bluuebunny/crossref_metadata_2025_split huggingface dataset:
1235-P: A Prospective Characterization of Metabolic and Metabolomic Profiles of COVID-19–Associated New-Onset Diabetes Patients Presenting with DKA from India
Authors: DASGUPTA RIDDHI , MONDAL S , GARAI R , CHOWDHURY B , HAZRA A , LODH M , GANGULY A 
Published: May 2022

Background: Recent evidence suggests a bidirectional relationship between COVID-infection and new-onset diabetes (NOD) presenting with DKA.
Methodology: This one-year prospective study comprised of 29 COVID-negative DKA (controls) and 52 COVID-positive-DKA patients (18 NOD, 15 T1DM ,T2DM) . NOD were previously normoglycemic and negative for GAD/IA-2/ZnT8 autoantibodies. After 75g- OGTT with estimation of glucose, C-peptide, FFA and insulin at 0,15, 30,45, 60,90 ,120, 150 and 180minutes, Insulin secretion rate (ISR) [C-peptide-deconvolution] , Hepatic insulin sensitivity [AUC-glucose × AUC-insulin during first 30-minutes of OGTT ], Peripheral insulin sensitivity [ dG/dt ÷ mean plasma insulin concentration; dG/dt rate of decline in plasma glucose concentration]were calculated alongwith Metabolomics and Adipose tissue gene expression. All tests were performed at admission and 4, 8, and 12-months of followup.
Results: At baseline, ISR in NOD was significantly reduced than controls (p=0.001) but similar to T1DM (p=0.15) . Nearly 83% (n=17) of NOD with DKA had near-complete recovery of ISR on follow-up compared to T1DM (all p&lt;0.01) ,with non-remitters (n=3) having significantly worse admission Hba1c and IL-6 (all p&lt;0.01) . NOD had significantly increased hepatic and peripheral insulin resistance compared to T1DM (all p&lt;0.05) ,but similar to T2DM (all p&gt;0.05) . Their Metabolomics revealed increased inflammatory phosphatidylcholines, that correlated with peripheral glucose uptake (p&lt;0.01) ,while RNA sequencing showed significantly enhanced WNT5A , TLR4 (Toll-like Receptor-4) and RETN (resistin) than T1DM and T2DM (both p=0.001) .
Conclusion: Our study provides novel insights into COVID-associated NOD with DKA. Majority have near-complete recovery of insulin secretion while simultaneous multi-tissue insulin resistance and inflammatory adipose tissue profiles persist as drivers of hyperglycemia .

Disclosure
R.Dasgupta: None. S.Mondal: None. R.Garai: None. B.Chowdhury: None. A.Hazra: None. M.Lodh: None. A.Ganguly: None.
1249-P: How Can Serum Adiponectin Levels Be Evaluated in Clinical Settings?
Authors: ONO SHOMA , DAIMON MAKOTO , KAMBA AYA , MIZUSHIRI SATORU , MURABAYASHI MASAYA , NISHIYA YUKI , ITO RYOMA , TAMURA AYUMI 
Published: May 2022

Objective: Adiponectin, an adipocytokine, effects on various metabolic process including glucose regulation, and its decreased levels in serum have been reported as a risk for incident diabetes (DM) . However, cross-sectional studies often reported serum adiponectin levels (Ap) as increased in DM. We hypothesized that such inconsistency can be explained as abnormalities other than DM per se resided in the study subjects to be responsible for the increased Ap. Therefore, we here examined the effects of various conditions such as age, hypertension, dyslipidemia, and factors representing microangiopathies on association between DM and Ap in a general population.
Research Design and Methods: Among 1816 participants of the population-based Iwaki study of Japanese held in 2014-2017, 1771 subjects with complete data set including Ap were included, and the association between Ap and the above factors was analyzed by regression analysis and ANOVA with multiple factors adjustment.
Results: Ap showed positive correlation (p &lt; 0.each) with age, HDL-cholesterol, and urinary albumin excretion (uACR) , and negative correlation (p &lt; 0.each) with neutral fat, BMI, HbA1c, and waist circumference. As a whole, DM group had lower Ap than non-DM group (p &lt; 0.01) . However, when the subjects were stratified based on uACR (&lt;30 (normal) and &gt;30 mg/gCr) , DM group had significantly lower Ap than non-DM group (p&lt;0.01) in the normal group, but not in the other group (p=0.55) , indicated that increased uACR may be responsible for the increase in Ap in DM.
Conclusion: We here showed uACR, an indicator of microangiopathy, as a factor linking such inconsistency. Namely, although Ap is decreased in subjects prone to be diabetic and, thus, patients with DM should have lower Ap accordingly, patients with DM may have increased Ap depending on status of their complication such as microangiopathy. To strengthen this hypothesis, we now conducting analyses with stratification based on various other conditions and, longitudinal analyses as well.

Disclosure
S.Ono: None. M.Daimon: None. A.Kamba: None. S.Mizushiri: None. M.Murabayashi: None. Y.Nishiya: None. R.Ito: None. A.Tamura: None.
125-LB: Individualized Cost-Effectiveness Assessment of Sodium–Glucose Cotransporter 2 Inhibitors (SGLT2i) vs. Sulfonylureas as Add-On Therapy in People with Inadequately Controlled Type 2 Diabetes (T2D) Under Metformin Monotherapy
Authors: GUAN DAWEI , NIU SHU , FONSECA VIVIAN , SHI LIZHENG , LAITEERAPONG NEDA , GUO JINGCHUAN , SHAO HUI 
Published: May 2022

The cost-effectiveness of SGLT2i can be modulated by patients’ characteristics, such as cardiovascular risks. We performed an individualized cost-effectiveness assessment of SGLT2i when added to metformin in people with inadequately controlled T2D to quantify the modulating effect of patients’ characteristics on the cost-effectiveness of SGLT2i. We identified survey participants with T2D receiving metformin monotherapy who had an A1c level above 7.0% from the National Health and Nutrition Examination Survey (2013-2018) . We applied a simulation-based smoothing method to populate the survey sample to its represented national population. We used the BRAVO diabetes model to simulate the lifetime cost and QALYs associated with SGLT2i or sulfonylureas. Treatment escalations were governed by the A1c level at 7% and 8% consequentially. Both costs and QALYs were discounted at 3% annually, and the incremental cost-effectiveness ratio (ICER) threshold was set at $100,000/QALYs. The study sample included 2.89 million individuals. Compared with sulfonylureas, the use of SGLT2i was associated with an average of $9,400 higher medical cost and 0.10 additional QALY, leading to an ICER of $94,000/QALY in the overall population. SGLT2i was cost-effective in people with a history of heart failure (ICER: $67,000/QALY) and myocardial infarction (ICER: $94,000/QALY) , and marginally cost-effective in stroke patients (ICER: $100,000/QALY) . Among individuals without CVD, SGLT2i was cost-effective only in subgroups with HbA1c &gt; 7.5%, age &gt; 60, and diabetes duration &gt; 10 years. Overall, SGLT2i was only cost-effective in individuals with a baseline 10-year CVD risk over 16%, constituting 51.6% of the overall population. Our results align closely with the ADA guideline on the recommended population for SGLT2i use. Out-of-pocket payment subsidy or cost-sharing reduction of SGLT2i should be prioritized in patient subgroups in which SGLT2i has high economic values.

Disclosure
D. Guan: None. S. Niu: None. V. Fonseca: Consultant; Abbott, Asahi Kasei Corporation, Bayer AG, Novo Nordisk, Sanofi, Research Support; Fractyl Health, Inc., Jaguar Gene Therapy, Stock/Shareholder; Abbott, Amgen Inc., BRAVO4Health, Mellitus Health. L. Shi: None. N. Laiteerapong: None. J. Guo: None. H. Shao: Board Member; BRAVO4HEALTH, LLC.
1256-P: Lower Diabetes Technology Adoption and Worse Glycemic Control in Minorities with Type 1 Diabetes
Authors: CONWAY BAQIYYAH , SHAH VIRAL , RASMUSSEN CRISTY GENO , GONZALEZ ANDREA GERARD , SNELL-BERGEON JANET K. 
Published: May 2022

Introduction: Poorer outcomes in acute and late complications of type 1 diabetes (T1D) persist among racial/ethnic minorities, and technology adoption may be lower in these groups. Technologies such as continuous glucose monitors (CGM) and insulin pumps (CSII) enhance diabetes management and improve glycemic control. We examined differences in use of diabetes technology by race/ethnicity among patients 12 and older followed at the Barbara Davis Center who had T1D for at least 1 year.
Methods: Use of CGM and/or CSII vs. neither was examined in 5,539 patients by racial/ethnic groups: Non-Hispanic White (NHW, n=3,945) , Black (n=161) , Hispanic (n=719) and Other racial groups (OR, n=714) . General liner models compared HbA1c and technology use by race/ethnicity.
Results: Black, Hispanic and OR patients were younger, had shorter T1D duration, higher HbA1c and less use of technology. In linear models adjusted for age, diabetes duration and visits over the past year, use of technology was associated with lower HbA1c in each race/ethnic group. However, among technology users, minority patients had higher HbA1c compared to NHW patients.
Conclusion: HbA1c was highest and diabetes technology use lowest among Blacks and Hispanics. Efforts to increase technology use for diabetes management in these populations may result in greater glycemic control and ultimately the reduction of acute and late complications of diabetes.

Disclosure
B.Conway: None. V.Shah: Advisory Panel; Medscape, Sanofi, Consultant; Dexcom, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk. C.Geno rasmussen: None. A.Gerard gonzalez: n/a. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc.

Funding
NIH grant P30-DK116073
1264-P: Racial and Ethnic Inequities in Use of Diabetes Technology among Medicare Advantage Beneficiaries with Type 1 Diabetes
Authors: KOMMAREDDI MALLIKA , WHERRY KAEL , VIGERSKY ROBERT A. 
Published: May 2022

Objective: Recent research highlighted racial and ethnic inequities in the use of diabetes technology among Medicare Fee-For-Service beneficiaries with type 1 diabetes. This study considers inequities among Medicare Advantage beneficiaries.
Methods: We assessed use of continuous glucose monitoring (CGM) and insulin pump technologies among beneficiaries with type 1 diabetes using a national database of health care claims between 2018 and 2020. The prevalence of CGM, pump, and combined technology was assessed annually (N = 17231 in 2018; N = 16298 in 2019; N = 15877 in 2020) by race and ethnicity. Within each year and type of technology, chi-square tests assessed differences in use between racial and ethnic groups.
Results: Prevalence of diabetes technology increased within each racial and ethnic group over the study period. There were significant differences in technology use between groups by year (p &lt; 0.001) . In 2020, 37.1% of White beneficiaries used CGM devices, compared to 27.8% of Asian, 25.8% of Black, and 21.0% of Hispanic beneficiaries. The absolute difference in CGM use between White beneficiaries and those in other groups was stable or increased from 2018 to 2020. Similar trends were observed in pump use alone or with CGM.
Conclusion: While prevalence of diabetes technology increased across all racial and ethnic groups from 2018 to 2020, racial and ethnic inequities have persisted.

Disclosure
M.Kommareddi: Employee; Medtronic. K.Wherry: Employee; Medtronic. R.A.Vigersky: Employee; Medtronic.
1269-P: The Type 1 Diabetes Knowledge Portal: An Open-Access Resource for Insights into the Genetic and Genomic Basis of Type 1 Diabetes
Authors: COSTANZO MARIA C. , KUDTARKAR PARUL V. , NAYAK UMA , ONENGUT-GUMUSCU SUNA , SUN YING , RICH STEPHEN S. , FLANNICK JASON , GAULTON KYLE J. , BURTT NOËL 
Published: May 2022

Type 1 diabetes (T1D) is a complex disease and more than 100 genetic loci influencing T1D risk have been identified to date. Discovering the genes and biological mechanisms through which these variants impact T1D requires the integration of multiple data types. We have created the T1D Knowledge Portal (T1DKP; type1diabetesgenetics.org) to help researchers utilize genetic and functional genomic data to generate hypotheses about the genes involved in T1D and its complications. The T1DKP aggregates genetic association data from the T1D community along with relevant functional genomics (e.g., accessible chromatin, 3D conformation, gene expression, gene perturbation) data, which are loaded via a sister resource, the Common Metabolic Diseases Genome Atlas (cmdga.org) . Using the HuGeAMP software platform developed for the Common Metabolic Diseases Knowledge Portal (CMDKP; cmdkp.org) within the Accelerating Medicines Partnership for Common Metabolic Diseases, the T1DKP integrates data by applying bioinformatic methods such as meta-analysis of genetic association results to generate “bottom-line” p-values, enrichment of genetic association within tissue-specific genomic annotations, and more. Interactive visualizations allow the user to explore results and to perform custom, on-the-fly analyses. The T1DKP also includes expert-curated lists of predicted effector genes of T1D loci, displaying the supporting evidence behind each prediction. Since the T1DKP is nested within and built upon the same framework as the CMDKP, users may navigate seamlessly to see results relevant to other metabolic disorders. In total the T1DKP project aims to accelerate our understanding and treatment of T1D by providing decision support for researchers as they prioritize loci, variants, and genes for experimental study.

Disclosure
M.C.Costanzo: Other Relationship; Pfizer Inc. P.V.Kudtarkar: None. U.Nayak: None. S.Onengut-gumuscu: None. Y.Sun: None. S.S.Rich: None. J.Flannick: None. K.J.Gaulton: Consultant; Genentech, Inc., Stock/Shareholder; Neurocrine Biosciences, Inc., Vertex Pharmaceuticals Incorporated. N.Burtt: n/a.

Funding
National Institutes of Health (5UM1DK105554-07)
127-LB: Real-World A1C Changes and Prescribing Provider Types among T2DM Patients Initiating Treatment with Oral Semaglutide
Authors: FRAZER MONICA S. , SWIFT CAROLINE , LESZKO MICHAEL , SARGENT ANDREW , BUYSMAN ERIN , ALVAREZ SARA B. , NOONE JOSHUA , GUEVARRA MICO 
Published: May 2022

Purpose: To describe A1c changes and characteristics of patients with type 2 diabetes mellitus (T2DM) initiating oral semaglutide (sema) , by baseline A1c ≥9% and &lt;9%.
Methods: Retrospective analysis using medical and pharmacy claims data from 11/01/2018-12/31/2020 from commercial and Medicare Advantage with Part D enrollees, aged 18+. Patients had ≥1 claim for oral sema (first claim=index date) , ≥1 T2DM diagnosis, continuous enrollment for 12 months before and including index (baseline) , and 6 months post-index (follow-up) , pregnant females excluded. Results were stratified by patient’s last baseline A1c (&lt; or ≥9%) .
Results: Patients initiating oral sema who had ≥1 baseline A1c (n=994) had a mean age of 59 years, 50.4% were male, and 63.1% had commercial coverage. Among patients with baseline and follow-up A1c values (n=652) , mean A1c change was -0.8% (1.49) . Among a subset with ≥90 days of continuous oral sema treatment and ≥1 A1c after ≥90 days of treatment (n=200) , the A1c ≥9% group had a mean A1c change of -2.7% (2.1) . While half of index treatments were prescribed by primary care and internal medicine providers (50.6% overall) , a higher percentage of patients with A1c &lt;9% had oral sema prescribed by an endocrinologist (24.4% vs. 16.1%; p=0.006) .
Conclusions: Results suggest that oral sema is an effective T2DM treatment in the real-world, especially among patients with A1c values ≥9% prior to treatment initiation. Patients with T2DM in this population are more often prescribed oral sema by primary care physicians than endocrinologists.

Disclosure
M. S. Frazer: None. C. Swift: Employee; Novo Nordisk. M. Leszko: None. A. Sargent: None. E. Buysman: None. S. B. Alvarez: Employee; Novo Nordisk, UnitedHealth Group. J. Noone: Employee; Novo Nordisk. M. Guevarra: None.
1271-P: The Gut Microbiota Related Genetic Variant at ABO Locus, Circulating Metabolome, and Type 2 Diabetes Risk: Prospective Study in UK Biobank
Authors: TANG RUI , WANG XUAN , MA HAO , LI XIANG , HEIANZA YORIKO , QI LU 
Published: May 2022

Background: Gut microbiota has been implicated in the development of type 2 diabetes (T2D) . A recent genome-metagenome-wide study identified that genetic variants at the ABO locus (SNPs rs3758348, rs8176632, rs602662, and rs601338) were associated with the abundance of the gut microbiome. This study aimed to investigate whether the gut microbiota-related genetic variants at the ABO locus were associated with T2D and blood metabolome. We also analyzed the associations of the gut microbiota-related Metabolomic Risk Score (MRS) with incident T2D.
Methods: A total of 456,274 participants who are free of T2D at baseline and have available data on genetic variants from the UK Biobank population were included in this study. Plasma metabolome was profiled by a high-throughput NMR-based metabolic biomarker profiling platform among 109,0 participants. The MRS score was constructed with genetic variant-associated metabolites.
Results: We observed that the gut microbiota-related variant rs3758348 was significantly associated with T2D in the fully adjusted model (hazard ratio [HR] per copy of the C allele 1.06; [95% CI, 1.02-1.10]; P=0.0012 for trend) . We found that a total of 91 metabolites were significantly associated with rs3758348 (false discovery rate &lt; 0.05) . Using elastic net regularized regressions, we generated a weighted MRS applying the 91 metabolites to predict the incidence risk of T2D. In multivariable Cox regressions, the weighted MRS showed a significant association with T2D incidence after adjusting for age, sex, BMI, alcohol status, smoking status, physical activity, and diet quality score (HR=1.49 [95% CI, 1.41-1.59], P&lt;0.0001) .
Conclusion: Our study indicates that the gut microbiota-related genetic variant and metabolomic profile significantly predict T2D risk, independent of traditional risk factors.

Disclosure
R.Tang: None. X.Wang: None. H.Ma: None. X.Li: None. Y.Heianza: None. L.Qi: None.

Funding
National Heart, Lung, and Blood Institute (HL071981, HL034594, HL126024) , the National Institute of Diabetes and Digestive and Kidney Diseases (DK115679, DK091718, DK100383) , the Fogarty International Center (TW010790) , and Tulane Research Centers of Excellence Awards.
1283-P: Paired Box 4 R192H (rs2233580) Variant Associated with Type 2 Diabetes Influenced the Response to the Treatment with Hypoglycemic Agents
Authors: TEERAWATTANAPONG NIPAPORN , TANGJITTIPOKIN WATIP , SRISAWAT LANRAPHAT , NARKDONTRI TASSANEE , YENCHITSOMANUS PA-THAI , PLENGVIDHYA NATTACHET 
Published: May 2022

Paired Box 4 (PAX4) variants increase the risk of type 2 diabetes (T2D) and influence response to the treatment with hypoglycemic agents (HAs) in certain Asian populations. However, the influence of PAX4 variants associated with T2D on response to the treatment with different HAs and their combinations is unclear. This study aims to investigate the effects of the PAX4 R192H (rs2233580) variant associated with T2D on the therapeutic efficacy of antidiabetic medications in Thai T2D after following up for 3 years. A total of 526 patients who were followed up at the Diabetic Clinic of Siriraj Hospital during 2016 - 20 were enrolled. The rs2233580 variant was genotyped by rhAmp analysis and assessed the associations between genotypes and glycemic control by treatment with different HAs combinations by Generalized Estimating Equations (GEE) analysis. The average age at diabetes diagnosis of the patients was 54.9±9.59 years and the average diabetes duration was 9.7±6.55 years. The patients who carried GA+AA genotypes and were treated with a combination of sulfonylurea (SU) , biguanide (Bi) , thiazolidinediones (TZD) , and insulin (Ins) had lower fasting plasma glucose (FPG) compared with that of the patients who carried GG genotype (p=0.02) but FPG levels were significantly higher in the patients who received SU monotherapy (p=0.04) . Lower HbA1c was observed in the patients who carried GA+AA genotype and SU-Bi-Ins treatment compared with that of the patients who carried wildtype (p=0.002) . A treatment of Bi-TZD-Ins yielded higher HbA1c levels in the patients who carried GA+AA genotype compared with that of the patients who carried GG genotype (p&lt;0.001) . Therefore, different genotypes might distinctively impact therapeutic effect of HA combinations on FPG and HbA1c. Taken together, genotypes of the PAX4 R192H (rs2233580) variant associated with T2D influence the response to HA combinations, providing evidence of pharmacogenetics in diabetes treatment.

Disclosure
N.Teerawattanapong: None. W.Tangjittipokin: None. L.Srisawat: None. T.Narkdontri: None. P.Yenchitsomanus: None. N.Plengvidhya: None.
1289-P: Role of Metformin and Lifestyle Modification in Management of Latent Autoimmune Diabetes in Adults
Authors: VELAYATI SARA , SHANIK MICHAEL , ROMAO ISABELA J. 
Published: May 2022

Introduction: Latent autoimmune diabetes in adults (LADA) is atypical heterogenic diabetes that is frequently misdiagnosed as type 2 diabetes (T2DM) . LADA can demonstrate features of type 1 or T2DM.1 The diagnosis of LADA is well established, however, there are no universally accepted treatment guidelines. Few studies report the impact of metformin on long-term management in LADA. Most LADA cases will ultimately require insulin treatment.2 This case highlights the importance of early diagnosis of LADA and the potential benefit of using metformin with lifestyle changes to help maintain glycemic control.
Case presentation: A 27-year-old man with no past medical history presented with unintentional weight loss (30 lbs.) , frequent urination, blurry vision and dry mouth for 3 months. Physical exam was unremarkable, body mass index (BMI) : 24.5. Blood sugar: 381 mg/dL, HbA1c: 14% and C peptide: 0.97 ng/ml. He was diagnosed with T2DM and started on metformin 500 mg twice a day. Due to high clinical suspicion for atypical diabetes (young age, normal BMI and profound hyperglycemia) , immunological tests were done (reference ranges in parentheses) . GAD 65 antibody: 37.5 IU/mL (&lt; 5 IU/mL) , Islet cell antibody 1:16 (&lt;1:4) and Zinc Transporter 8 antibody: 97.2 U/mL (&lt; 15.0 U/mL) . The results were suggestive of LADA. The patient continued treatment with metformin, regular exercise and low carbohydrate/sugar intake. After a year of adherence with treatment, results showed normal C peptide, controlled fasting and post-prandial blood sugars demonstrated by continuous glucose monitoring, 1,5 anhydroglucitol:13ug/mL (10.7-32.0 ug/mL) and HbA1c: 5.3%.
Conclusion: Treatment with metformin combined with lifestyle changes appears to be beneficial in patients with LADA. This management has so far been able to preserve adequate beta-cell function, providing optimal glycemic control. Future studies are warranted to further evaluate the therapeutic mechanism of metformin in this patient population.

Disclosure
S.Velayati: None. M.Shanik: Consultant; Bigfoot Biomedical, Inc., Proteomics International, Research Support; Better Therapeutics, Speaker's Bureau; Abbott, Boehringer Ingelheim International GmbH, Novo Nordisk, Xeris Pharmaceuticals, Inc. I.J.Romao: None.