEI) 2015, a marker of overall healthy diet (higher score indicates healthier diet) . Of adults with or reporting preDM, 77.9% were unaware (mean age [years]: 51.2 [standard error, 0.5]; 44.6% [1.4] female; mean BMI: 30.3 kg/m2[0.2]) , 14.3% were aware (mean age: 57.4 [0.9]; 56.5% [2.6] female; mean BMI: 31.8 kg/m2 [0.5]) , and 7.8% were normoglycemic (mean age: 43.6 [1.4]; 71.1% [3.7] female; mean BMI: 30.6 kg/m2 [0.6]) . PreDM-aware and normoglycemic adults consumed less calories (p=0.002) , added sugars (p&lt;0.001) , and unprocessed red meat (p&lt;0.001) than preDM-unaware adults. PreDM-aware and preDM-unaware adults consumed more processed meat than normoglycemic adults (p=0.002) . HEI scores and fruit, vegetables, and whole grains intake were low overall and across groups (all p&gt;0.05) . Mean LTPA levels did not significantly vary across the 3 groups (p=0.22) . Overall, preDM awareness is associated with lower added sugars, red meat, and total overall calories intake, suggesting that efforts to increase awareness may lead to healthier eating among those with preDM.

Disclosure
K.R.Siegel: None. M.E.Pavkov: None. S.R.Benoit: None. G.Imperatore: None. K.M.Bullard: None.
1201-P: Glycemic Response Phenotypes on Metformin Monotherapy in Real-World Diabetes Care
Authors: RAGHAVAN SRIDHARAN , LIU WENHUI , WARSAVAGE THEODORE , PHILLIPS LAWRENCE S. , REUSCH JANE E. , CAPLAN LIRON 
Published: May 2022

Metformin is the most prescribed initial treatment for type 2 diabetes in many parts of the world. Glycemic response to metformin has been described based on glycemic change - a measure that ignores potential differences in glycemic trajectories or paths between the start and end of metformin monotherapy. We examined HbA1c trajectories over two years in adults treated with metformin and developed prediction models for treatment response. We studied adults treated with metformin alone for &gt;30 days after diabetes diagnosis in the US VA Health System from 20to 2016 who had a minimum of two HbA1c measurements from 90 days prior to two years after the first metformin prescription (N=140,413) . We included all HbA1c measurements (487,6total) during two years after metformin initiation, censoring at addition of a 2nd diabetes medication, metformin discontinuation, nursing home admission, death, or 90-day metformin non-adherence (medication possession ratio &lt;80%) . We used latent class mixed models to identify HbA1c trajectory classes, then used random forests machine learning to predict trajectory class membership based on demographic, laboratory, vital sign, and comorbidity data at the time of diabetes diagnosis. We found three HbA1c trajectories: stably low (89.7% of sample, mean HbA1c decrease from 7.2% to 6.6%) , brisk response (7.1% of sample, mean HbA1c decrease from 11.4% to 7.0%) , and non-response (3.1% of sample, mean HbA1c increase from 8.9% to 10.8%) . Of those in the stably low and brisk response classes at 2 years, 91% maintained HbA1c at ∼7% on metformin alone for 5 years after drug initiation. Random forests yielded prediction models that accurately predicted brisk response (91% accuracy) but not non-response (59% accuracy) . CONCLUSION: Three glycemic response phenotypes were evident by 6 months after metformin monotherapy initiation in real world data and persisted in the vast majority out to 5 years. Early HbA1c surveillance can inform diabetes treatment optimization with durable impact.

Disclosure
S.Raghavan: None. W.Liu: None. T.Warsavage: None. L.S.Phillips: Other Relationship; Cystic Fibrosis Foundation, Diasyst Inc., Research Support; Abbott Diabetes, AbbVie Inc., Janssen Pharmaceuticals, Inc., Janssen Scientific Affairs, LLC, Pfizer Inc. J.E.Reusch: Advisory Panel; Medtronic. L.Caplan: None.

Funding
US Department of Veterans Affairs (IK2-CX001907)
1205-P: Trends in Insulin Use and Glycemic Control in U.S. Adults with Diabetes, 1988–2020
Authors: VENKATRAMAN SIDDHARTH , SELVIN ELIZABETH , FANG MICHAEL 
Published: May 2022

Introduction: Insulin remains a last line therapy for type 2 diabetes, and formulations have improved significantly over the past 30 years. It is unknown whether these advancements have translated into better glycemic control in persons with diabetes.
Methods: We conducted a trends analysis of cross-sectional data from the National Health and Nutrition Examination Survey (NHANES, 1988-2020) . Our analysis included 8,658 nonpregnant adults aged ≥20 with diagnosed diabetes. We examined trends in self-reported diabetes medication use (insulin or oral) and glycemic control (A1c&lt;7.0%) , overall and by race/ethnicity.
Results: From 1988-1994 to 2013-2020, there was an increase in the proportion of US adults with diabetes using only oral glucose-lowering medications (43.5% to 55.2%, p=0.003) . The proportion of patients using insulin did not change over the same period (30.5% to 28.2%, p=0.81) . Glycemic control improved among users of oral medications (p&lt;0.001) (Figure 1a) . Among insulin users, glycemic control was unchanged (p=0.87) . Mexican American insulin users had a decrease in glycemic control (25.1% in 1988-94 to 9.9% in 2013-20, p=0.004) and had poorer glycemic control, overall, as compared to their non-Hispanic White or Black counterparts (Figure 1b-1d) .
Conclusions: Despite improvements in insulin formulations, insulin users have not seen improved glycemic control.

Disclosure
S.Venkatraman: None. E.Selvin: Other Relationship; Wolters Kluwer. M.Fang: n/a.
1236-P: Cardiometabolic Disease Risk in Metabolically Unhealthy vs. Healthy in Normal Weight and Obesity: Results from 2015 and 20KNHNES Data
Authors: SEO MYONG-WON , CHO WONHEE , ROSENBERG JARED , WHITE LINDSEY , KIM JOON YOUNG 
Published: May 2022

The concept of metabolically unhealthy vs. healthy obese (MUO vs. MHO) was expanded to non-obese individuals as obesity-related comorbidities exist in a subgroup of metabolically unhealthy vs. healthy normal-weight (MUNW vs. MHNW) . It is unclear if MUNW differs from MHO with respect to cardiometabolic health. Here, we applied a widely accepted definition of metabolic health (JAMA 20285: 2486) and examined differences in cardiometabolic risk factors among 4 subgroups of Korean adults (N=7,594) . Individuals with NW vs. obesity (BMI ≥25 kg/m2) were categorized as either MU or MH if those met one or more of the following criteria: triglyceride ≥150 mg/dl; fasting glucose ≥100 mg/dl; HDL &lt;40 mg/dl in men or &lt;50 mg/dl in women; and SBP ≥130 mmHg or DBP ≥85 mmHg. Despite a gradual increase in BMI and visceral adiposity index from MHNW to MUNW to MHO to MUO, surrogates of insulin resistance (TG/HDL) and arterial stiffness (estimated pulse wave velocity) were higher in MUNW vs. MHO (Table) . HOMA-IR was highest in MUO with no difference between MUNW and MHO (Table) . Individuals with MUNW vs. MHO are at least similar to or more vulnerable to cardiometabolic disease. Our data indicate that cardiometabolic risk is not solely dependent on adiposity, suggesting that early preventive efforts for chronic disease are needed for individuals with normal-weight, yet metabolically unhealthy.

Disclosure
M.Seo: None. W.Cho: None. J.Rosenberg: None. L.White: None. J.Kim: n/a.
1238-P: Diabetes Treatment Using Metformin Is Associated with Protective Effect for Emphysema Progression in Smokers
Authors: LI YISHA , CONWAY REBECCA B. , YOUNG KENDRA , PRATTE KATHERINE A. , FOER DINAH , RENNARD STEPHEN , AUSTIN ERIN , GWON YEONGJIN , KINNEY GREGORY L. 
Published: May 2022

Rationale: Type 2 Diabetes (T2D) is one of the leading chronic diseases among smokers. Chronic obstructive pulmonary disease (COPD) is common among people with diabetes, with the lung posited as an additional target organ of diabetes. Previous literature suggests that some medications treating comorbidities of COPD patients may also benefit lung function.
Objectives: We used a novel statistical method to identify comorbidity medications associated with pulmonary function progression and assess potential effects using an adjusted mixed effect model among smokers with and without COPD.
Methods: Participants from the COPDGene cohort who completed initial visit (P1) , and 5-year follow up (P2) from 20through 2017 with complete demographics, clinical information, and medication history were included in the study. A least absolute shrinkage and selection operator (LASSO) model with false discovery rate control by a knockoff filter was used to identify medication classes associated with COPD progression in participants with and without T2D treatment. An adjusted linear mixed model was then used to confirm the association between selected medication and the change in percent emphysema and other lung function variables from P1 to P2.
Results: A total of 3,786 out of 10,198 smokers with complete information from P1 and P2 were included. Overall, 359 out of 3,786 smokers reported having T2D at P1, 2out of 359 patients were treated with the class of biguanides (metformin) at P1. The LASSO selection identified metformin as strongly associated with percent emphysema change. Adjusted linear mixed models confirmed that metformin use is associated with the reduction of emphysema in smokers (p&lt;0.0001) from P1 to P2.
Conclusions: Our study identified and confirmed an association between metformin and reduced emphysema progression among smokers with and without COPD. Metformin, a common treatment for diabetes, may also have protective effect on lung function.

Disclosure
Y.Li: Employee; Vertex Pharmaceuticals Incorporated. R.B.Conway: None. K.Young: None. K.A.Pratte: None. D.Foer: Research Support; IBM Watson Health. S.Rennard: Advisory Panel; GlaxoSmithKline plc., Sanofi, Verona, Verona, Consultant; Bergenbio, Boehringer Ingelheim International GmbH, NovoVentures. E.Austin: None. Y.Gwon: None. G.L.Kinney: None.

Funding
U01HL089897U01HL089856
1241-P: Cross-Sectional Study of the Impact of the COVID-Pandemic on Diabetes Management in Primary Care in Ontario, Canada
Authors: CHENG ALICE Y. , HARRIS STEWART B. , KRAWCHENKO IRIS E. , TYTUS RICHARD , HAHN JINA , LIU AIDEN R. , WANG YANG , GOLDEN SHANE , GOLDENBERG RONALD 
Published: May 2022

Background: This study describes the impact of the pandemic on the management of people with type 2 diabetes (PwT2D) in a primary care network with existing virtual care capabilities in Ontario, Canada.
Methods: Using de-identified primary care electronic medical records, PwT2D who had at least one healthcare touchpoint between March 1, 2018 and February 28, 2021 were analyzed by time period (baseline: 2018-19, pre-COVID-19: 2019-20, COVID-19: 2020-21) . The primary outcome measures include the number of people with at least one visit, number of people with vital measurements or lab tests, and the vital or lab results.
Results: The three time periods had a similar average age and gender distribution (Table 1) . Compared to the pre-COVID-period, fewer people had any healthcare touchpoint (17% reduction) . In-person visits were reduced while more people had virtual visits. Fewer people had test results recorded during the COVID-vs. two pre-COVID-time periods, however, average results were similar across all three time periods.
Conclusion: Our study described the immediate impact of the COVID-pandemic on patterns of primary care for PwT2D. While the total number people getting tests remains below pre-pandemic levels, of those who sought care, the mean A1c, LDL-c and eGFR were comparable across the three time periods.

Disclosure
A.Y.Cheng: Advisory Panel; Abbott, AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Dexcom, Inc., Eli Lilly and Company, HLS Theraoeutics, Insulet Corporation, Janssen Pharmaceuticals, Inc., Medtronic, Novo Nordisk, Sanofi, Board Member; Type 1 Diabetes Think Tank Network, Other Relationship; Diabetes Canada, Speaker's Bureau; Bausch Health, Canada, Merck & Co., Inc. S.B.Harris: Consultant; Abbott, AstraZeneca, Eli Lilly and Company, Novo Nordisk, Sanofi, Other Relationship; Abbott, AstraZeneca, Bayer Inc., Dexcom, Eli Lilly and Company, HLS Therapeutics, Janssen Pharmaceuticals, Inc., Novo Nordisk, Sanofi, Research Support; Applied Therapeutics Inc., AstraZeneca, Canadian Institutes of Health Research, Juvenile Diabetes Research Foundation (JDRF) , Novo Nordisk, Sanofi, The Lawson Foundation. I.E.Krawchenko: Speaker's Bureau; Janssen Pharmaceuticals, Inc. R.Tytus: Other Relationship; Banty , Boehringer Ingelheim International GmbH, Canadian Health Research Company, Merck & Co., Inc., Novo Nordisk, Pfizer Inc. J.Hahn: Employee; Novo Nordisk Canada Inc. A.R.Liu: Employee; Novo Nordisk A/S, Novo Nordisk Canada Inc. Y.Wang: Other Relationship; Novo Nordisk Canada Inc. S.Golden: Other Relationship; Novo Nordisk Canada Inc. R.Goldenberg: Consultant; IQVIA Inc., Speaker's Bureau; Amgen Canada, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk Canada Inc., Sanofi.
1243-P: Who Is Achieving Long-Term Glycemic Control? Ten-Year Trends in 531,995 Indiana Adults
Authors: FU HELEN N. , HANNON TAMARA S. , WEINER MICHAEL , BALIUS PATRICK , WOLFSON JULIAN , SCHLEYER TITUS 
Published: May 2022

Despite advances in therapies, many patients with diabetes worldwide are not meeting glycemic control targets. The objective of this study was to characterize adult patients with T2D in Indiana with respect to glycemic control over a 10-year period. We retrospectively analyzed a cohort of 531,995 patients with T2D and generated summary statistics. The success rate for achieving glycemic control (A1c &lt;7 [&lt;65 y/o] or &lt;8 [&gt;=65 y/o]) was defined as (number of A1c tests meeting target) / (number of A1c tests) . Uncontrolled diabetes was defined as (number of A1c tests &gt;8) / (number of A1c tests) . We summarized 1,868,1year-level A1c observations from 20to 2018 by gender, age, and race. In four years within the 10-year period, rates of glycemic control decreased from 68% to 65% with inconsistent year-to-year change of 0.4-1.8%. The rate of uncontrolled diabetes increased from 19% to 23%. Females were more successful than males (67-71% vs. 62-66%) in achieving control.t4 Patients &gt;=65 y/o had the highest success rate (82-88%) , while 49% to 60% of younger patients were controlled. Whites had higher success (67-70%) and less uncontrolled diabetes (17-22%) than other races.t7 Blacks’ rates of success and uncontrolled diabetes were stable at ∼46%t6 and ∼27%, respectively.t7 Black males 18-44 y/o had the lowest success rate (40-45%) . Long-term rates of achieving glycemic control in adults with T2D in Indiana declined over a 10-year period. However, one third to one half of those aged &gt;=65 y/o achieved a high success rate for glycemic control (&gt;80%) . Achieving longitudinal glycemic control is least successful for male blacks aged 18-44. There is a need for diabetes health service research to study population health interventions tailored by age and race.

Disclosure
H.N.Fu: None. T.S.Hannon: Advisory Panel; Eli Lilly and Company. M.Weiner: Stock/Shareholder; AbbVie Inc., Accuray, Inc., Allscripts Healthcare Solutions, Amgen Inc., Boston Scientific Corporation, Bristol-Myers Squibb Company, Crispr Therapeutics Ag Com, Express Scripts Hdlg Co, General Electric Co., Globus Med, Inc., IBM, Integer Hldgs Corp Com, Integra Lifesciences Holdings Corp, Johnson & Johnson, Mallinckrodt PLC, Mead Johnson & Company, LLC., Medtronic, Metlife Inc Com, Mylan N.V., Novo Nordisk A/S, Nuvasive, Inc., Orthofix Medical Inc., Perspecta Inc Com, Pfizer Inc., Resmed, Inc., Roche Pharmaceuticals, Seaspine Hldgs, Inc., Senseonics, Stryker Corp., Teva Pharmaceutical Industries Ltd., Varex Imaging Corp., Varian Med Sys, Inc., Walgreens Boots Alliance, Inc. P.Balius: None. J.Wolfson: None. T.Schleyer: None.

Funding
T15LM012502, UL1TR002529, the Lilly Endowment