bluuebunny/crossref_metadata_2025_split huggingface dataset:
562-P: Analysis of Dietary Characteristics and Blood Glucose Control in Participants with Fragile Diabetes
Authors: LI PAN , ZHANG LIHUA , ZHANG JINGRONG , LIU FEN , YUAN XIANGLIN 
Published: May 2022

Objective: To investigate the dietary characteristics and blood glucose control in participants with fragile diabetes mellitus (FDM) .
Methods: A total of 61 diabetes participants in our hospital from January 20 to August 2021 were selected as the subjects. Demographic information, laboratory examination data, dietary status, nutritional indicators and blood glucose control of participants 1-3 days ahead of investigation were collected. By using nutrition calculator for dietary analysis, and dynamic blood glucose indicators, glucose metabolism indicators and incidence of hypoglycemia were compared between the two groups. SPSS23.0 software for data statistical analysis.
Results: A total of 61 participants were collected, including 28 FDM participants (45.9%) and 33 T2DM participants (54.1%) , which included 29 women (47.5%) and 32 men (52.5%) . A total of 42 (15 FDM and 27 T2DM) participants were monitored by dynamic glucose monitoring (CGM) . Compared with T2DM group, FDM group had higher level in breakfast energy supply, nutrient (vitamin B1, vitamin B2, calcium and iron) sources of animal origin, the intake of dairy products, the incidence of ketosis and hypoglycemia,β hydroxybutyric acid, half hour postprandial insulin, the incidence of dynamic glucose ≤3.9mmol/L and the amplitude of glucose fluctuation, but had lower level in nutrient sources of plant origin, half hour and 2 hour postprandial C peptide, the target glucose time (TIR) (P &lt; 0.05) . There were no significant differences in the intake of main nutrients in whole day, the time ratios of glucose&gt;13.9mmol/L,&gt;10mmol/L and&gt;7.8mmol/L between FDM and T2DM participants (P&gt;0.05) .
Conclusions: FDM participants are more challenging in blood glucose control and have a higher incidence of hypoglycemia. There are some differences in dietary structure between the two groups, and adjusting the structure of some nutrients may have a positive effect on blood glucose control in FDM.

Disclosure
P.Li: None. L.Zhang: None. J.Zhang: None. F.Liu: None. X.Yuan: None.
569-P: Effects of Racial Residential Segregation on Black Youth with Type 1 Diabetes
Authors: ELLIS DEBORAH A. , CUTCHIN MALCOLM , CARCONE APRIL I. , WEISSBERG-BENCHELL JILL , EVANS MEREDYTH A. , BOUCHER-BERRY CLAUDIA C. , MILLER JENNIFER , DROSSOS TINA , DEKELBAB M BASSEM , RHIND JILLIAN T. , WORLEY JESSICA , BUGGS-SAXTON COLLEEN 
Published: May 2022

Studies testing the effects of neighborhoods on the health of Black youth with T1D are limited. Racial residential segregation (RRS) is a form of structural racism that may affect health through various pathways, including limiting access to resources and increasing exposure to stress. The present study tested associations between RRS, diabetes management and glycemic control in a sample of 144 Black youth with T1D. Participants were recruited from seven pediatric clinics in two large US cities. Diabetes management was assessed by youth self-report using the Diabetes Management Scale (DMS) . RRS was calculated at the census block group level based on US census data using Location Quotient (LQ) s. LQs represented the ratio of Black to total population in the block group compared to the same ratio in the metro area. Mean youth age = 13.3 years (SD=1.7) , mean HbA1c = 11.5% (SD=2.7%) , mean family income = $34,163 (SD=$25,549) and mean LQ = 3. (SD=1.49) , indicating residence in highly segregated neighborhoods. In bivariate analyses, RRS was associated with HbA1c (r= .28, p= .001) but not DMS (r= -.08, p= .311) . Stepwise multiple regression was used to further test the effects of RRS on HbA1c. Covariates including youth age, insulin delivery method, and family income were entered on Step 1. RRS and a composite measure of neighborhood adversity were entered on Step 2. The R2 change on Step 2 was significant (p= .007) , indicating improved model fit. The final model accounted for 26% of the variance in HbA1c [F (5, 146) = 9.9, p= .001]. Only age (β= .23 p= .003) , insulin delivery method (β= -20 p= .01) and RRS (β= .18 p= .04) had significant effects on HbA1c. Results suggest that RRS had independent effects on glycemic control of Black youth with T1D even after controlling for effects of family income and neighborhood adversity. Findings are consistent with other studies demonstrating negative health consequences of structural racism; advocacy and policy-making to address such inequities could improve diabetes population health.

Disclosure
D.A. Ellis: None. A.I. Carcone: None. M.A. Evans: None. C.C. Boucher-Berry: None. J. Miller: Other Relationship; Element Bars, Inc. T. Drossos: None. M. Dekelbab: None. J.T. Rhind: None. J. Worley: None. C. Buggs-Saxton: Research Support; Boehringer Ingelheim International GmbH, National Institute of Diabetes and Digestive and Kidney Diseases.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK110075)
571-P: Body Mass Index Moderates the Association between Diabetes Distress and Objective Self-Management Behaviors in Adolescents with Type 1 Diabetes
Authors: TROJANOWSKI PAIGE , O'DONNELL HOLLY K. , VIGERS TIMOTHY B. , ALONSO GUY T. , MAJIDI SHIDEH , PYLE LAURA , SNELL-BERGEON JANET K. , WADWA R. PAUL , DRISCOLL KIMBERLY A. 
Published: May 2022

High diabetes distress is associated with elevated A1C in adolescents with T1D; however, no studies have examined the relationship between diabetes distress and objective measures of self-management behaviors. Whether adolescent diabetes distress and BMI are associated is also unclear. This cross-sectional study examined the relationship between diabetes distress and average daily blood glucose (BG) readings, carbohydrate entries, and insulin boluses administered as well as the interaction of diabetes distress and BMI Z-score (zBMI) on these behaviors in 1adolescents (M age 14.7±1.9 years, 47.7% male, M zBMI 0.51±0.88 kg/m2) . Objective self-management behaviors were assessed via diabetes device downloads prior to beginning intervention for a RCT. BG data was available for the full sample, while carbohydrate and bolus analyses reflect pump users only (n=78) . In separate multiple hierarchical regressions, diabetes distress, zBMI, and their interaction accounted for significant variance in average daily carbohydrate entries (R2=0.21, p&lt;0.001) and boluses administered (R2=0.20, p&lt;0.001) but not BG readings. Main effects of distress were not significant. zBMI moderated the relationship between diabetes distress and average daily carbohydrate entries (p&lt;0.01) and boluses administered (p&lt;0.05) ; those with higher zBMI and higher distress engaged in fewer daily self-management behaviors while those with higher zBMI and lower distress entered carbohydrates and bolused more frequently. This is the first study to demonstrate a relationship between diabetes distress and BMI in the context of objectively measured self-management behaviors in youth with T1D. Although separate interventions exist to improve self-management or diabetes distress, none address them together while also intervening on weight. Decreasing diabetes distress could be an especially important intervention target for youth with high BMI.

Disclosure
P.Trojanowski: None. H.K.O'donnell: None. T.B.Vigers: None. G.T.Alonso: None. S.Majidi: None. L.Pyle: None. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc. R.Wadwa: Advisory Panel; Dompé, Consultant; Beta Bionics, Inc., Other Relationship; Tandem Diabetes Care, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Tandem Diabetes Care, Inc. K.A.Driscoll: None.

Funding
National Institutes of Health (7DP3DK113363-02)
573-P: Continuous Glucose Monitoring Measures Impact Cognitive Function in Long-Duration Type 1 Diabetes
Authors: SHAH HETAL , YU MARC GREGORY , BOUMENNA TAHANI , GAUTHIER JOHN , THAM REGINA , ADAM ATIF , KING GEORGE L. 
Published: May 2022

As people with type 1 diabetes (T1D) live longer, they are increasingly presented with greater health risks tied to aging-related cognitive decline. We previously reported that participants of the Joslin 50-year Medalist Study (“Medalists”) , with T1D ≥50 years, have impaired cognitive function compared to controls without diabetes, and similar to those with type 2 diabetes. While glycemic control has been shown to impact cognitive function, the impact of day-to-day continuous glucose monitoring (CGM) measures is unclear. CGM provides measures of glycemic variability uncaptured by HbA1c alone. A 2-week block of CGM data was procured from a subset of Medalists (n=64) who also had undergone a cognitive battery testing psychomotor function (Grooved Pegboard) , verbal learning and memory (RAVLT- immediate and delayed recall) , working memory (Wechsler) and executive function (WASI) . In a cross-sectional study, log-transformed CGM metrics were tested for associations with cognitive domains in linear regression models adjusted for duration of diabetes, education status and sex. Better psychomotor function was associated with a higher time in range 70 - 180 mg/dL (p=0.04) , and with lower: glucose coefficient of variation (p=0.02) , time above range (TAR) &gt;180 -250 mg/dL (p=0.01) , TAR &gt; 250 mg/dL (p=0.07) , mean glucose (p=0.07) and glucose management indicator (p=0.07) . Better delayed recall associated with lower time below range &lt; 70 mg/dL (p=0.02) and better immediate recall with lower TAR &gt; 180 -250 mg/dl (p=0.08) . Lower HbA1c previously associated with better executive function in the Medalists, but not with other cognitive domains. This CGM study shows that glucose variability and hyperglycemia impact psychomotor function, while hypoglycemia impacts verbal learning and memory. Thus, better day-to-day glucose management in conjunction with long-term HbA1c control, are potentially important to prevent cognitive decline in aging populations with long-duration T1D.

Disclosure
H.Shah: None. M.Yu: None. T.Boumenna: None. J.Gauthier: None. R.Tham: None. A.Adam: None. G.L.King: Advisory Panel; Medtronic, Research Support; Janssen Pharmaceuticals, Inc.

Funding
Beatson Foundation
576-P: Cocreating a Virtual Care Platform That Delivers Mental Health Support to Adults with Type 1 Diabetes (T1D) Living in Rural and Remote Communities
Authors: TANG TRICIA S. , JOHAL PARTEEK , AZHAR AYMAN , FISHER LAWRENCE , POLONSKY WILLIAM H. , GÖRGES MATTHIAS 
Published: May 2022

Introduction: While mental health (MH) is the cornerstone of diabetes care, access to MH support in rural and remote communities in British Columbia (BC) is limited. The purpose of this study was to design REACHOUT, a virtual care platform, to deliver peer-led MH support to adults with T1D in geographically marginalized communities in BC.
Methods: The REACHOUT platform was co-created by our T1D Patient Partner Team (n=16) and experts in digital health, biomedical engineering, behavioural science, and rural health. REACHOUT is built as a customizable extension to the Rocket.chat open-source platform, deployed privately on Amazon Web Services servers in Canada; it offers various forms of encryption to maintain data security. We applied an Agile iterative development approach with multi-staged feedback from T1D Patient Partners and key stakeholders in a participatory action framework.
Results: The REACHOUT app has three support delivery features: 1) 1-ON-1 SUPPORT delivered by an individual Peer Supporter (PS) self-selected by the participant from a library of PS profiles. Profiles include descriptors such as stage of life, hobbies, and interests, sociodemographic information, diabetes history and treatment etc. Mode, content, and structure of communication are driven entirely by participants’ support preferences and needs; 2) 24/7 COMMUNITY CHAT ROOMoffers “just-in-time” group support and accommodates needs for emotional validation, normalization, and non-judgmental acceptance; 3) VIDEO HUDDLES are monthly PS-led virtual group sessions highlighting a distress or resilience related theme (e.g. workplace bias and discrimination, cooking low-carb, insurance coverage challenges) .
Conclusions: Launched in November 2021, the REACHOUT pilot supports 40 participants with 40 PS. Adoption and utilization patterns for each of the support delivery mechanisms are being monitored and will be compared in mid-2022.

Disclosure
T.S.Tang: None. P.Johal: None. A.Azhar: None. L.Fisher: Consultant; Ascensia Diabetes Care, Research Support; Eli Lilly and Company. W.H.Polonsky: Consultant; Abbott Diabetes, Boehringer Ingelheim International GmbH, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Intuity Medical, Inc., Provention Bio, Inc., Sanofi. M.Görges: Research Support; Careteam Technologies Inc, Excelar Technologies, IDENTOS Inc, MedStack Inc, SecureKey Technologies Inc, Smile CDR Inc, Thrive Health, Xerus Medical.

Funding
Juvenile Diabetes Research Foundation (2-SRA-2020-986-S-B)
577-P: The Association of Prediabetes, Awareness and Risk Perception, and Lifestyle Behaviors among U.S. Young Adults: NHANES 2005–2018
Authors: YAN ALICE , WANG JASON J. , SHI ZUMIN 
Published: May 2022

Introduction: Individuals with prediabetes (preDM) are at increased risk of developing type 2 diabetes (T2DM) and cardiovascular disease. We know little about the risk perception and lifestyle behaviors of young adults with preDM.
Methods: This nationally representative cross-sectional analysis of 2005-2018 National Health and Nutrition Examination Survey data was conducted on nonpregnant young adults (aged - 34) . PreDM and Diabetes (DM) were based on fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) definitions recommended by the American Diabetes Association. We used fasting sample weight to generate nationally representative estimates. Measures also include sociodemographic, lifestyle behaviors (diet, physical activity, and sleep) , awareness, and perceived risk for diabetes or preDM. Analyses were accounted for the complex sample design and performed using Stata 17.
Results: Overall, among 4272 young adults, the weighted prevalence of PreDM and DM were 26% and 2.6%, respectively. There was a significant difference (p&lt;0.001) in the awareness of their disease condition between individuals with preDM (3.7%) and those with DM (13.2%) . The multivariable logistic regression model found that women were less likely to have preDM than men. Obese subjects were more likely (OR=3.19, 95%CI 2.39 - 4.27) to have preDM. College education, higher income, and physical activity (600 -1200 MET minutes/week) were protective factors against preDM. Long sleep duration (&gt;=9 hours per day) is associated with a 56% increased risk for prediabetes (95%CI 1.02 - 2.39) .
Conclusions: The high prevalence of preDM in young adults reinforces the critical need for effective public health strategies that promote lifestyle behaviors, including physical activity, and improve sleep quality.

Disclosure
A.Yan: None. J.J.Wang: None. Z.Shi: None.
578-P: Telemedicine Intervention Is Effective in Changing Psychological and Behavioral Correlates of Weight Loss in the REAL HEALTH-Diabetes Trial
Authors: VAKHARIA JANAKI , DELAHANTY LINDA M. , THAWEETHAI TANAYOTT , YU CHU , WEXLER DEBORAH J. 
Published: May 2022

Prior studies have shown that telemedicine (telemed) weight loss interventions are non-inferior to in-person in achieving weight loss. The REAL-HEALTH Diabetes RCT studied the effectiveness of a group lifestyle intervention (LI) for weight loss in adults with T2D and overweight/obesity. Intervention was delivered either in-person (LI-IP) or via telephone (LI-Tele) . We found clinically significant weight loss with no difference between arms. We sought to determine whether there was a difference between the LI-IP and LI-Tele arms in change of psychological and behavioral correlates of weight loss from baseline to 6 months. We compared the change scores for psychological (diabetes-related distress, depression, diet self-efficacy and autonomous motivation for regulation of diet) and behavioral (dietary restraint, fat related diet behavior) measures between the LI-IP (n=69) and LI-Tele (n=72) groups. There was no significant difference between the groups in mean age (62 years) , percent male (44.7%) , race (79.4% white) , baseline HbA1c (7.7%) and baseline BMI (34.7 kg/m2) . At 6 months, scores for all the measures improved from baseline in both arms with no significant difference between LI-IP and LI-Tele (Table 1) , demonstrating that telemed LI was as effective as the in-person intervention at improving psychological and behavioral correlates of weight loss.

Disclosure
J. Vakharia: None. L.M. Delahanty: Advisory Panel; Lilly Diabetes, Omada Health, Inc., WW International, Inc., ZOE Limited. Stock/Shareholder; Jana Care Inc., Omada Health, Inc., ZOE Limited. T. Thaweethai: None. D.J. Wexler: Other Relationship; Elsevier, Novo Nordisk, UpToDate.

Funding
T32 DK007028
581-P: Implementing the 3Ms eHealth Intervention in Clinical Settings: Exploring Caregivers’ and Health Care Providers’ Impressions
Authors: REARDON MADELEINE , MCKENZIE LAUREN , CARCONE APRIL I. , WEISSBERG-BENCHELL JILL , EVANS MEREDYTH A. , ELLIS DEBORAH A. 
Published: May 2022

Adolescence is a high-risk period during which youth with T1D often experience declines in illness management and increases in HbA1c. Black youth with T1D have higher HbA1cs and are more likely to engage in suboptimal management compared to White youth, elevating their risk. Parental monitoring, i.e., direct supervision of adolescents' daily diabetes care, is associated with youth diabetes management. eHealth interventions may be an effective strategy to increase parental monitoring with high dissemination potential. The present study explored caregivers’ and health care providers’ (HCP) impressions of The 3Ms, an eHealth intervention to improve parental monitoring of Black adolescents’ daily diabetes management. Semi-structured interviews were completed with caregivers (N=21) who completed The 3Ms and pediatric diabetes HCPs (N=7) . Data were analyzed using content analysis by two coders who resolved all coding discrepancies to consensus. Caregivers rated the helpfulness of The 3Ms 8.6 out of (SD = 1.4) and indicated a high likelihood of recommending The 3Ms to others (M = 9.2/10, SD = 1.4) . Primary themes were that The 3Ms was a helpful reminder to caregivers of the importance of parental supervision of adolescents’ diabetes care, The 3Ms mnemonic provided clear, simple supervision strategies, and the intervention increased collaboration between adolescents and caregivers. HCPs feedback centered on facilitators (e.g. HCP and institutional buy-in) and barriers (e.g. disruption to clinic flow, and resource limitations including space, staff, and technological resources) to using The 3Ms in diabetes clinics. HCPs reported that ancillary psychosocial support in conjunction with routine clinical care could benefit patients and families in improving diabetes health. Next steps include testing the efficacy of The 3Ms for improving caregivers’ supervision behaviors and improving youth diabetes outcomes.

Disclosure
M.Reardon: None. L.Mckenzie: None. A.I.Carcone: None. J.Weissberg-benchell: None. M.A.Evans: None. D.A.Ellis: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (DK11075- A1)
586-P: COVID-Vaccine Attitudes and Uptake in Young Adults with Type 1 Diabetes (T1D)
Authors: DESAI KISHAN R. , CARREON SAMANTHA A. , DURAN BRENDA , LEVY WENDY , LYONS SARAH , STREISAND RANDI , TANG TRICIA S. , MCKAY SIRIPOOM , ANDERSON BARBARA , DEVARAJ SRIDEVI , MINARD CHARLES G. , HILLIARD MARISA E. 
Published: May 2022

Objective: Vaccination can help prevent COVID-infection and serious health complications. This is particularly important for people with diabetes, who may be at higher risk for COVID-complications. While unvaccinated adults tend to be younger in general, there are no data on vaccine attitudes or uptake in young adults with T1D. We explored vaccine uptake in young adults with T1D across demographic and clinical factors and identified common reasons for not getting the vaccine.
Methods: At baseline of an ongoing behavioral intervention trial (Feb-Dec 2021) , 35 young adults with T1D (M age= 20.2±1.6, 57% female, 54% non-Hispanic White, 23% Hispanic, 9% Black, 14% other/multiple, M A1c=8.9±2.4%) reported on vaccination status. Unvaccinated participants provided open-text comments on their reasons.
Results: Overall, 69% of participants were vaccinated (2 doses) . Unvaccinated participants had higher median A1c than vaccinated participants (9.7% vs. 7.6%, p=0.03) ; every 1.0% increase in A1c was associated with 22.2% decreased odds of being vaccinated. There were no differences in vaccine uptake by age, gender, race/ethnicity, education, employment, pump or CGM use, or health insurance. The unvaccinated participants reported reasons including: distrust of the vaccine research/effectiveness (4) , uncertainty about health impacts (including T1D) /waiting to see impact on others’ health (2) , no time to get vaccinated (1) , indifference (1) , no desire for vaccination (2) , and still thinking about it (1) .
Conclusion: In a small, diverse sample of young adults with T1D, COVID-vaccinations mirrored national rates. Some participants may have been vaccinated after completing surveys at baseline. Patterns of high A1c and unvaccinated status may place young adults at increased risk as the pandemic continues. Healthcare providers are well positioned to counsel young adults about vaccine information and considerations related to T1D, which may reduce misinformation and increase uptake.

Disclosure
K.R.Desai: None. S.Devaraj: None. C.G.Minard: None. M.E.Hilliard: None. S.A.Carreon: None. B.Duran: None. W.Levy: None. S.Lyons: None. R.Streisand: None. T.S.Tang: None. S.Mckay: None. B.Anderson: None.
590-P: Improving Access to Fresh Vegetables Is Associated with Lower Stress, Anxiety, and Depression in Predominantly Mexican-American Adults with or At-Risk of Noninsulin Treated Diabetes
Authors: ARAM MCKENNA L. , GLANTZ NAMINO M. , LAREZ ARIANNA , KERR DAVID 
Published: May 2022

Poor diet is the leading cause of ill health in the U.S., including type 2 diabetes (T2D) , obesity as well as anxiety and stress. A medical prescription program providing access to fresh vegetables was associated with improved cardiometabolic health for predominantly Mexican-American adults at risk for or with non-insulin treated T2D. In a sub-study, we used the Depression Anxiety Stress Scales (DASS-21) short form to assess depression, anxiety, and stress.From August 20to November 2021, 1participants (73 female, 92% Mexican, 34% with non-insulin treated T2D, age 55.1 [12.6] years) were recruited using English/Spanish community outreach materials and received prescriptions for 21 servings/week of fresh vegetable for weeks.Compared to baseline, post-prescription DASS-21 results indicated significantly lower stress (-2.9 [-4.38, -0.82, mean [95% CI], p-0.0056) ; anxiety (-2.4 [-0.68, -4.04]) ; and depression (-3.7 [-5.74, -1.7]) (Table) associated with improved self-reported mood (p=0.0using 100mm Likert scales) , sleep (p=0.02) , and less pain (p=0.008) .
In summary, improving access to fresh vegetables is associated with better psychological health for predominantly Mexican-American adults with or at-risk of non-insulin treated T2D.

Disclosure
M.L.Aram: None. N.M.Glantz: Research Support; Abbott. A.Larez: Research Support; Abbott. D.Kerr: Advisory Panel; Abbott Diabetes, Novo Nordisk A/S, Sanofi, Consultant; Evidation Health, Research Support; Novo Nordisk A/S, Stock/Shareholder; Glooko, Inc., Hi.Health.

Funding
US Department of Agriculture (#2018-33800-28404)