bluuebunny/crossref_metadata_2025_split huggingface dataset:
572-P: Perspectives of People with Diabetes and Caregivers Experiencing Insulin Pump Infusion Set Failure (IPISF) : A Qualitative Study
Authors: BLANCO LUIS E. , VANENGELEN LISANNE M. , GRAY JOHN C. , WILCOX JOHN H. 
Published: May 2022

Aim: IPISF can be a life-threatening complication and remains a serious issue for individuals who utilize automated insulin delivery (AID) systems. This study assessed the emotional burden of IPISF and how infusion failure affects sentiment towards insulin pump use.
Methods: 50 follow-on interviews (10/2020 - 05/2021) were performed with Caregivers (CG) and People with Diabetes (PWD) from the 2020 Diatech Diabetes - T1D Exchange Insulin Pump Infusion Set Failure Management Survey. Participants consented to a 1-hour video call interview covering topics related to insulin pump use and experiences with infusion set failures. Audio recordings were transcribed using Trint Software and qualitative interview data was analyzed using thematic analysis, R, and Python.
Results: 39 PWD and CG were interviewed (PWD age 40.1±20.9 years, CG age 46.2±6.3 years, 72% female, 72% white, 50% household income ≥$100K/year, CSII use for 11.5±8.2 years, 48% use AID, HbA1c 6.9±1.4%, TIR 69.9±18.9%, infusion set wear time 2.9±0.8 days, 62% having ≥1 IPISF/month) . Participants shared quotes on how IPISF is “a direct correlation to my level of happiness...kind of irks me and just makes me angry...because as the caregiver, it's my responsibility to make sure that it goes right” and technology that reduces IPISF and improves detection “would probably be the first step in making me even reconsider going back on the pump.” Identified themes showcase the burden of diagnosing and managing infusion failures when overcoming existing alarm fatigue, trusting care team input, and general stress of CSII therapy.
Conclusions: IPISF’s clinical impact is associated with hyperglycemia and DKA, yet IPISF can also affect the mental health of people who use CSII therapy. CSII users heavily rely on hyperglycemia to detect IPISF and can have issues identifying true IPISF from other confounding factors, thus increasing the risk of CSII therapy and justifying the need for better IPISF detection.

Disclosure
L.E.Blanco: Other Relationship; Diatech Diabetes, Inc. L.M.Vanengelen: None. J.C.Gray: Other Relationship; Diatech Diabetes, Inc. J.H.Wilcox: Other Relationship; Diatech Diabetes, Inc.

Funding
The West Coast Consortium for Technology & Innovation in Pediatrics (Indirect Support Request)
587-P: Discrepancies in Patient Perceptions of Health Care Interactions and Diabetes Empowerment Reveal Potential Impact of Weight Bias in Type 2 Diabetes Care
Authors: STEVENSON JULIA , GOWEN REBECCA , YE EMILY , WOOD RICHARD 
Published: May 2022

Background: Weight bias is associated with adverse health consequences and may be experienced by people with type 2 diabetes (T2D) from multiple sources, including healthcare providers (HCPs) . This study assessed T2D patients’ sentiments surrounding their most recent visit with their HCP and psychosocial self-efficacy related to diabetes management across body mass index (BMI) range.
Methods: In September 2020, 2,975 adults with T2D in the United States completed an online questionnaire, including a series of questions about experiences at their last healthcare visit and the Diabetes Empowerment Scale-Short Form (DES-SF) to assess diabetes-related psychosocial self-efficacy. Health and demographic information were collected. BMI was calculated using patient-reported measures for height and weight.
Results: Respondents with a BMI of 40.0 or higher were more likely to feel blamed by their HCP for having diabetes (9%) compared to those with BMIs of 18.5-24.9 (4%) , 25.0-25.9 (5%) , and 30.0-34.9 (5%) , and more likely to feel as though their provider doubted their ability to manage their diabetes or follow their treatment plan (17%) compared to those with BMIs of 25.0-25.9 (11%) and 30.0-34.9 (12%) . Adults with T2D and a BMI of 35.0 or higher scored significantly lower on the DES-SF than those with BMIs of 18.5-24.9 and 25.0-29.9. Respondents with a BMI ≥40.0 were less likely to agree with the DES-SF subitem that they can ask for support surrounding having and caring for diabetes when they need it (63%) , compared to those with BMIs of 18.5-24.9 (74%) , 25.0-25.9 (68%) , and 30.0-34.9 (69%) .
Conclusions: These findings suggest that T2D patients with higher body mass index scores are more likely to feel stigma when interacting with HCPs, which may negatively impact diabetes empowerment and patient-provider relationships, emphasizing the need for increased focus on weight neutrality in diabetes care.

Disclosure
J.Stevenson: Other Relationship; Abbott Diabetes, Ascensia Diabetes Care, Beta Bionics, Inc., Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, LifeScan, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc. R.Gowen: Other Relationship; Abbott Diabetes, Ascensia Diabetes Care, Beta Bionics, Inc., Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, LifeScan, Medtronic, Roche Diabetes Care, Tandem Diabetes Care, Inc., Virta Health Corp. E.Ye: Employee; dQ&A. R.Wood: Other Relationship; Multiple companies and patient organizations (&gt;10) .
595-P: Creation of a Food Insecurity Risk Score for Adults with Diabetes
Authors: EGEDE LEONARD E. , WALKER REBEKAH J. 
Published: May 2022

Current measurement of food insecurity in the US has largely focused the USDA scales. However, these scales do not capture multidimensional risk associated with food insecurity, account for stigma associated with being considered food insecure, or adequately capture the idea of nutrition security which is particularly important for individuals with diabetes. We aimed to create a more comprehensive set of questions allowing identification of an individual as being food insecure without reliance on questions only focused on food quantity and cost. We used data collected from 614 adults with type 2 diabetes recruited for a cross-sectional study on social determinants of health in Milwaukee, Wisconsin. The mean age of the sample was 55 years with mean duration of diabetes diagnosis of 9 years. The 6-item USDA food insecurity scale was used as the outcome with a variety of questions capturing social risk used to create a risk score for food insecurity. A series of questions were tested with the final risk score ranging from 0-7 based on questions including: 1) income less than $25,000, 2) going without food, clothing, or housing due to needing funds for medical care, 3) being worried or stressed about paying rent or mortgage, 4) being worried or stressed about money to buy nutritious meals, 5) not seeing a doctor due to cost, 6) not filling prescriptions due to cost, and 7) neighborhood being unsafe due to crime. In the full sample of adults with diabetes, those indicating 2 risks were 3.5 times more likely to be food insecure, those indicating 3 risks were 10.8 times more likely to be food insecure, and those indicating 4+ items were 54.2 times more likely to be food insecure. Use of this tool can identify food insecure adults in a way that captures food and nutrition security while being inclusive of individuals who may feel stigma associated with food insecurity. In addition, it can identify levels of risk capturing multiple facets of the underlying issue of poverty to screen more comprehensively.

Disclosure
L.E.Egede: None. R.J.Walker: 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)
597-P: Diabetes Stigma, Sociodemographics, and Psychosocial Outcomes in Adolescents and Young Adults: The SEARCH for Diabetes in Youth Study
Authors: EITEL KELSEY B. , ROBERTS ALISSA J. , DAGOSTINO RALPH , BELL RONNY A. , BELLATORRE ANNA , BARRETT CATHERINE E. , CRISTELLO ANGELICA , DABELEA DANA , DOLAN LAWRENCE M. , JENSEN ELIZABETH T. , LIESE ANGELA D. , MARCOVINA SANTICA M. , MAYER-DAVIS ELIZABETH J. , REYNOLDS KRISTI , PIHOKER CATHERINE 
Published: May 2022

We examined the association between diabetes stigma, sociodemographic and psychosocial variables in AYAs with type 1 (T1D) and type 2 diabetes (T2D) in the SEARCH for Diabetes in Youth study, 2016-2019. A 5-question survey assessed frequency of perceived stigma experience, from which we created a total stigma score. We used multivariable modeling to examine these associations adjusting for sex, race/ethnicity, age, clinic site, diabetes duration, education level, health insurance type, treatment regimen, and HbA1c levels. Analyses were stratified by diabetes type. Of the 1,6AYAs who completed the stigma survey, 78% had T1D, 56% were female, and 48% were non-Hispanic White. Mean (SD) age at study visit was 21.7 (5.1) years (range - 24.9 years) . Mean (SD) HbA1c level was 9.2% (2.3) . Participants with T1D with lower household income had higher stigma scores compared to those with higher household income (p=0.03) . Among AYAs with T1D or T2D, higher stigma score was associated with food insecurity (p&lt; 0.01) , disordered eating behaviors (p &lt; 0.01) , depressive symptoms (p &lt; 0.01) , and decreased AYA (p&lt;0.01) and diabetes quality of life (p &lt; 0.01) scores. Diabetes stigma is associated with food insecurity and decreased psychosocial functioning and therefore is important to address in providing comprehensive diabetes care.

Disclosure
K.B.Eitel: None. E.T.Jensen: Consultant; Regeneron Pharmaceuticals Inc. A.D.Liese: None. S.M.Marcovina: None. E.J.Mayer-davis: None. K.Reynolds: Research Support; Amgen Inc., Merck & Co., Inc., Novartis Pharmaceuticals Corporation. C.Pihoker: None. A.J.Roberts: None. R.Dagostino: Consultant; Aetion, Inc., AstraZeneca, Biogen, Bristol-Myers Squibb Company, Daiichi Sankyo, Merck & Co., Inc. R.A.Bell: None. A.Bellatorre: None. C.E.Barrett: None. A.Cristello: None. D.Dabelea: None. L.M.Dolan: None.

Funding
The SEARCH for Diabetes in Youth Cohort Study (1R01DK127208-01, 1UC4DK108173) is funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases and supported by the Centers for Disease Control and Prevention.
6-OR: Vascular Endothelial ROCK2 Deficiency Promotes Browning and Burning of White Adipose Tissue
Authors: TAKEDA YUSUKE , MATOBA KEIICHIRO , UKICHI RIKAKO , SEKIGUCHI KENSUKE , NAGAI YOSUKE , KANAZAWA YASUSHI , UTSUNOMIYA KAZUNORI , NISHIMURA RIMEI 
Published: May 2022

The accumulation of visceral fat is associated with multiple coronary risk factors such as glucose intolerance, dyslipidemia, and hypertension. We have previously demonstrated that Rho/Rho-associated protein kinase (ROCK) signaling is activated in animal models of diabetes and is involved in the pathogenesis of vascular complications. Specifically, ROCK is implicated in the molecular basis of inflammation- and ischemia-induced tissue damage through the actions on NF-κB dynamics. These findings support the hypothesis that ROCK signaling could be one of the important therapeutic targets for preventing cardiorenal events. However, isoform-specific roles of ROCKs have not been clarified yet. In this study, we aimed to determine the tissue-intrinsic roles of ROCK2 in the setting of obesity. To this end, we generated vascular endothelium-specific ROCK2 knockout mice (ER2KO) by crossing ROCK2 floxed mice with VE-Cadherin-Cre mice. ER2KO mice were fertile and had the same lifespan as wild type mice. Notably, ER2KO gained weight at a slower rate than wild type mice under high-fat diet feeding. Fat composition, as assessed by magnetic resonance imaging, was significantly lower in ER2KO, even though ER2KO displayed increased food intake. The gene expression analysis revealed increased expression of PPARα, a browning-inducing factor, and its downstream components, CIDEA, IL-4, and IL-10, in white adipose tissue obtained from ER2KO mice. ER2KO mice also showed an elevation in body temperature after fasting, suggesting that endothelial ROCK2 may negatively regulate fat browning.
In summary, vascular endothelial ROCK2 negatively regulates fat accumulation through the mechanism of browning inhibition.

Disclosure
Y. Takeda: None. K. Matoba: None. R. Ukichi: None. Y. Nagai: None. Y. Kanazawa: None. K. Utsunomiya: None. R. Nishimura: Speaker's Bureau; Abbott Diabetes, Astellas Pharma Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Merck & Co., Inc., Novo Nordisk, Ono Pharmaceutical Co., Ltd., Sanofi, Taisho Pharmaceutical Holdings Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited, Terumo Corporation.

Funding
a Grant-in-Aid for Scientific Research from Japan Society for the Promotion of Science, the MSD Life Science Foundation, the Takeda Science Foundation, the Suzuken Memorial Foundation, Sanofi KK, Tanabe Pharma, and Takeda Pharmaceutical., Kazunori Utsunomiya has received research support from Terumo, Novo Nordisk Pharma, Taisho Pharmaceutical, Böehringer Ingelheim, Kyowa Hakko Kirin, Sumitomo Dainippon Pharma, and OPharmaceutical as, Rimei Nishimura has received speaker honoraria from Astellas Pharma, Nippon Boehringer Ingelheim, Eli Lilly Japan KK, Kissei Pharmaceutical, Medtronic Japan, MSD, Novartis Pharma KK, Novo Nordisk Phar.
60-OR: High Prevalence of Multiorgan Steatosis and Fibroinflammation, Identified by Multiparametric Magnetic Resonance Imaging, in People with Type 2 Diabetes
Authors: EICHERT NICOLE , GIBBONS KARYNA , HAMID AZLINDA , RAMKHELAWON RAJESHWAR , WOOLGAR VIRGINIA E. , SURIANO ROBERT , THOMAIDES-BREARS HELENA B. , BANERJEE RAJARSHI , KEMP GRAHAM , ALI SARAH , THANABALASINGHAM GAYA , CUTHBERTSON DANIEL 
Published: May 2022

Type 2 diabetes (T2D) is a multi-system disease characterised by a high prevalence of co-morbidities and micro- and macro-vascular complications. The aim of this study was to provide --comprehensive assessment of multi-organ health and pre-clinical detection of diabetes-related organ damage with a single, non-contrast MRI scan. We recruited 138 adults with T2D (median 62 yrs, 60 % male; BMI 31 kg/m2, 92 % on metformin [NCT04114682]) . MRI data were acquired to derive organ-specific measures of size, fat deposition, fibroinflammation, body composition and aortic distensibility (CoverScan®, Perspectum Ltd.) . Reference values of MRI metrics were based on 92 healthy volunteers and published literature. Statistical significance of co-prevalence was assessed by simulation assuming that values were independently binomially distributed. There was a high prevalence of abnormality in individual organs (Figure, left) . Prevalence of low skeletal muscle index and elevated pancreatic fat were associated with T2D duration. There was further evidence of co-prevalence of organ abnormalities (Figure right; 86 % with at least 2 organs affected) . Aortic stiffness was frequently associated with organ steatosis. MRI assessment can enrich the current blunt assessment of multi-organ abnormalities in T2D to inform earlier intervention and treatments.

Disclosure
N.Eichert: Employee; Perspectum Ltd. S.Ali: Other Relationship; NICE committee for diabetes. G.Thanabalasingham: Speaker's Bureau; Boehringer Ingelheim International GmbH. D.Cuthbertson: Other Relationship; AstraZeneca, Novo Nordisk. K.Gibbons: None. A.Hamid: None. R.Ramkhelawon: Other Relationship; NICE committee. V.E.Woolgar: None. R.Suriano: None. H.B.Thomaides-brears: Employee; Perspectum Ltd, Stock/Shareholder; Perspectum Ltd. R.Banerjee: Employee; Perspectum Ltd., Other Relationship; Perspectum Ltd., Stock/Shareholder; Perspectum Ltd. G.Kemp: None.

Funding
Innovate UK (Digital Health Technology Catalyst scheme) ; Perspectum Ltd.
613-P: Rural Caregiver Perceptions of an Occupation-Based Coaching Telehealth Intervention to Improve Child Diabetes Management and Quality of Life
Authors: JEWELL VANESSA D. , FUNK KATIE J. , CURRIE ALEXIS , SHIN JULIA , KNEZEVICH EMILY , VALDEZ ANDREA D. , BUNSNESS MAGGIE 
Published: May 2022

Caregiver diabetes training and psychosocial support after a child’s type 1 diabetes diagnosis is critical for successful diabetes management and family quality of life. Disruption to family routines and increased stress are frequently reported after a child’s type 1 diabetes diagnosis. However, limited services exist that blend both caregiver medical training and psychosocial support. After the implementation of a 12-week, novel occupational therapy coaching telehealth intervention designed to promote rural caregiver independence with their child’s type 1 diabetes management and improve caregiver psychosocial well-being, we interviewed rural caregivers to explore their perceived quality of life. Utilizing a phenomenological design, 8 caregivers completed a semi-structured interview. Zoom interviews were recorded, transcribed verbatim, and coded using a phenomenological analysis. Caregiver ages ranged from 34-50 years, 86% were married, and all held a minimum of an associate degree. Their children were diagnosed with type 1 diabetes at 12 months to 9 years and time since diagnosis ranged from months to 8.5 years. Three distinct themes emerged related to caregivers’ experiences after diagnosis: occupational deprivation and decreased well-being; longing for connection with social supports; and desire for knowledgeable, relatable, and accessible providers. Two themes emerged related to after receipt of the telehealth coaching intervention: satisfaction with diabetes management and psychosocial support and hope for childhood normalcy. Overall, the caregivers reported satisfaction with the intervention as it provided validation of their lived experience of raising a child with diabetes in a rural community. The caregivers also reported a sense of hope that their children can successfully participate in important everyday activities, which ultimately improved the caregivers’ quality of life.

Disclosure
V.D.Jewell: Research Support; Dexcom, Inc. K.J.Funk: None. A.Currie: None. J.Shin: Research Support; Dexcom, Inc. E.Knezevich: Research Support; Dexcom, Inc. A.D.Valdez: None. M.Bunsness: None.

Funding
Creighton University Health Science Strategic Faculty Investment Fund
617-P: Ten Years of the National Diabetes Prevention Program: Organizational Strategies to Adjust Program Delivery due to the COVID-Pandemic
Authors: BELL MIRIAM , ELY ELIZABETH 
Published: May 2022

The National Diabetes Prevention Program (National DPP) is a nationwide delivery system for a lifestyle change program (LCP) proven to prevent or delay onset of type 2 diabetes. As a result of the COVID-public health emergency (PHE) declared in March 2020, in April 2021, the National DPP distributed a brief survey to approximately 2,000 CDC-recognized organizations to assess how they adjusted program delivery, including actions and strategies taken to navigate delivery during the PHE. 412 responses were received between April and June 2021. 148 paused delivery and 62 remained paused at the time of response. Of those that paused, 1 (74%) reported applying strategies such as phone calls, emails, and texts to keep in contact with participants. Of these, 64% reported they had resumed or restarted their cohorts at the time of response. When asked what influenced the decision to pause cohorts, 63% of organizations that normally deliver in-person, paused due to participant hesitancy toward use of or lack of access to technology. Of the 360 organizations that normally use in-person delivery, 260 reported switching to virtual delivery during the PHE. Of these, more than half reported difficulties in making that transition, mainly due to participant hesitancy to use or lack of access to technology. When asked if any support was provided to participants outside the scope of the LCP, 61% responded no. Of the 39% that did provide support, 84% of responding organizations indicated providing COVID-related support to participants; these were mainly organizations classified as Hospitals/Healthcare Systems/Medical Groups/Physician Practices. Many CDC-recognized organizations may have paused delivery at some point during the PHE, but based on these survey results, plans for future delivery remains strong. With the help of technology and strategies employed, 225 of the 412 organizations that responded indicated they would be starting new cohorts during the PHE.

Disclosure
M.Bell: n/a. E.Ely: None.
621-P: Disrupted Sleep in a Diverse Sample of Young Adults with Type 1 Diabetes (T1D)
Authors: CARREON SAMANTHA A. , MINARD CHARLES G. , DESAI KISHAN R. , LEVY WENDY , LYONS SARAH , DURAN BRENDA , STREISAND RANDI , TANG TRICIA S. , MCKAY SIRIPOOM , ANDERSON BARBARA , DEVARAJ SRIDEVI , BUTLER ASHLEY , HILLIARD MARISA E. 
Published: May 2022

Introduction: T1D management, age-related stressors and the COVID-pandemic may impair sleep for young adults with T1D. Disparities in A1c and exposure to life stressors may contribute to poorer sleep among people from minoritized racial/ethnic groups. We aimed to describe sleep, correlations with A1c, and sleep patterns across racial/ethnic groups in young adults with T1D during the pandemic.
Methods: Young adults with T1D (n=37, M age=20.2±1.6 yrs, 57% female, M A1c=8.9±2.4%) completed an adapted Pittsburgh Sleep Quality Index and 1 sleep-related question from a COVID-questionnaire at baseline of a behavioral trial.
Results Overall, 41% endorsed worse sleep during the pandemic, which was correlated with poorer sleep quality (r=-.69, p&lt;.001) and shorter sleep duration (r=-.35, p=.04) . Higher A1c was linked with less frequent T1D management-related sleep disruptions (r=-.44, p=.007) . There were no significant differences in sleep variables among racial/ethnic groups. See Table for sleep descriptions for each racial/ethnic group.
Conclusions: Young adults with T1D experienced disrupted sleep, worsened by the pandemic. Clinicians should counsel patients about optimizing sleep and overnight diabetes management, especially those with higher A1c. While small sizes reduced power to detect group differences, initial patterns suggest a need for future research examining disparities in sleep for young adults with T1D.

Disclosure
S.A.Carreon: None. B.Anderson: None. S.Devaraj: None. A.Butler: None. M.E.Hilliard: None. C.G.Minard: None. K.R.Desai: None. W.Levy: None. S.Lyons: None. B.Duran: None. R.Streisand: None. T.S.Tang: None. S.Mckay: None.

Funding
NIDDK RDK119246 (PI Hilliard) ; NIH/NIDDK Research Supplement to Promote Diversity in Health-Related Research (3R01DK119246-03S1, PI: Hilliard, Mentee: Carreon)