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In the phase 3 SURPASS studies of tirzepatide (TZP) , a novel dual GIP/GLP-1 receptor agonist developed for the treatment of type 2 diabetes, 23%-62% of TZP-treated participants achieved a HbA1c Disclosure A.Y. Cheng: Advisory Panel; Abbott, AstraZeneca, Bayer AG, Boehringer Ingelheim (...)
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Previous research on hybrid closed loop (HCL) systems has demonstrated their potential to improve glycemic outcomes and reduce the burden of diabetes care for people with T1D. We sought to describe adolescents' real world use the 670G Medtronic and Tandem Control IQ (CIQ) systems including the (...)
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Aims: How do physicians assess AID-Systems in terms of their current and future importance for diabetes care?Methods: In 2021 3diabetologists in Germany (48% female, average age 53.7 years) were asked via online surveys about their current and future assessment of AID-Systems.The results were (...)
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A fully implantable automated insulin delivery system consisting of an intraperitoneal pump and an implantable CGM sensor (Bionic Invisible Pancreas - BIP) is under development. The occurrence of potential benefits or barriers to the use of the BIP was assessed in people with diabetes under (...)
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Globally, 13 million people (4 million in USA) inject insulin with single use disposable syringes daily. Compared to syringe and vials, pens are known to increase adherence and diabetes control and to reduce healthcare utilization costs. Yet, pens are largely unavailable to low-income groups, (...)
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Objective: evaluate the metabolic impact and metrics of the new hybrid closed loop insulin delivery system on the quality of life in patients with type 1 diabetes.Methods: Metrics obtained with CGM with >80% of CGM readings over a 4-week period in real life: Time in Range (TIR%) [target 70-180 (...)
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Aims: Aim of the study was to investigate cognitive performance in elderly with type 1 diabetes (T1DM) on insulin pump (CSII) and the correlation between time in range (TIR) and cognitive scores (CS) . Differences in CS according to duration of disease were also investigated.Methods: Subjects (...)
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The discordance between the amount of new therapies for Type 2 diabetes (T2D) and improved outcomes highlights an unmet need for tools to help primary care providers (PCPs) make appropriate therapy adjustments. Here we present a novel CGM-based Glucose Pattern Insights Report (GPIR) that (...)
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Early-life antibiotic exposure perturbs the microbiome, dysregulates intestinal immune gene expression, and accelerates and amplifies type 1 diabetes (T1D) development in NOD mice. We have previously shown that cecal microbiota transfer (CMT) from healthy donors rescues antibiotic-induced T1D (...)
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Introduction: Hypoglycemia is a common side effect of type 1 diabetes (T1D) therapy with consequences ranging from physical and cognitive impairment to reduced quality of life. Studies evaluating consequences of level 2 (L2H, glucose levelDisclosureM. K. Talbo: None. M. Lebbar: None. V. (...)
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Brown adipose tissue (BAT) is a thermogenic organ that promotes metabolic fitness. In humans, there are two spatiotemporally distinct phases of BAT ontogeny: the prenatally developed dorsal-anterior-located interscapular and retroperitoneal BAT; and the postnatally emerged anterior cervical and (...)
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Background and Aims: Members of the diabetes community have started developing their own Do-It-Yourself Artificial Pancreas Systems (DIY APS) , also known as Open-Source Automated Insulin Delivery (AID) Systems and use the online hashtag “#WeAreNotWaiting” to promote the development of it. DIY (...)
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Diabetes and pregnancy are independently associated with increased risk of severe COVID-infection. However, little is known about the relationship between severe COVID-and diabetes in pregnancy. We sought to determine whether diabetes in pregnancy was associated with increased risk of (...)
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Introduction: Type 2 Diabetes (T2D) is associated with reduced muscle mass, strength and function leading to frailty and disability. Little is known regarding the continuous movement patterns and glucose fluctuation in these functional states. Aims: To identify differences in movement patterns (...)
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Introduction: Diabetes (DM) is a risk factor for fracture but women with DM have less osteoporosis by bone density (BMD) , due in part to higher body mass index (BMI) . The FRAX fracture risk calculator incorporates age, race/ethnicity, BMD, BMI, and other risk factors but not DM. Few studies (...)
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The phosphoinositide 3-kinase (PI3K) pathway is a common target for oncologic therapies and mediates much of insulin’s action. The PI3K? inhibitor alpelisib is effective in advanced breast cancer but causes hyperglycemia in up to 80% of patients. The FDA label recommends metformin as first-line (...)
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The correlation between the hemoglobin A1C and BMI in patients with type 2 diabetes is well established. The present study was undertaken to examine whether a similar correlation is present in patients with prediabetes. Between 2017 and 2021, patients within the Ascension Lourdes primary care (...)
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Background: Sleep disorders are highly common in type 1 and type 2 diabetes with important cardiometabolic implications. Maturity Onset Diabetes of the Young (MODY) has unique features compared to type 1 or type 2 diabetes, such that patients are generally lean and not using insulin.Objective: (...)
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Background: The level of prostate-specific antigen (PSA) was reported to be reduced in type 2 diabetes mellitus (T2DM) . Possible low PSA levels in T2DM patients reduce the sensitivity of prostatic cancer (PCa) screening. To improve the effectiveness of early PCa screening inT2DM, it is (...)
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Type 2 diabetes (T2D) is a leading cause of morbidity and mortality in Mexico. Routine identification of persons with high risk for developing T2D is poorly executed in low- and middle-income countries. Thus, we aimed to analyze the characteristics of participants of a public health initiative (...)
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Functional Exercise Capacity (FEC) , a universal predictor of cardiovascular and all-cause mortality, is lower in adults and youth with diabetes for reasons that are poorly understood. Skeletal muscle is key determinant of FEC. We hypothesized that skeletal muscle capillary and mitochondrial (...)
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Objective: To investigate the change of muscle strength and body composition during short-term intensive insulin therapy (SIIT) and their association with treatment effects in patients with newly diagnosed type 2 diabetes (T2DM) .Research Design and Method: Patients with newly diagnosed T2DM (...)
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Type 2 diabetes (T2D) is associated with increased risk of pancreatic cancer. Our knowledge of exocrine pancreas histopathology in T2D is incomplete. To determine whether T2D is associated with changes in the pancreatic exocrine compartment, we analyzed tissue sections from the pancreatic head, (...)
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The main function of the pancreatic ?-cell is glucose-stimulated insulin secretion (GSIS) which serves to maintain whole body glucose homeostasis. Under type 2 diabetic conditions, a subset of ?-cells fail and lose expression of key transcription factors (TFs) required for GSIS. Among these TFs (...)
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In type 2 diabetes, deficit of insulin secretion is often ascribed to the reduction of ?-cell volume, implying that regeneration of ?-cells could be one of its radical treatments. Hitherto, several models are known to elicit ?-cell compensation in rodents. Among them, application of partial (...)
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Objective: Exogenous insulin remains the leading therapy for type 1 diabetes mellitus, T1D. However, current insulin formulations and delivery methods do not match the precision of functioning beta-cells, and even intensive monitoring of blood glucose and use of insulin pumps are not enough to (...)
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Background: The SEARCH for Diabetes in Youth Study has provided critical insights into the epidemiology of pediatric T2D. The 2021 report estimated an annual percent change (APC) in prevalence of 4.8% between 2009 to 2017. Multi-center longitudinal cohort studies generate robust data, but are (...)
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Insulin-mediated pseudoacromegaly (IMPA) is a rare, severe insulin resistance syndrome characterized by tall stature, acanthosis nigricans, obesity, and acromegalic features. Patients with IMPA have normal growth hormone and IGF-1. However, they have markedly increased insulin levels. Our group (...)
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Case Description: A lean, 17-year-old Caucasian male with type 1 diabetes diagnosed at age 9 experienced an abrupt increase in his insulin requirements. He was managed on mixed daily injections. Daily insulin requirements increased from 1.7 units/kg/day to 3.3 units/kg/day over 6 months. His (...)
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Hepatocyte Nuclear Factor-1A (HNF1A) is a master regulator of key glucose-responsive genes in metabolic organs such as the intestine, liver, kidney, and pancreas. Heterozygous mutations in HNF1A cause Maturity-Onset-Diabetes-of-the-Young (HNF1A-MODY) . Mutant carriers are normoglycemic in (...)
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Introduction: KidneyIntelX is a multiplex immunoassay of 3 plasma biomarkers with 7 clinical variables combined using machine-learning to generate a risk score for progressive decline in kidney function over 5 years in individuals with early-stage diabetic kidney disease (DKD) .Methods: A (...)
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GLP1R agonists such as Exendin-4 (E) together with DYRK1A inhibitors such as Harmine (H) significantly increase human ?-cell replication in vitro and in vivo. Importantly, 3-month treatment with H+E combination markedly increases human beta cell mass (?7-fold) in islets transplanted in (...)
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While African Americans (AA) were underrepresented in the SGLT2i CVOT, the results from those trials were generalized to all, regardless of race. Our goal was to evaluate the risk of heart failure hospitalization (hHF) among AA vs. White (Wh) vs. Hispanic (His) patients with type 2 diabetes (...)
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The goal of this mechanistic trial was to determine the kidney and cardiovascular effects of combined treatment with an SGLT2i (empagliflozin 25mg QD) and an ACEi (ramipril 10mg QD) for 4 weeks in patients at risk of renal hyperfiltration.In this randomized, double-blind, placebo-controlled, (...)
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Within the CNS, the paraventricular nucleus of the hypothalamus (PVH) is critical for energy homeostasis, as developmental or mechanical lesions targeting the PVH lead to massive obesity. The PVH is composed of multiple cell types expressing an assortment of neuropeptides, receptors, and (...)
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Patients with T2D remain at high risk of cardiovascular (CV) events despite adequate glycemic and LDL-C control. Changes in HDL particle composition and function may explain part of this increased CV risk. The aim of this study was to determine the proteomic composition of isolated HDL (...)
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The current gold standard for assessing the function of human islet in vivo, is to engraft islets under the kidney capsule of hyperglycemic, immunodeficient mice. Current models, such as Streptozotocin (STZ) treatment or NSG-Akita mice, are limited due to instable hyperglycemia and/or morbidity (...)
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Aim: ANGPTL8 plays an important role in regulating lipoprotein lipase activity. Its plasma level is increased following nutrient ingestion. Its not well characterized whether insulin or glucose drive the increased ANGPTL8 after food uptake. To address this, we examined the dynamic relationship (...)
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Elevated Drp1-mediated mitochondrial fission was proposed to promote NAFLD, as inhibition of hepatic Drp1 in early life prevented high-fat diet induced liver steatosis in mice. However, whether Drp1-knockdown (Drp1si) can reverse established NASH in adulthood is unknown. Hepatocyte-restricted (...)
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Objective: To address the long-term effectiveness of VLCI for T2D, we report changes in lipids, inflammatory, hepatic, and renal markers at 5y.Research Design and Methods: Of the 200 subjects with T2D reaching 2-years in a non-randomized, controlled trial of CRC emphasizing VLCI, 169 (84.5%) (...)
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Background: It is well established that compared to age-matched men, pre-menopausal women are protected against metabolic disease (obesity, diabetes, hepatic steatosis) . However, both epidemiological data on menopause and pre-clinical ovariectomy models show that disruption of estrogen (...)
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Amylin improves glucose homeostasis through at least three distinct mechanisms of action, including prevention of the postprandial rise in plasma glucagon, slowing of gastric emptying, and increased satiety, leading to decreased caloric intake and potential weight loss. Clinical efficacy has (...)
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Amino acids control alpha cell secretion and growth, while glucagon stimulates hepatic amino acid uptake and ureagenesis, forming the liver-alpha cell axis. Patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes have increased levels of glucagon and amino acids pointing to a (...)
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Glycemic responses differ by exercise classification (i.e. aerobic, interval, resistance) in individuals with T1D, but the impact of insulin delivery modality (multiple daily injections [MDI], pump, closed loop) on these differences is unclear. Data from the Type 1 Diabetes Exercise Initiative (...)
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Cystic fibrosis related diabetes (CFRD) occurs in 19% of adolescents and 40-50% of adults with CF. The partial to complete insulin deficiency leads not only to hyperglycaemia, but also to loss of muscle mass and induction of a catabolic state. Therefore, insulin is the only recommended therapy (...)
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Type 1 diabetes (T1D) is a complex autoimmune disease where genes and environmental factors impact pathogenesis. Analysis of the >150 loci identified by GWAS reveals the compelling theme that candidate genes cluster into pathways. A pathway connecting environment to T1D genetics is the (...)
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The response of beta cells to inflammatory cytokines contributes to type 1 diabetes (T1D) risk, but the specific genes that underlie this response and mediate beta cell survival remain largely unknown. In this study we used a suite of functional genomics assays combined with human genetics, to (...)
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The cis-regulatory programs of specific cell types in the pancreas that are affected in type 1 diabetes (T1D) are poorly understood. Single cell technology enables detailed interrogation of genomic profiles of cell types within a heterogeneous tissue, and when applied to samples across disease (...)
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DNAme is associated with past HbA1c in DCCT/EDIC but these associations were examined when there was separation in HbA1c distribution by trial intervention arm. Thus, we performed an epigenome-wide association study (EWAS) of DNAme and HbA1c in a T1D cohort without intervention or risk factor (...)
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A key limitation of genome-wide association studies (GWAS) is that they do not specify either the underlying causal variant (s) or the effector gene (s) at a given locus. The widely reproduced obesity FAIM2 locus, named arbitrarily after the nearest gene, is relatively understudied given it is (...)
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Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1A) is a nuclear transcriptional coregulator that plays a major role in the control of metabolism and mitochondrial biogenesis. We showed that a diabetes-linked single nucleotide polymorphism (SNP rs8192678) within the (...)
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Obesity and insulin resistance have been identified as major global health concerns. They are associated with increased intestinal chylomicron production and subsequent remnant lipoprotein accumulation which lead to postprandial dyslipidemia. Dietary composition influences metabolic output of (...)
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Background: Weight loss is the cornerstone of therapy for people with overweight/obesity. Pemvidutide is a dual GLP-1/glucagon receptor agonist that provides GLP-1/glucagon agonism in a balanced (1:1) ratio, which is hypothesized to enhance weight loss and minimize gastrointestinal (...)
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Background: Low-carbohydrate diets decrease hemoglobin A1c among patients with type 2 diabetes mellitus. However, evidence on effects of low-carbohydrate diets on hemoglobin A1c among individuals with prediabetes is limited.Methods: We conducted a randomized parallel-group trial of 150 adults (...)
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Background: The Republic of the Marshall Islands (RMI) has the highest rate of type 2 diabetes (T2D) in the world. Lifestyle interventions, including plant-based diets and exercise, have been shown to effectively manage T2D.Objective: We therefore conducted the largest plant-based lifestyle (...)
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Objective: The aim was to identify changes in food, nutrient intake, and diet quality on a low-fat vegan diet and associations with changes in body weight and body composition.Methods: Overweight adults (n=244) were randomly assigned to follow a low-fat vegan diet (n=122) or make no diet (...)
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Bile acids (BAs) are synthesized from cholesterol in the liver and are essential for nutrient absorption. The host-derived primary BAs are transformed into secondary BAs in the intestine. Various BA subtypes may play pivotal roles as endocrine molecules to affect glucose and insulin metabolism. (...)
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Background and Aims: Meal management is a major challenge for people with type 1 diabetes (PWD) . We aimed to explore 3 approaches to complex meal planning, from a most comprehensive scheme in open loop (OL) to a simplified, carbohydrate (CHO) counting-free scheme when using the MiniMed™ 780G (...)
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Background: Time restricted eating (TRE) involves restricting the ad libitum eating window to a specific number of hours daily, while water fasting for the remaining hours.Objective: This study examined if changes in body weight and metabolic risk factors during TRE, differ in women based on (...)
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Fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs) are fermentable short-chain carbohydrates that include fructans, galactooligosaccharides (GOS) , lactose, excess fructose, mannitol and sorbitol. Low FODMAP diets in irritable bowel syndrome were associated with reductions in (...)
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Curcumin has well documented beneficial effects against diabetes but its poor bioavailability limits its use. Here, we investigated the effects of two monocarbonyl curcumin analogues - (2E,6E) -2,6-bis[ (2-trifluoromethyl) benzylidene]cyclohexanone (C66) and (2E,6E) -2,6-bis (...)
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Regression to normal glucose regulation (NGR) has been reported in response to lifestyle modification and medications. In this secondary analysis of the D2d study, a randomized trial of 4,000 IU/d of vitamin D3 vs. placebo, we determined whether vitamin D increased regression to NGR in people (...)
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Background: Digital therapeutics platforms provide accessible and multidisciplinary care for the management of T2D. The current study explored the effectiveness of the Diabefly program for improving glycemic control in people with T2D.Methods: Diabefly program provides a combination of mobile (...)
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Hypoglycemia is the key limiting step for optimizing glycemic control in older adults. Continuous glucose monitoring (CGM) technology has not been well-evaluated in insulin treated older patients with type 2 diabetes (T2D) .Methods: This prospective observational cohort study assessed of (...)
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Background: Despite research establishing the strong benefits of continuous glucose monitors (CGMs) in the management of diabetes, adoption remains low among people with type 2 diabetes (T2D) . The present mixed-method study describes CGM attitudes and use among people with T2D.Method: Members (...)
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Background: Advances in diabetes technology have led to reliance on continuous glucose monitors (CGM) for glycemic management. Insufficient wear time due to device malfunction, insertion problems, displacement or removal for imaging, medical procedures or hospitalization is common. Prescription (...)
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Introduction: Breathe Well-being Diabetes Reversal Program (BDRP) provides personalized Lifestyle Management (LSM) including coaching on diet and exercise as needed by individuals with type 2 diabetes mellitus (T2DM) along with tracking their blood glucose levels, weight, and physical (...)
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Introduction: Digital multicondition platforms seek to assist persons with diabetes in management of their diabetes and comorbidities. Hypertension is reported in over two-thirds of patients with type 2 diabetes. Both are major risk factors for cardiac, stroke, and kidney disorders. Dario’s (...)
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Introduction: As the prevalence of type 2 diabetes (T2D) continues to grow worldwide, individuals struggle with how to integrate diabetes self-management into their lives. This is complicated by the high rate of depression and stress among persons with T2D. A multicondition behavior (...)
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We investigated the efficacy of real-time continuous glucose monitoring (rtCGM) and intermittently scanned continuous glucose monitoring (isCGM) on change in A1C. CORRIDA LIFE was a 12 month, real-world, non-randomized trial that assessed the impact of rtCGM (Dexcom G5 or G6) vs. isCGM (...)
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Research assessing predictors of preventive screening often focuses on individual patient factors, despite known relationships between neighborhood environment and health. Using a retrospective cohort study of 519,826 patients meeting US Preventive Service Task Force guideline recommendation (...)
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Background: The RCT data on CGMS and GV in patients with T2DM have used limited measure of GV metrics. In patients with T2DM on CGMS, we examined whether the use of blinded or unblinded CGMS will affect their GV across a broad swatch of metrics.Methods: A randomized control study involving 40 (...)
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Background: Hypoglycemia and its impact on people with diabetes is typically reported retrospectively and is subject to recall bias. Ecological momentary assessment (EMA) uses repeated sampling to collect real time, granular data about patient experiences, typically over 3-5 days. We developed (...)
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IDF-DaR guidelines recommend late Suhoor (pre-dawn meal) , this does not give much time for correction and can lead to breaking the fast in the early hours.Objective: To estimate Hypoglycemia risk in T1D fasting Ramadan when eating Suhoor 90-120 minutes before dawn versus 30 minutes before (...)
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Aim: To decide most appropriate time to measure fasting blood sugar (FBS) using continuous glucose monitoring (CGM) .Methodology: All persons who came to our clinic between 1st March to 30th August’21 were screened. Out of 60 persons with A1c 130mg/dl who were measuring after 7.30am (using (...)
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Tirzepatide (TZP) , a novel GIP-GLP-1 dual agonist, improved fasting measures of insulin sensitivity partially attributable to weight loss in Phase 2 studies. Studies in mice demonstrated that GIP receptor agonism with TZP improved insulin sensitivity independent of weight loss. To further (...)
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Tirzepatide (TZP) , a novel dual GIP/GLP-1 receptor agonist, led to greater HbA1c, fasting serum glucose and body weight reductions vs. placebo (PBO) in people with early T2D (baseline mean T2D duration 4.7 y and 54% no prior diabetes medications) from the 40-wk SURPASS-1 trial. In a Phase 2b (...)
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Tirzepatide (TZP) is a novel dual GIP/GLP-1 receptor agonist for the treatment of type 2 diabetes. Across the SURPASS 1-5 clinical studies, TZP 5, and 15 mg demonstrated significant improvements in HbA1c (-1.9 to -2.6%) , body weight (-6.6 to -13.9%) and systolic blood pressure (SBP) (-2.8 to (...)
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Tirzepatide, a once weekly GIP/GLP-1 receptor agonist in development for T2D, demonstrated superior glycemic control in the Phase 3 SURPASS clinical trial program. This post-hoc analysis assessed glycemic control with tirzepatide in participants stratified by baseline (BL) HbA1c (?8.5%, >8.5%) . (...)
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Gastroparesis is a serious medical condition characterized by delayed gastric emptying and symptoms of nausea, vomiting, bloating, fullness after meals, and abdominal pain. An innate immune dysregulation and injury to the interstitial cells of Cajal and other components of the enteric nervous (...)
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Significant phenotypic diversity exists among T1D patients, supporting the existence of distinct disease endotypes (e.g. duration of the post-onset partial remission period) . To broaden our understanding of T1D heterogeneity and its relationship to disease progression and therapeutic (...)
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Breakdown of self-tolerance is an important common mechanism in autoimmunity. We use machine learning (ML) to identify common patterns and dissimilarities between type 1 diabetes (T1D) , rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) based on immune phenotyping. PBMCs were (...)
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Obesity induced chronic low-grade inflammation is a central risk factor for the development of metabolic syndrome. It has been well documented that high LDL-c induces inflammation. The proinflammatory cytokine Il-23 plays a pivotal role in the pathogenesis of inflammatory diseases. IL-23 and (...)
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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 (...)
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Estrogen is a powerful, beneficial regulator of skeletal muscle mitochondria. Premenopausal women with type 2 diabetes (T2D) have relatively greater complications associated with their T2D compared with the effect of the disease in men. We hypothesize that this impact of T2D in women is in part (...)
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Purpose: To understand the relative importance of support tools for HCPs to increase engagement with diabetes devicesMethods: Primary care, pediatric and adult endocrinology HCPs completed an online survey assessing their comfort with continuous glucose monitors, connected insulin pens, insulin (...)
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Introduction: Many biobanks use machine learning algorithms to predict patient phenotypes such as type 1 diabetes (T1D) . It is not known how these algorithms perform in patients with different ancestral backgrounds or whether incorporating genetic data improves phenotypic (...)
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Background: Very Low-Calorie Diet (VLCD) is effective for rapid weight loss but is associated with lean mass (LM) loss. Resistance exercise training (RET) and high-intensity interval training (HIIT) are known to promote muscle hypertrophy or improvements in cardiopulmonary fitness (CPF) . We (...)
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Objectives: Diabetes and diabetic dyslipidemia with high triglycerides (TGs) are commonly associated. Saroglitazar is the first dual PPAR ?/? agonist which has been approved in India for diabetes dyslipidemia management. This study aimed at evaluation of the efficacy and long-term safety of (...)
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Type 2 diabetes is frequently complicated by nonalcoholic fatty liver disease (NAFLD) , which is mainly caused by high-fat and high-calorie diets, and obesity. In this regard, both the quantity and quality of fat accumulating in the liver are important, and in particular, the proportion of each (...)
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Fasting dyslipidemia is characterized by a lipid profile with elevated triglycerides, increased small dense LDL and low HDL-cholesterol, and is a commonly comorbid with insulin resistance. Bile acid (BA) signalling has been suggested to improve hepatic insulin sensitivity and lipid accumulation (...)
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Dyslipidemia is a common co-morbidity of insulin resistance, where chronic elevations in hepatic and intestinal lipoproteins are linked to cardiovascular disease. Postprandial production is regulated in-part by gut-derived hormones such as glucagon-like peptide (GLP) -1. Although (...)
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Background: Polypeptide N-Acetylgalactosaminyltransferase 2 (GALNT2) gene has been associated with serum lipid levels, insulin resistance, and adipogenesis. One of its variants, rs4846914 has been shown to associate with Triglycerides and HDL levels in global genome-wide association studies. (...)
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Background: Previous studies reported inconsistent effects of testosterone therapy on the lipid profile in men with hypogonadism.Methods: Of 370 men with hypogonadism and T2DM, 190 received testosterone undecanoate 1000 mg/12 weeks (T-group) , 180 opted against treatment (CTRL) . Means and (...)
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In addition to glycemic control, the ADA recommends weight management for patients with type 2 diabetes (T2D) with overweight or obesity. This analysis explored the association between weight loss and patients’ quality of life using pooled data from the SURPASS clinical trials, regardless of (...)
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Diabetic macular edema (DME) is a major cause of vision loss for people with diabetes. Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is the standard of care for DME; however, there is an unmet need for new strategies that address the multifactorial nature of DME, reduce (...)
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Introduction: As per the recent International Diabetes Federation (IDF) atlas, there are 537million adults living with diabetes. Indians with the same body mass index (BMI) have higher central adiposity and insulin resistance compared to Caucasians. High insulin resistance in people with (...)
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Among patients with type 2 diabetes (T2D) treated with statins, residual cardiovascular (CV) risk remains. Because icosapent ethyl (IPE) has been shown to decrease CV risk in patients on statin therapy, we explored potential eligibility for IPE therapy in VERTIS CV (NCT01986881) , the CV (...)
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Background: One of the leading causes of chronic kidney disease, DKD is associated with increased oxidative stress and chronic inflammation. CU01-10is dimethyl fumarate (DMF) which being developed for treatment of DKD. DMF attenuated renal fibrosis via the Nrf2-mediated inhibition of (...)
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Diabetes results from diminished functional ?-cell mass. Small molecule inhibitors of Dual Specificity Tyrosine Phosphorylation Regulated Kinase 1A (DYRK1A) markedly increase human ?-cell replication in vitro and in vivo. Furthermore, combination of DYRK1A inhibitors such as Harmine (H) with (...)
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Long-acting dual amylin and calcitonin receptor agonists (DACRAs) are novel candidates for treatment of type 2 diabetes (T2D) and obesity due to their beneficial effects on both body weight, glucose control and insulin action. Cagrilintide, which is currently in clinical trials, has shown (...)
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Dual amylin and calcitonin receptor agonists (DACRAs) are known to induce a significant weight loss and improve glucose tolerance and glucose control in rats. However, it is unknown if DACRAs has an insulin sensitizing effect beyond that induced by weight loss and if DACRAs affect tissue (...)
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C-peptide area under the curve (AUC) at ?1 year, a standard endpoint of recent-onset T1D clinical trials, is derived from a 120-minute mixed meal tolerance test (MMTT) . We analyzed whether composite glucose and C-peptide endpoints, useful in post hoc analyses of prevention trials, could detect (...)
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Finerenone is a potent and selective mineralocorticoid receptor (MR) antagonist that slowed progression of CKD and reduced risk of CV outcomes vs. placebo in patients with CKD and T2D in the FIDELIO-DKD and FIGARO-DKD phase 3 trials. MR overactivation is involved in DR pathogenesis. To evaluate (...)
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The bacillus Calmette-Guerin (BCG) vaccine was first introduced a century ago for tuberculosis prevention and is today being tested in double-blinded, randomized clinical trials for treatment of diverse forms of autoimmunity, including type 1 diabetes (T1D) and multiple sclerosis (MS) . At our (...)
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CF related diabetes is common with pancreatic insufficient CF (PI-CF) . Highly effective modulator therapy enhances aberrant CF transmembrane conductance regulator (CFTR) function and improves pulmonary and nutritional status. Ivacaftor therapy for indicated CFTR mutations enhanced insulin (...)
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Background: CGM provide real-time glucose data that allows users to manage their diabetes holistically. This study aimed to assess the association between glycemic control and CGM use in PwT2D-BI.Methods: This retrospective study used IBM MarketScan® 2015 - 2019 Databases to identify PwT2D-BI (...)
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Background: Although DKA has been traditionally managed in intensive care units (ICU) , some studies suggest that DKA can be safely treated in non-critical care areas.Objective: To compare safety & efficacy of a DKA IV insulin protocol in ICU with stepdown unit (SDU) .Methods: A (...)
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Medical conditions can affect haematological factors altering relationship between HbA1c and glucose. Patients were recruited at hospital over 3 visits (*1/**2&3 only) comprising 20 with diabetes and in Fig 1 with liver disease (LD) & hepatitis C (HC) on ribavirin*, on dapsone*, with (...)
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Introduction: The challenge of managing type 2 diabetes mellitus is well known and was especially highlighted during the pandemic. Advances in the use of technology have resulted in improved glycemic control. The GluCare program uses Remote Continuous Data Monitoring (RCDM) and leverages (...)
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Background: InRange has previously demonstrated that insulin glargine 300 U/mL (Gla-300) is non-inferior to insulin degludec 100 U/mL (IDeg-100) in terms of time in glucose range 70--180 mg/dL (primary endpoint) and total glucose coefficient of variation (CV) as measured by CGM in people with (...)
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As undiagnosed diabetes (DM) rises in Africa and A1C performs suboptimally, attention turns to the OGTT. Obtaining Glucola (75g glucose) for the OGTT is difficult. Analyzing Africans in America data, we previously found that duplicate OGTT were highly reproducible for DM detection (k=0.84) ; (...)
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Background: Patients with nonalcoholic fatty liver disease (NAFLD) and fibrosis stage ? 2 (F2-F4) are at risk for adverse outcomes and considered to be candidates for clinical trials. We aimed to use two NITs combined to rule in and rule out fibrosis stages F2-F4 among patients with (...)
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Since type 2 diabetes (T2D) is a heterogenous disease, treatment of T2D appears to be better personalized depending on their underlining conditions. A recent attempt to classify adult-onset DM based on only 6 DM related variables (GAD antibodies, age at diagnosis, BMI, HbA1c, and HOMA2 indices) (...)
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Understanding the association between glycemia and A1c by race can improve screening for prediabetes and type 2 diabetes (T2D) . This association was examined cross-sectionally in 1016 Black and 2658 White persons screened for D2d (mean age 60; fasting glucose [FG] 1mg/dL; A1c 5.9%) . Of these, (...)
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Since advanced microangiopathy of diabetes severely impairs activities of daily living (ADL) and quality of life (QoL) and macroangiopathy is life-threatening regardless of severity, treatment of diabetes requires appropriate risk management to avoid all such complications. However, current (...)
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Introduction: Both long COVID and Type 2 Diabetes (T2D) are multi-system conditions requiring multi-organ assessment to monitor organ health and detect co-morbidities earlier. Here, we defined multi-organ abnormalities in both patient groups with a rapid, non-contrast MRI scan.Methods: We (...)
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Rationale: CRCs are known to be key determinants of patient outcomes in T2D; however, the burden of undiagnosed CRCs in unselected T2D population remains unclear, particularly in low-to-middle income countries (LMICs) . ‘Take CaRe of Me’ (TCOM) programme aims to determine the global burden and (...)
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Macrovascular and microvascular complications were evaluated during the first 2 years of LANDMARC, a 3-year prospective observational study (CTRI/2017/05/008452) that included participants with T2D on ?2 antihyperglycemic medications. Out of 6234 evaluable participants (mean baseline values - (...)
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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 (...)
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Background: In patients with type 2 diabetes (T2D) and non-ketotic presentation, low C-peptide (CP) and positivity for glutamic acid decarboxylase antibodies (GADA+) indicate early insulin requirement. In GADA- patients, the associations of CP with insulin use, glycemic response and severe (...)
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Background: Cost-related medication nonadherence (CRMN) occurs when an individual takes less medication than what is prescribed due to difficulty affording their medications. In adults with diabetes, medication nonadherence is associated with worse glycemic control and increased healthcare (...)
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Background: Early recognition of chronic kidney disease (CKD) is crucial to slow its progression, yet underdiagnosis remains high. This study assesses prevalence of and factors associated with undiagnosed stage 3 CKD in patients with pre-existing type 2 diabetes (T2D) .Methods: REVEAL-CKD is a (...)
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Strategies are needed to expand diabetes education and support among persons with diabetes (PWD) . We designed a personalized conversational agent (“chatbot”) to provide diabetes education and monitoring. Feasibility and preliminary efficacy were assessed in a pilot cohort of adults with type 2 (...)
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Background: GDM (gestational diabetes mellitus) increases the lifetime risk of maternal T2DM by 7-fold and increases the risk for maternal and fetal complications. Prenatal education on nutrition, exercise, and T2DM risk among women with GDM increases the likelihood of postpartum diabetes (...)
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We sought to determine if online, virtual patient simulation (VPS) -based continuing medical education (CME) can improve performance of diabetologists/endocrinologists (D/Es) and PCPs in comprehensive management of T2D.Methods: The CME comprised a patient presenting at two different time points (...)
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LY is an acylated peptide analog of oxyntomodulin, a dual glucagon and GLP-1 receptor agonist. We conducted 2 randomized, double-blind, phase 1 multiple ascending subcutaneous dosing studies in healthy subjects (S1, NCT03325387) and in T2D patients (S2, NCT03928379) to evaluate safety, (...)
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Aim: To assess whether periodic fasting reduces albuminuria and activates nephropathy-driven pathways in patients with type 2 diabetes and diabetic nephropathy.Methods: Forty patients with type 2 diabetes (HbA1c 7.8±0.2% [62.1±2.3 mmol/mol]) and increased albumin-to-creatinine ratio (ACR) were (...)
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The ACT1ON pilot study evaluated the feasibility of three dietary strategies to optimize weight and glycemic management among young adults with T1D and overweight or obesity. As a secondary measure, self-reported physical activity (PA) was collected at baseline, 3-, 6-, and 9-months from 68 (...)
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This phase 3, treat-to-target study evaluated efficacy and safety of URLi vs. lispro in 716 pediatric patients (pts) with type 1 diabetes (T1D) . After 4-week lead-in to optimize basal insulin, pts were randomized to double-blind URLi (n=280) or lispro (n=298) injected 0-2 min prior to meals, (...)
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Our objective was to compare renal hemodynamic function between obese youth with and without type 2 diabetes (T2D) and relate these measures to adipose insulin resistance (IR) .We assessed insulin sensitivity and kidney function in obese youth with (n=31, 15.8 ± 1.8 years, BMI 35.6 ± 6.6 kg/m2) , (...)
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Introduction: DSMES is a critical component of diabetes (DM) care. Providers are expected to perform this service, but time for it is limited, especially for ongoing support. Digital tools, like mobile applications (apps) , show promise in extending efforts and supporting self-management, but (...)
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Although we showed a significant association of poor adherence to OHAs with start of dialysis, this relationship according to the estimated glomerular filtration rate (eGFR) was not clarified. Patients with eGFR 2 are at high risk for dialysis. To identify the impact of MA by eGFR categories, (...)
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The Insulin-only Bionic Pancreas (BP) Pivotal Trial compared the BP initialized only with body weight vs. standard-of-care (SC) . The BP autonomously determines all insulin doses. Meals are announced without carbohydrate counting. For adults aged 19-75 the mean adjusted difference of HbA1c at (...)
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Food insecurity, or the lack of consistent access to enough food for an active, healthy life, is associated with worse glycemic control and higher mortality in adults with diabetes. However, little is known regarding the burden of food insecurity on health-related quality of life, a global (...)
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Access to specialized diabetes care is limited due to shortage of endocrinologists and distance to specialty clinics. In addition, referrals to out-of-network providers frequently results in suboptimal care coordination. Tele-mentoring models such as ECHO (Extension for Community Healthcare (...)
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Objectives: Individuals living with type 1 diabetes (T1D) are encouraged to participate in physical activity (PA) . It is vital that technology used to manage diabetes, such as a continuous glucose monitor (CGM) , provides reliable results during and after exercise. Currently, the Dexcom G6 CGM (...)
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Exercise is an important lifestyle intervention for the prevention and treatment of NAFLD. Importantly, exercise can reduce hepatic steatosis independent of changes in body mass, which may stem from increased oxidative demand in liver during exercise. Increased hepatic gluconeogenesis (GNG) and (...)
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Evidence suggests that hyperglycemia can blunt improvements in aerobic capacity (VO2peak) with exercise training. Accordingly, people with diabetes have lower VO2peak than normoglycemic controls, increasing their risk of complications and mortality. We hypothesized that reducing blood glucose (...)
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High-intensity interval training (HIIT) improves skeletal muscle mitochondrial oxidative capacity in humans with different degrees of insulin sensitivity, whereas it increases insulin sensitivity along with number of circulating small extracellular vesicle (SEV) mainly in insulin resistant (...)
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ADA guidelines recommend that people with type 1 diabetes (PWT1D) start exercise with blood glucose (BG) levels of 7-mmol/L. Those fearing hypoglycemia often start higher, which may affect kidney function and electrolyte balance. We examined serum and urine electrolyte concentration during (...)
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Aim: Maintaining in-range glucose on days with PA is challenging for youth with T1D, often requiring fine-tuning of diet and insulin. We examined how PA and macronutrient intake impact glycemic outcomes in youth with T1D.Methods: Youth and parents completed 3-day PA and diet records and youth (...)
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Background: We examined the association of time-of-day bout-related moderate-to-vigorous physical activity (bMVPA) with changes in glycemic measures and use of antidiabetic medications in adults with type 2 diabetes.Methods: Look AHEAD participants were randomly assigned to a lifestyle (...)
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Background and purpose: Exercise is widely perceived to benefit glycemic control through remodeling metabolic pathways in patients with type 2 diabetes mellitus (T2DM) . Circadian clock-regulated metabolic pathways could be reprogrammed by dietary challenges, timing of exercise relevant to (...)
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Muscle strength, balance, and flexibility has been associated with the development of type 2 diabetes and atherosclerosis, but little is known whether the physical score (PS) , which integrates these physical fitness indices, can predict future metabolic diseases. We investigated the (...)
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The Insulin-only Bionic Pancreas (BP) Pivotal Trial compared the BP initialized only with body weight vs. standard-of-care (SC) . The BP autonomously determines all insulin doses. Meals are announced without carbohydrate counting. For youth aged 6-17 the mean adjusted difference of HbA1c at 13 (...)
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We examined the association between diabetes stigma and glycemic control, treatment regimen, and acute and chronic complications in adolescents and young adults (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 (...)
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Background: High intensity exercise-induced hyperglycemia is recognized in T1D clinical guidelines, but its occurrence after high intensity intermittent exercise (HIIE) in acute studies is inconsistent. This meta-analysis aimed to examine the available evidence of BG responses to HIIE in adults (...)
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While physical activity (PA) improves physical health, and wearable accelerometers clarify PA behavior, patterns of PA and cardiometabolic risk have not been well studied in ethnic minorities. In the Mil Familias observational cohort study of Hispanic/Latino adults with or at risk for type 2 (...)
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Background: Automated Insulin Delivery (AID) devices in type 1 diabetes (T1D) are becoming standard of care, and the need for adaptive AID systems is now well recognized. However, very little is known about how self-treatment behaviors should be adapted to the action of an AID system, (...)
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Objective: The wear duration of insulin infusion sets (IIS) is impacted by initial local trauma caused by cannula insertion and sustained inflammation due mostly to insulin infusion, both of which affect insulin absorption. Efforts have been made to mitigate cannula kinking at insertion and (...)
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Background: The objective of this study was to evaluate glycemic outcomes using a structured initiation protocol for Hybrid Closed Loop (HCL) MiniMed 670G and Advanced Hybrid Closed Loop (AHCL) Minimed 780G system in children and adolescents with Type 1 Diabetes (T1D) previously treated with (...)
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Objective: This paper analyses the glycemia distribution impact in a deep learning (DL) model for glucose forecast on T1D patients.Method: Data of 139 adult T1D patients equipped with DBLG1 System are used. Data of 70% of the patients is used for hyperoptimizing a DL model (hyperop set) and 30% (...)
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Background: Open-source automated insulin delivery (AID) systems have shown to be safe and effective in clinical and real-world studies and to increase quality of life (QoL) in adult users. However, there is a lack of evidence on the effect on health-related QoL and general wellbeing in (...)
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Objective: Medtronic Mio™ 30 infusion set (M30IS) is a single-use consumable for pump users with pre-loaded inserter, utilizing a 30° insertion angle, and labeled for 3-day use. The M30IS wear duration is impacted by initial local trauma caused by insertion & cannula and sustained (...)
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Introduction: There is need to improve glucose control and QoL for type 1 diabetes (T1D) using automated insulin delivery (AID) . We evaluated non-glucose signals in subjects with T1D on AID using the multi-functional Empatica E4 device (E4) .Method: During a 2-week prospective AID study for 12 (...)
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Prior studies using frequent self-monitored blood glucose in patients with type 2 diabetes on oral medications reported that the relative contribution of fasting glucose gradually increased with increasing HbA1c levels (30% for A1c 10.2%) . This has led to targeting fasting glucose first to (...)
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Administration of the LRH-1 agonist BL0refrains hyperglycemia in 3 mouse models of type 1 diabetes (T1DM) . This antidiabetes action correlated with beta cell mass preservation and the presence of anti, rather than pro, inflammatory immune cells, indicating tolerization. Herein, we sought to (...)
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Introduction: Psychological stress may adversely affect glucose control. However, the effect of stress on efficacy of automated insulin delivery (AID) in Type 1 Diabetes (T1D) is still unknown. We evaluated non-glucose signals in subjects with type 1 diabetes on AID using the Empatica E4 device (...)
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Background: To maintain glucose control in T1DM is especially difficult in children that have unpredictable amounts of physical activity and broad eating patterns. Advances in diabetes technology include Continuous Subcutaneous Insulin Infusion (CSII) and patch/tubeless micropumps are newer (...)
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Despite increasing prevalence of T1D in ethnic minorities, they remain underrepresented in research studies evaluating diabetes technologies. Experiences of diverse cohorts are essential to assessing acceptability of diabetes devices. The Control-IQ Observational (CLIO) Study is an ongoing (...)
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Patients with diabetes may struggle to comply with numerous injections required for blood glucose control. Previous studies have shown subcutaneous insulin infusion devices, such as V-Go, are an effective alternative to injections despite the limitation of the total daily dose of insulin (TDD) (...)
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Peripheral artery disease (PAD) caused by atherosclerosis leads to considerable morbidity and mortality throughout the world, in large part, due to tissue damage from both acute and chronic occlusive ischemia. Preclinical studies have identified mechanisms involving bone marrow derived (...)
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In 2021, 1 out of adults suffered from diabetes mellitus globally. A major complication resulting from this is diabetic foot ulcers (DFU) , which can lead to amputation if improperly managed. Current clinical approaches to DFU have significant limitations, such as the high cost involved in the (...)
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Five Phase 3 SURPASS trials have shown robust efficacy of novel dual GIP/GLP-1 receptor agonist, tirzepatide, in glycaemic control and body weight (BW) loss in adults with Type 2 Diabetes (T2D) . A key secondary endpoint investigated the effect of tirzepatide (5, 10, and 15 mg) versus placebo (...)
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The PIONEER 8 (NCT03021187) trial demonstrated significant glucose-lowering efficacy of oral semaglutide vs. placebo (pbo) in patients (pts) with T2D inadequately controlled with insulin. Additionally, those assigned to oral semaglutide (7 or 14 mg daily) had a lower total daily insulin dose at (...)
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Background and Aims: Sensorimotor polyneuropathy (DPN) is the most common diabetic complication and a major contributor to increased morbidity and mortality in diabetic patients. With diagnostic methods still being limited, we aimed to correlate the phase angle (PhA) , a marker derived from (...)
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Lanifibranor therapy resulted in both NASH resolution and fibrosis reduction in the phase 2b NATIVE study in patients with non-cirrhotic NASH, compared to placebo. PPAR signaling is involved in common pathways of NASH and type 2 diabetes (T2D) . We evaluated the association between the effect (...)
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Aims: This study aimed to investigate maternal preferences for gestational diabetes mellitus (GDM) screening options in China to identify an optimal GDM screening strategy.Methods: Pregnant women at 24?28 gestational weeks were recruited from Shandong province, China. A discrete choice (...)
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Introduction: Improvements in glycemic outcomes have stalled since 20in some international surveys. We examined the latest trends in drug use and glycemic outcomes following recent introduction of newer classes of glucose lowering drugs (GLDs) in a territory-wide analysis.Methods: Using data (...)
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Introduction: Socioeconomic and educational status impact diabetes self-management and are believed to affect utilization of digital health programs, which could widen healthcare disparities. The objective of this study was to examine SDoH within members of Livongo for Diabetes, a RDMP, and (...)
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Introduction: The initiation of insulin is significantly delayed in patients with type 2 diabetes. To facilitate primary care doctors for decision making we have written a simple computer program using Python.Methods: The program incorporates evidence based recommendations for insulin (...)
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Patients with diabetes who are hospitalized often have changes in diabetes treatment regimen during hospitalization. In the ReCoDED study done at our institution, it was found that discharge instructions provided by Endocrine teams were not always accurately translated into discharge (...)
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T1DX-QI is a network of over 40 pediatric and adult centers that share best practices to improve outcomes for people with T1D. Guidelines for comprehensive diabetes care recommend integration of psychosocial screening; however, variable resources and clinical structures influence the degree to (...)
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Supaglutide (Supa) is a novel once-weekly, human-derived long-acting GLP-1 analogue developed for patients with type 2 diabetes. In this study, we investigated the safety, pharmacokinetics (PK) , pharmacodynamics (PD) and potential immunogenicity of single-dose subcutaneous injections of Supa (...)
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In patients with breast cancer (BCa) and diabetes (DM) , diabetes distress (DD) and treatment satisfaction (DTS) can influence cancer management and outcomes, yet there is limited data on how important these factors are in the BCa DM population. In this pilot study we assessed the impact of (...)
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Introduction: Diabetes treatment requires the involvement of people with diabetes in the form of regular exercise and lifestyle measures. Exercise is an important strategy in the management of diabetes. Regular exercise is necessary for good Glycaemic control and Metabolic health. Newer methods (...)
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Despite the increase in telehealth services in diabetes care during the COVID-pandemic, studies have found disparities in telemedicine (TM) use among patients. Our Diabetes Clinic currently cares for 1400 patients with type 1 diabetes (T1D) with 46% being publicly insured and for 375 patients (...)
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Background: A previous meta-analysis identified a weak association between diabetes and breast cancer (BCa) risk among postmenopausal women. The heterogeneity among studies, however, was substantial, and many of the included studies were susceptible to residual confounding by body mass index (...)
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Objective: Ischemia in pancreatic islets is critical to beta cell function, however, clinical evidences on the implications for diabetes are lacking. Pancreatectomy can induce diabetes, but the mechanisms are not clearly elucidated. Therefore, we examined if cardiovascular disease (CVD) risk (...)
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Diabetes (DM) can be classified into 5 subtypes characterized by distinct progression in dysglycaemia and complications. Using 5 clinical variables, we categorized 7017 participants from the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial into 1/auto-immune DM (n=241) , (...)
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NAFLD is common in diabetes, however the prevalence and clinical features of NAFLD in T1DM are not well defined.A retrospective, unicenter, cross-sectional analysis was performed of adults with T1DM at our institution from 2015-2018. The hepatic steatosis index (HSI) , Framingham steatosis (...)
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ADA guidelines recommend screening for significant fibrosis in patients with type 2 diabetes and steatosis or elevated ALT. In contrast, there are limited or inconsistent data about the prevalence of NAFLD and liver fibrosis in patients with type 1 diabetes (T1D) . We screened patients with T1D (...)
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Previous studies linked refined grains intake to risk of gestational diabetes (GDM) ; however, the underlying mechanisms remain understudied. We aimed to identify and validate refined grains-related metabolites as biomarkers for GDM. In a nested case-control study of 91 women with GDM and 180 (...)
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We examined links among dietary patterns (DPs) , insulin resistance (IR) , and diabetes risk by heritage (Cuban, Dominican, Mexican, Puerto Rican, and Central and South American) in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) . HCHS/SOL is a population-based cohort of 16,415 (...)
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Background: We aimed to examine age-specific association and population attributable fraction (PAF) of risk factors for all-cause and cause-specific mortality in people with type 2 diabetes.Methods: We used data from 360,202 people with type 2 diabetes who underwent metabolic assessment in (...)
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Purpose: To describe A1c changes and characteristics of patients with type 2 diabetes mellitus (T2DM) initiating oral semaglutide (sema) , by baseline A1c ?9% and DisclosureM. S. Frazer: None. C. Swift: Employee; Novo Nordisk. M. Leszko: None. A. Sargent: None. E. Buysman: None. S. B. Alvarez: (...)
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Purpose: The purpose of this real-world evidence (RWE) cohort study was to evaluate whether utilization of Cyclical-Pressure Topical Wound Oxygen (TWO2) therapy had any impact on the incidence of Diabetic Foot Ulcer (DFU) related hospitalizations and amputations over a 12-month period in (...)
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Introduction: Genome-wide association studies have identified numerous glycemic traits-associated SNPs with myocardial infarction (MI) and stroke. However, conventional regression methods combining these large numbers of highly significant SNPs in a weighted genetic risk score (wGRS) have only (...)
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Evidence supporting the involvement of EVs in the pathogenesis/severity of SARS-CoV-2 infection is starting to accumulate. However, little is known about their specific associations in the context of COVID-and type 2 diabetes interaction. Our study included 48 plasma samples (N=12/group) (...)
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Diabetes in general, and specifically in the context of obesity, is characterized by hyperglycemia resulting in non-enzymatic glycation of proteins, a key event in the pathophysiology of diabetes and its chronic complications. Yet, the full scope of molecular targets for glycation, particularly (...)
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FoxO1 is a major target of insulin action and regulates expression of ATGL and its inhibitor, G0S2, in the liver (Cell Rep 15:349, 2016) . Here, we asked whether ATGL mediates effects of FoxO1 in liver-specific insulin receptor knockout (LIRKO) mice. Studies in LIRKO and IR/FoxO1 double (...)
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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the US, encompassing a disease spectrum defined by steatosis, inflammation (NASH) , and fibrosis. Although the incidence of NASH is less in women compared with men, the mechanistic basis for this (...)
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Gluco-regulatory disturbances such as hepatic insulin resistance, hyperinsulinemia and prediabetes are commonly present in patients with nonalcoholic fatty liver disease (NAFLD) and those individuals may over time develop full-blown type 2 diabetes. Chronic liver diseases such as NAFLD and (...)
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Type 2 Diabetes (T2DM) and prediabetes are characterized by ?-cell and ?-cell dysfunction which can occur independently. Defects in ?-cell response to rising glucose can be evaluated with an oral or intravenous challenge: the former reflects normal physiology, the latter is unaffected by incretins (...)
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To determine the underlying mechanism of pramlintide effects on postprandial (PP) glucagon concentrations, we studied thirteen C-peptide negative T1D subjects (Age 35±yrs, BMI 27.6±2.2 kg/m2, fasting plasma glucose 9.4±4 mM, HbA1c 7.1±1%) on two occasions in random order, with and without 30 ?g of (...)
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Background: Sleep deprivation (SD) , recognized as a public health epidemic, impaired glucose metabolism, yet little is known about the association between sleep and bone health.Methods: Twenty 5-week-old male Wistar rats and randomly divided into the CSD and normal control (NC) groups after (...)
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An induction of lipolysis by ?3-adrenergic agonist CL316,243 (CL) increases plasma free fatty acid (FFA) level resulting later in ectopic lipid accumulation in liver. The peak of FFA stimulates insulin secretion and causes acute drop of blood glucose (BG) in chow-fed mice. This glucose-lowering (...)
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Diabetes patients with unmet social needs (e.g., housing instability, food insecurity) may be less able to complete recommended processes of care than patients without these challenges. We examined survey data from a multi-state sample of Medicaid patients with diabetes (n=6,087) identified by (...)
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Fasting insulin (FI) is a heterogeneous trait with high variability between individuals and populations. Increased FI is associated with an increased risk of type 2 diabetes (T2D) and its complications, including coronary artery disease (CAD) and hypertension (HTN) . We hypothesize that we (...)
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The loss of insulin receptor (IR) in white adipose tissue (WAT) is a feature of type 2 diabetes. Previously, we have demonstrated that feeding mice a preventive selenium rich HFD (SRHFD) , while not influencing obesity development, counteracted diet-induced downregulation of IR and insulin (...)
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Protein restriction in the postweaning diet in mice impairs glucose metabolism by reducing insulin secretion from pancreatic ? cells. TUDCA in obese rodents and humans normalized insulin secretion, increased insulin clearance, furthermore recovered mass and the number of ? cells per islet in (...)
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We recently reported that normal pancreatic islets or beta cell lines contain a subset of proinsulin molecules that have not achieved the three intramolecular disulfide bonds required for native insulin structure. Indeed, we found that non-native proinsulin monomers can form intermolecular (...)
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Background: In pancreatic ?-cells under diabetic conditions, metabolic stressors cause mitochondrial dysfunction and reduce oxidative phosphorylation, resulting in impaired intracellular metabolism. It has been suggested that aberrant activation of (...)
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Pancreatic ? cells compensate with intense insulin secretion in obese individuals, failure of which marks a vital step in progression to type 2 diabetes (T2DM) . Steroidogenic factor-1 (SF-1) is a nuclear receptor which also locates in non-steroidogenic tissues and participates in metabolic (...)
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Dynamic insulin secretion is a key focus of ? cell research, with microfluidic devices emerging as a potential means to effectively evaluate this performance parameter in vitro. However, most devices maintain isolated islets in suspension despite evidence that collagen-islet interactions are (...)
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Background and Aims: It has been shown that metabolic remodeling from oxidative phosphorylation to glycolysis via activation of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3 (PFKFB3) occurs in pancreatic beta cells in non-Asians with diabetes, resulting in impaired beta cell function. (...)
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Hepatic epidermal growth factor receptor (EGFR) expression and activation are decreased during steatosis in humans and animal models of obesity. Restoring EGFR activation in obesity-induced endoplasmic reticulum (ER) stress and diabetes is a potential therapy to improve liver function and (...)
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IDegLira-HIGH trial was a non-inferiority, prospective, randomized clinical trial, comparing the efficacy and safety of insulin degludec/liraglutide combination (IDegLira) and a regimen of multiple daily injections (MDI) with basal-bolus insulin (BB) in adults (>18-80 years of age) , with type (...)
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Background and aims: Mechanisms underlying weight loss induced remission of type 2 diabetes (T2DM) have been reported only in people with BMI >27kg/m2. The Personal Fat Threshold hypothesis postulated that the same mechanisms in people with BMI 2. Pathophysiology during stepwise dietary weight (...)
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Background and Aims: Insulin Degludec (IDeg) , in comparison with Insulin Glargine U100 (IGla) , reduces the risk of hypoglycemic events in people with type 1 diabetes (T1D) . The impact on CGM assessed glycemic metrics: the coefficient of variation (CV) , time in range (TIR) , time below range (...)
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The mitochondrial calcium uniporter (MCU) facilitates mitochondrial calcium influx, and several enzymes that catalyze key steps of the tricarboxylic acid (TCA) cycle require calcium for their activation. As such, it is generally accepted that rates of mitochondrial oxidation correlate with (...)
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Type 2 diabetes mellitus (T2DM) is associated with impairment of resting-state functional connectivity (rsFC) and cognition. Intranasal insulin (INI) has emerged as potential treatment for T2DM-related cognitive decline. INI treatment has increased perfusion and low-frequency fluctuations in (...)
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Diabetes is the leading cause of peripheral neuropathy (PN) , which results in loss of nerve supply in tissues like skin, adipose and muscle. While there are currently few treatments for PN, early mitigation in the pre-diabetic state with tissue neurotrophic factors may improve nerve function (...)
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Introduction: Renin-angiotensin system (RAS) inhibitors decrease urinary albumin:creatinine ratio (UACR) and are guideline recommended drugs for kidney protection but are ineffective in lowering UACR in up to 40% of cases. We hypothesized that rotation to another drug class overcomes resistance (...)
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Delaying insulin when indicated in type 2 diabetes (T2D) prolongs exposure to hyperglycemia. In the GRADE study, adults (N=5047) with T2D (duration 7.5%. Written consent included acceptance of injectable medications, including insulin, and to add or intensify insulin therapy after outcome (...)
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We analyzed the efficacy of Twin Precision Treatment (TPT) : a novel whole-body digital twin enabled precision nutrition that measures weight, physical activity, sleep, and sensor glucose values, for achieving remission, at six months among 199 people with T2D enrolled in RCT. The mean age was (...)
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Aims: This post hoc analysis of the real-world EVOLVE study investigated safety and effectiveness of insulin aspart (IAsp) vs. other bolus insulins in pregnant women with pre-existing type 1 diabetes.Methods: Maternal, pregnancy and infant outcomes were assessed in women receiving bolus (...)
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Alterations of fatty acid metabolism have been associated with diabetes. Triacylglycerol (TAG) can be obtained from dietary sources and synthesized de novo. The composition and location of the fatty acyl groups in a TAG can affect its physicochemical features such as melting temperature, and (...)
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Background: The high insulin costs have associated with underuse and poor adherence among patients with types 2 diabetes (T2D) . Basaglar was approved by FDA in 2015 as a follow-on insulin to reference insulin Lantus. It presents an opportunity to reduce costs and improve adherence to insulin (...)
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The micronutrient iron is a risk factor for type II diabetes (T2D) . The effects of iron are, in part, mediated by the iron-sensing hypoxia inducible factor (HIF) pathway. The interactions of iron and hypoxia in the progression of T2D are not fully understood. Mice were fed a fast-food (FF) (...)
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Insulin acts through the insulin receptor (IR) tyrosine kinase and two major canonical post-receptor signaling pathways (the IRS-1/PI3K/Akt pathway and the Shc/Ras/MAP kinase pathway) to exert its classic metabolic and mitogenic actions. To create a detailed map of how different domains of the (...)
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Newborns are exposed to environmental microbes that colonize the gut and increase in diversity during childhood to establish the resident microbiota. Concurrently, insulin-producing ?-cells enter a postnatal window of proliferation and maturation. We found that germ-free animal models exhibit (...)
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While poor glycemic control increases the risk of diabetic kidney disease (DKD) , its impact on renal function decline among those with established DKD is unclear. To examine this, we tested the relationship between baseline HbA1c and renal outcomes in the 3-year Preventing Early Renal Loss (...)
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Aim: The study aimed to identify latent profiles of diabetes burnout and examine if there are significant differences in psychosocial well-being, diabetes outcomes, and demographic characteristics between individuals with varying burnout profiles.Methods: A national sample of adults with T1D (...)
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Background: Anti-vascular endothelial growth factor (anti-VEGF) therapy has revolutionized the treatment of severe diabetic retinopathy (DR) , but significant subset of patients showed inadequate response to anti-VEGF. We have previously reported that retinol binding protein 3 (RBP3) prevented (...)
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Purpose: Diabetic retinopathy has a complex pathogenesis, and mitochondrial damage is considered to play a central role. Diabetes dysfunctions the mitochondria and damages their DNA (mtDNA) , decreasing the transcription of mtDNA-encoded genes including Cytochrome B (CYTB) , which is important (...)
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Background: Intensive glycemic control reduces the risk of diabetic retinopathy (DR) in people with type 1 diabetes (T1D) . However, the impact of glycemic control during the peri-diagnostic period on the long-term risk of DR is not known.Aim: To evaluate the association between the glycemic (...)
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Aim: To identify correlates of device uptake in people with insulin-requiring diabetes before and after interacting with DiabetesWise.org, a free, unbranded online resource.Methods: The sample included 458 participants (Mage=37.1, SD=9.73; 66% female; 81% type 1) with minimal diabetes device (...)
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Background: The T1D Exchange Quality Improvement Collaborative (T1DX-QI) is a national quality improvement network focused on improving health outcomes for patients with diabetes by sharing and using data to refine best practices among 41 participating clinics. Due to Covid-restrictions, (...)
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Introduction: Hospital readmissions are more common in persons admitted with diabetes as a primary diagnosis, accounting for approximately 20% of unplanned readmissions.1 Poor clinical outcomes and higher costs result.2 Helping people remain out of the hospital with improved diabetes (...)
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Melanocortin 4 receptor gene (MC4R) mutations result in early-onset obesity, but it is unclear how they affect abdominal fat distribution, intrahepatic fat, and related metabolic sequelae. 484 overweight/obese (BMI >85th percentile for age, sex, and height) youth (6-21 years) were screened for (...)
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Background: The prevalence of youth-onset type 2 diabetes (T2D) has been rising. There is a paucity of data on the risk factors for hyperosmolar hyperglycemic state (HHS) compared to diabetic ketoacidosis (DKA) in this population.Methods: We used the national Kids’ Inpatient Database to identify (...)
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Background: CSII is used with increased frequency; however, there are no studies evaluating human skin histology related to its use. Objectives: 1) to investigate the skin histology and metabolite changes at CSII sites and 2) associate possible changes with clinical characteristics in a cohort (...)
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Nonalcoholic fatty liver disease (NAFLD) increases overall and CVD mortality. We prospectively observed 774 T1D to assess impact of FLI (based on BMI, waist, GGT and triglycerides) on all-cause death and CVD (MI, stroke, amputation, revascularizations) risk. Over a 11-year follow-up, 57 (...)
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Background: Youth with type 2 diabetes (T2D) develop early treatment failure. Most patients do not self-monitor blood glucose (SMBG) levels at recommended frequency. Continuous glucose monitor (CGM) has been shown to improve glycemic control in pediatric T1D and adult T2D. Its feasibility and (...)
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Gut microbial composition is associated with metabolic risk and differs markedly between industrialized (IND) and non-industrialized (non-IND) populations.Objective: To characterize the gut microbiome of American Indian (AI) children with overweight/obesity relative to IND and non-IND (...)
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Background: Mississippi ranks second for childhood obesity prevalence (22%) above the national average of 16 % with significant racial and health disparities. Since March 2020, stay-at home orders, virtual learning, stress, and poor lifestyle may have provided a perfect setup leading to new (...)
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Patients with type 2 diabetes (T2D) who maintain poor glycemic control despite use of complex insulin regimens may not benefit from this costly and burdensome treatment approach. In a 16-week feasibility pilot, we proactively simplified the insulin regimens of patients with clinic refractory (...)
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Pre-diagnostic disturbances in gut microbiome and metabolome have been associated with an increased risk of diabetes in non-pregnant populations. However, such prospective studies in pregnant women are scant. We aimed to develop and validate microbiome-derived metabolite predictive markers in (...)
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In animal models, pregnancy is associated with distinct morphological and functional adaptations in the endocrine pancreas, particularly characterized by ? cell hyperplasia and hypertrophy. Failed islet adaptation to increased metabolic demands in pregnancy contributes to the development of (...)
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Introduction: Diabetic cardiomyopathy (DbCM) is characterized by abnormal cardiac structure/function, associated with incident HF, and has a 67% prevalence in the community. However, the prevalence of DbCM in a real-world, electronic health record (EHR) system is not known.Methods: Adult (...)
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This study aims to examine the impact of the association between metabolic syndrome (MetS) and metabolic dysfunction-associated fatty liver disease (MAFLD) , which both have insulin resistance and are pathophysiologically similar, on the development of new-onset cardiovascular disease, with and (...)
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Heart failure (HF) is associated with metabolic alterations, including insulin resistance (IR) . Perturbations in lipid metabolism and insulin signaling may impact outcomes, but the relationship between IR and mortality is not well characterized. The Lipoprotein Insulin Resistance Index (LPIR) (...)
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Prediabetes is a heterogenous metabolic condition. We calculated 5 pathway-based partitioned polygenetic risk scores (pPRS: beta-cell, proinsulin, obesity, lipodystrophy and liver/lipid scores) based on 94 type 2 diabetes (T2D) -associated variants in 3677 individuals with prediabetes from the (...)
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Background: Improvement of beta-cell function is reportedly involved in the improvement of glucose tolerance and remission of diabetes after bariatric and metabolic surgery. However, the impact of this surgery on beta-cell function in Japanese patients is not clear. The objective of this study (...)
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Background: HbA1c has been associated with COVID-poor outcomes in diabetic and non-diabetic populations, while patients living in census tracts with high levels of social vulnerability [measured using the CDC’s Social Vulnerability Index (SVI) ] have experienced poorer outcomes.Objective: To (...)
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Few prospective cohort studies still exist on the association between serum fatty acid (FA) proportions and the enzymes involved in their synthesis and the onset of type 2 diabetes (T2D) . Thus, the aim of the present study was to investigate whether or not serum FA proportions or FA ratios, (...)
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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 (...)
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Objective: The rare risk association of bullous pemphigoid (BP) with use of dipeptidyl peptidase-4 inhibitors (DPP-4i) had been reported including genetic association with HLA variants. We assessed genetic susceptibility of BP associated with DPP-4i use in patients with type 2 diabetes (T2D) (...)
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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 (...)
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African ancestry populations are underrepresented in human genetic studies, which leaves a knowledge gap about genetic and environmental risk factors for metabolic disease which can bias healthcare treatment. To alleviate these shortcomings, we conducted a series of genome-wide association (...)
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The activation of monocytes and macrophages plays a central role in chronic inflammation associated with type 2 diabetes mellitus (T2D) and cardiovascular disease. However, the precise epigenetic mechanisms involved are unclear. From RNA-seq analysis we found dysregulated expression of several (...)
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A better understanding of the relationship between insulin and inflammation may have important implications for the treatment and prevention of diabetes. Chronic inflammation and diabetes are associated with coronary artery disease (CAD) . That said, many studies found no correlation between (...)
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Aim: Our study predicted treatment responses in patients with painful DPN (diabetic peripheral neuropathy) by developing a deep learning model using resting state functional magnetic resonance imaging (fMRI) neuroimaging datasets.Methods: Forty-three consecutive patients who received (...)
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Objective: Damage to Schwann cells play a crucial role in diabetic peripheral neuropathy (DPN) . To observe whether HMGB1 inhibitor (Glycyrrhizic acid, GA) can prevent diabetic Schwann cells damage and its potential mechanisms.Methods: RSC96 cells were divided into 5 groups: NG group (5.6 (...)
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Aims: Altered functional connectivity has been identified in key brain regions involved in somatosensory perception in patients with painful diabetic peripheral neuropathy (painful-DPN) , using resting state functional-magnetic resonance imaging (fMRI) . This study aimed to examine the impact (...)
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Objective: We aimed to assess the role of chronic inflammation in the pathogenesis of cardiovascular autonomic neuropathy (CAN) , a serious complication of type 1 diabetes (T1D) .Methods: We leveraged an ongoing randomized, placebo-controlled clinical trial targeting inflammation with salsalate (...)
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Background: Preclinical data has shown that GLP-1 receptor agonists play a role in nerve regeneration and repair. However, few studies have investigated the effects of these compounds on nerve function in humans. The aim of this study was to examine the effect of Liraglutide (Lira) on somatic (...)
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The relationship between mean glucose measured using a continuous glucose monitor (CGM) and hemoglobin A1c (A1C) was evaluated in adults with type 1 diabetes (T1D) or type 2 diabetes (T2D) . Data from participants enrolled in the MOBILE, DIAMOND, and WISDM trials and randomized to the CGM arm (...)
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Background: Coronavirus (COVID-19) disease portends a poor prognosis in patients with type 1 diabetes (T1D) . As a consequence, the booster dose of Covid-vaccination should be prioritized in these patients. Nonetheless, concerns exist about vaccine-induced dysglycemia.Objectives: Aim of this (...)
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Introduction: Continuous glucose monitoring (CGM) is increasingly being used in the management of diabetes. Racial disparities in use of CGM may contribute to disparities in health outcomes. Studies have shown disparities in use of CGM among different races. However, most of these studies were (...)
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Youth with T1D and their parents are susceptible to diabetes-related nocturnal awakenings, which have been associated with reduced sleep duration and quality. We conducted an observational study of youth with T1D starting on the Tandem Control-IQ (CIQ) hybrid closed-loop (HCL) system to (...)
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Background and Aims: The pivotal trial of the MiniMed™ 780G system showed that optimized settings of active insulin time (2 hours) and target glucose (100mg/dL) improved glycemic outcomes.1 This study analyzed real-world glycemic outcomes of individuals with T1D in Chile, 6 months after AHCL (...)
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Objective: MiniMed™ 780G system use has improved glycemic control in clinical trials1,2 and real-world data analyses3. This study evaluated real-word glycemic outcomes before and 6 months after AHCL initiation by individuals with T1D living in Chile.Methods: Data from 37 MiniMed™ 780G users (aged (...)
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Background: Short-term continuous subcutaneous insulin infusion treatment (CSII) in patients with newly diagnosed type 2 diabetes (T2DM) can improve ?-cell function and insulin sensitivity, which results in long-term remission. However, the effect of CSII on peripheral neuropathy is rarely (...)
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Background: The T1D Exchange Quality Improvement Collaborative (T1DX-QI) is a learning network of over forty US type 1 diabetes clinics. Clinics share best-practice ideas for quality improvement and use data for population health research. This study benchmarks insulin pump use across pediatric (...)
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Background: We compared glycemic outcomes and participant experience during MiniMed™ 780G Advanced Hybrid Closed Loop (AHCL) system use while announcing all meals vs. announcing meals at will.Methods: Participants with T1DM used the AHCL system at home during two 90 days phases in which they (...)
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This study aimed to perform a systematic review related to how anxiety and other psychosocial factors impact quality of life in parents and their children with type 1 diabetes (T1D) who utilize a continuous glucose monitor (CGM) . Electronic databases and published references were utilized to (...)
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Background and Hypothesis: Elevated plasma apoB-lipoproteins (hyperapoB, mostly LDL) predicts the incidence of type 2 diabetes (T2D) and its risk factors including systemic activation of the interleukin-1 system (measured as plasma IL-1 receptor antagonist, IL-1Ra) . Moreover, native LDL induce (...)
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Background and Aims: It is well-known that diabetes self-management is important for glycemic outcome, also among insulin pump users. We aimed to explore which factors were independently associated with HbA1c.Methods: Adult insulin pump users (18+) with type 1 diabetes from the Capital Region (...)
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Insulin exposure and action are known to differ on each of 3 days of infusion set wear during CSII. We extend these observations to 1 week in a pilot phase study comparing conventional Teflon angled infusion sets to a prototype extended wear set using Capillary Biomedical SteadiFlow™ technology. (...)
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The Omnipod® 5 Automated Insulin Delivery System is a waterproof (IP28) hybrid closed-loop system where the continuous glucose monitor (CGM) communicates directly with the algorithm on the Pod to modulate insulin delivery automatically. However, the system relies on Bluetooth® wireless (...)
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Breslow’s Health Practice Index (HPI) includes recommendations for a healthy lifestyle and is composed of 7 simple lifestyle factors (sleep, breakfast, snacks, body mass index (BMI) , physical activity, drinking alcohol, and smoking status) . Cardiovascular health metrics (CVHMs) defined (...)
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High truncal fat is known to be a risk factor for cardiovascular disease (CVD) , but high leg fat has a protective effect on CVD. We investigated the association between truncal fat-to-leg fat ratio (TLR) and carotid plaque score PS) in patients with type 2 diabetes (T2D) . A total of 1966 (...)
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A Phase 1, randomized, 1-day 5-period crossover study in adults with type 1 diabetes on CSII investigated whether pain is dependent on the site and/or depth of infusion of ultra rapid lispro (URLi) excipients.Forty participants (mean age 40.5 years; BMI 27.5) were randomized to 1 of 5 infusion (...)
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Use of CGM in T2D is rising rapidly, yet little is known regarding its effects on glucose management in the VHA. We thus identified new CGM users (new CGM sensor prescriptions for T2D on insulin) and non-users (T2D receiving glucose strips) during the years 2015-2020 and used national VHA (...)
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We evaluated the association between age of onset of type 2 diabetes and the risk for major diabetes complications. We included 1.1 million people with type 2 diabetes from the Australian diabetes registry, followed from 2010-2019. We evaluated the incidence of hospitalization for, or death (...)
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Menin is an epigenetic regulatory protein that plays a key role in beta-cell proliferation and function, as previously demonstrated though increased beta-cell mass generation in Men1 knockout mice (Ja et al., 2021;13 (5) :e13524) . Here, we demonstrate the marked potential of an oral menin (...)
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Purpose: Patients referred for pancreas transplantation represent a subset of difficult to treat diabetics, who may have clinical factors preventing them from achieving a goal Hgb A1C of ?7%. Advanced insulin delivery systems with continuous glucose monitor (CGM) have been developed to offer (...)
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Food insecurity, a modifiable risk factor, has a significant impact on individuals' health and well-being. This study examined the association between food insecurity and glycemic goals among Medicare beneficiaries aged ?65 years with type 2 diabetes (T2D) , using the 20Medicare Current (...)
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Dairy consumption has been associated with a modestly lower risk of type 2 diabetes and other components of the metabolic syndrome in few cohort studies. However, confounding by overall diet quality and physical activity levels remains present. We evaluated 4,934 adults who participated in the (...)
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Insulitis involves the infiltration of predominantly CD3+ T cells in islets in a patchy distribution between lobes in a pancreas. We hypothesized that gene expression profiling of insulin containing islets (INS+CD3-) vs. insulin containing insulitic islets (INS+CD3+) would show heterogeneity in (...)
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Mammalian 5?-AMP-activated protein kinase (AMPK) is a key nutrient sensor for maintaining cellular energy status and a known therapeutic target for glucose control in type 2 diabetes (T2D) . Despite current understandings of its well-established roles in regulating glucose metabolism in various (...)
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Roux-en-Y gastric bypass (GB) surgery and sleeve gastrectomy (SG) improve glucose tolerance, in part, by enhancing prandial insulin levels. Post-meal hyperinsulinemia after GB is caused by larger insulin secretion and lower metabolic clearance rate of insulin (MCRI) . Reduced prandial MCRI (...)
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Dopamine (DA) D2-like receptors are key physiological modulators of metabolism under healthy and disease states. While D2-like receptors are expressed both in the central nervous system (CNS) and within the periphery, the respective metabolic roles of CNS and peripheral D2-like receptors remain (...)
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The use of sodium-glucose cotransporter-2 (SGLT2) inhibitors has recently been associated with euglycemic diabetic ketoacidosis (euDKA) . The absence of hyperglycemia can delay recognition of euDKA. We aimed to increase screening rates for euDKA by implementing a passive alert to providers in (...)
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Background: Chargemaster prices are the list prices that providers and health systems assign to each of their medical services in the US. These charges are often several factors of magnitude higher than those extended to individuals with either private or public insurance, however, these list (...)
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Diabetes is the leading cause of ESKD, a costly and disabling condition that often results in premature death. This study aimed to predict incident ESKD among individuals with T2D comorbid with CKD. The ACCORD clinical trial data were split into a training set and a validation set by a ratio of (...)
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Glucose-stimulated pancreatic islets show different patterns of Ca2+ signaling with fast, slow and mixed fast/slow oscillations. However, it is not clear whether they are characteristic features of individual islets. We report islet spontaneous slowdown from fast to slow/mixed Ca2+ oscillation (...)
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Both the endocrine and exocrine pancreas demonstrate morphological and chemical changes associated with T2D development. Despite significant progress, chemical profiles of the islets and acinar tissue following disease progression are not well characterized. In this work we investigated (...)
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Objective: To study the role and mechanism of Kcnq1ot1 by targeting to regulate miR-92a-1-5p to effect insulin secretion in pancreatic ? cells.Methods: The qRT-PCR was used to detect the expression of Kcnq1ot1 in different tissues of C57BL/6J mice, Min6 with PA intervention, islets of T2D model (...)
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Type 1 diabetes (T1D) has become viewed as an autoimmune disease initiated and propagated by stress responses in islet ? cells. The integrated stress response (ISR) is activated upon inflammatory signaling and delimits protein production through the actions of phospho-eIF2?. We hypothesized that (...)
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Diabetes is a risk factor for COVID-19 infection-related complications, increasing fear in this population. The effect of the pandemic on quality of life for youth with type 1 diabetes (T1D) has not been evaluated.Youth with T1D (n=108, mean age 11.6±4.0 yrs, mean T1D duration 5.3±3.9, 57.4% (...)
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Hydroxycarboxylic acid receptor 2 (HCA2) , formally known as GPR109A, is a metabolite-sensing receptor expressed predominately on adipocytes, immune cells and intestinal epithelial cells. The primary endogenous ligand of HCA2 is ?-hydroxybutyrate (?OHB) , which is elevated during periods of (...)
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GABA is an inhibitory neurotransmitter synthesized and secreted by ?-cells that is reported to modulate glucagon, somatostatin (SST) , and insulin secretion. However, the direction of the effect of GABA, whether stimulatory or inhibitory, on insulin secretion is controversial. Our results from (...)
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Disruption of the intestinal mucosa contributes to insulin resistance in obesity and Type 2 diabetes. Probiotic supplementation, which restores gut microbiota composition and fortifies intestinal barrier function, has therapeutic potential to treat obesity and metabolic disease. Treatment of (...)
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ZP8396, currently in phase 1, is a long-acting, amylin analogue designed to improve solubility and stability and allow for co-formulation with other peptides at physiological pH. Here we present in-vivo efficacy and formulation design space of ZP8396. The acute effects on body weight (BW) loss (...)
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Multi-receptor incretin agonists are being developed for several metabolic disorders. LY is an investigational triple agonist with potent activity on glucose-dependent insulinotropic polypeptide (GIP) , glucagon-like polypeptide-1 (GLP-1) , and glucagon receptors. LY was safely studied in a (...)
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In the Restoring Insulin Secretion (RISE) Study, youth (Y) compared to adults (A) had enhanced ?-cell (greater incremental C-peptide [CP] responses) and ?-cell responsiveness (greater glucagon [GG] suppression) . As GLP-1 increases CP and decreases GG, we measured GLP-1 (Mercodia) during a 3-h (...)
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Background: We assessed the longitudinal trajectory of beta-cell function with respect to baseline incretin effect in youth with obesity.Methods: At baseline and two years, youth with obesity and 2-h glucose ? 120mg/dL underwent a 3-hour OGTT and isoglycemic intravenous glucose infusion (to (...)
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Evidence supports diabetes distress’ (distress hereafter) effect on diabetes self-management. Few studies have examined factors that influence distress. We used self-reported cross-sectional data from Medicaid beneficiaries in Louisiana to examine psychosocial and clinical factors and their (...)
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This study describes the mental health of US adults with and without diabetes (ND) over an 18-month period of the COVID-pandemic. A 12-month web-based survey was administered in May 2020 (N = 2,176) to June 2021 and November 2021 (18MO; N = 1,192) including demographics, pandemic experiences, (...)
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Background: The relationship of sarcopenia with relevant features of T2D and its treatment are inconsistent in the literature.Aims: To evaluate the prevalence of sarcopenia in insulin treated older adults with T2DM.Methods: This is a cross sectional data from a prospective observational cohort (...)
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Background and Aims: TIR (blood glucose 70-180 mg/dL) , measured by continuous glucose monitoring (CGM) , provides a more comprehensive picture of glycemic control than A1c alone. Derived TIR (dTIR) , a calculated estimate of TIR, is useful when CGM data are unavailable. This post hoc analysis (...)
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The effectiveness of Gla-300 in PWT2D switching from NPH is not widely documented. REALI database combines individual data from 14 European studies in T2D. We analyzed data from PWT2D uncontrolled on prior basal insulin (BI) , 1282 switching from NPH and 2899 from other non-NPH BIs (mainly (...)
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Aims: Poor glycemic control may contribute to the very high mortality rate in patients with type 2 diabetes (T2D) receiving hemodialysis (HD) . Whether analogue compared to human insulin therapy associates with different outcomes is unknown.Methods: Incident HD patients with T2D on insulin (...)
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Despite a high prevalence of DM and CVD in older adults in the US, relatively little is known about how CVD prevalence varies by sociodemographic factors in older adults with DM. Using the 2017-20Medicare Current Beneficiaries Survey, we examined the prevalence of self-reported myocardial (...)
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Aims: Our previous study validated that controlled attenuation parameter (CAP) was a sensitive surrogate marker for evaluating metabolic derangement. However, prospective studies are needed to assess its usefulness for transition of metabolic status over time. In this study, predictive effect (...)
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While elevations in baseline fasting plasma glucose (FPG) are associated with risk of type 2 diabetes mellitus (DM) , some individuals with lower FPG will also develop DM. The aim of this study was to identify factors associated with DM in people with a baseline FPG of ? 80mg/dL. Using the (...)
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Introduction: Diagnosis of T2DM necessitates clinical tests that are time-consuming and expensive. Machine learning (ML) techniques can accelerate the diagnosis and classification of T2DM and allow clinicians to personalize treatments based on blood glucose concentrations (BGC) , physical (...)
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Glycemic change from baseline to 2-years was examined during the second year of LANDMARC, a 3-year prospective observational study (CTRI/2017/05/008452) , which included participants with T2D taking ?2 antihyperglycemic medications (with/without glycemic control) . Out of 6234 evaluable (...)
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Waist circumference (WC) is currently one of the components of metabolic syndrome (MetS) , but the cutoff points of WC for diagnosing MetS vary between races and genders. Therefore, the aim of this study is to search an anthropometric indicator instead of WC that would be applicable across (...)
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The association between screen time (ST) , including that for smartphones, and overweight/obesity (OW/OB) in children was examined separately for boys and girls, considering the influence of lifestyle factors including diet, physical activity, and sleep time. A cross-sectional study was (...)
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In adults, short sleep duration and late bedtime were associated with hyperglycemia and obesity, but these relationships in children are little known. We evaluated the association of bedtime and sleep duration with overweight/obesity or hyperglycemia in children by sex, considering the effects (...)
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Surrogate indices for insulin resistance of various insulin-responsive tissues are critical in epidemiological studies of youth at risk for developing type 2 diabetes (T2D) . Having established surrogate indices for peripheral insulin sensitivity (JCEM 2011; 96:2136) , we aimed to develop HIR-I (...)
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The hemoglobin glycation index (HGI) is the difference between observed HbA1c and predicted HbA1c from FPG using linear regression. HGI is an important biomarker of clinical management/drug treatment outcomes and can identify individuals at high risk for multiple adverse events and outcomes (...)
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The aim of this analysis of the XENSOR study was to assess the effect of 2 weight-loss drugs on hepatic serum biomarkers in patients with overweight or obesity and insufficient weight loss (WL) after a lifestyle modification program. A retrospective real-world study (RWS) was conducted (...)
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Background: Body mass index (BMI) and waist circumference (WC) are routine clinical estimates of obesity. We tested the fidelity of BMI and WC against direct body fat measures in Black (B) vs. White (W) Americans.Subjects and Methods: We analyzed the relationship between BMI vs. total fat, WC (...)
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Aims: FABP1’s relationship with obesity-related hyperuricemia remains unknown. We aimed to evaluate FABP1-level changes in patients with obesity-related hyperuricemia and changes after laparoscopic sleeve gastrectomy (LSG) .Materials and Methods: Participants were categorized according to uric (...)
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We here aimed at comparing the value of systolic blood pressure (BP) earlier versus later in life to predict cardiovascular mortality. In a cardiovascular observation study (OS) we prospectively recorded fatal cardiovascular events over up to years in 1282 patients of whom 570 had the Metabolic (...)
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Insulin resistance is a major contributor to nonalcoholic fatty liver disease (NAFLD) . NAFLD is a progressive disease that leads to impaired hepatic function and liver cirrhosis. Increased ketogenesis has been correlated with a protective phenotype in mice and humans. During our study we (...)
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Previously, we identified complement-1q like-3 (C1ql3) secreted protein as a hub gene affecting pancreatic islet function in obese mice using network biology. We demonstrated that the recombinant C1ql3 protein inhibits insulin secretion stimulated by exendin-4 (an agonist for GLP-1 receptor) (...)
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Male mice lacking the androgen receptor (AR) in islet ? cells exhibit blunted glucose-stimulated insulin secretion (GSIS) , leading to hypoinsulinemia and hyperglycemia. We showed that dihydrotestosterone (DHT) activation of an extranuclear AR in ? cells potentiates GSIS by amplifying the (...)
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Diabetes is associated with elevated plasma cholesterol (Chol) , with its intracellular accumulation resulting in ?-cell dysfunction. In steroidogenic tissues, StAR facilitates Chol transport from the outer to inner mitochondrial membrane for subsequent metabolism. We have shown that StAR is (...)
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Lipid droplets (LDs) , organelles important for intracellular lipid metabolism, are actively formed in rat and human adult beta cells and affect islet function and health. Acute mobilization of LDs by adipose triglyceride lipase in beta cells is known to support insulin secretion. As LD (...)
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Single-cell RNA sequencing (scRNA-seq) of human islets requires cell dissociation and does not provide information on the transcriptional status of islet cells. On the other hand, single-nucleus RNA sequencing (snRNA-seq) does not require cell dissociation and provides abundant information on (...)
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Neurocognitive decline, dementia and stroke are associated with obesity and type 2 diabetes (T2D) in adults. Volumetric brain changes and cerebral vascular impairment, which may mediate these outcomes, have been demonstrated in youth-onset T2D and obesity. A key to understanding the brain (...)
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Release of glutamate in the ventromedial hypothalamus (VMH) is important for stimulating the counterregulatory hormone responses to hypoglycemia. It is currently not known whether VMH glutamatergic neurotransmission is influenced by adrenergic inputs. To address this question, we examined (...)
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Background: Restoration of symptoms in response to hypogycemia has been seen in people with type 1 diabetes (T1D) and impaired awareness of hypoglycaemia (IAH) using an education and diabetes technology approach (HypoAware Study) and a psycho-educational approach addressing cognitions (HARPdoc (...)
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Background: People in the Appalachian region of KY face serious and unique health challenges influenced by socioeconomic status, rural location, and culture. Diabetes prevalence in the Appalachian region of KY is known to be consistently higher when compared to national and state-wide (...)
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Introduction: The multi-center T1D Exchange QI Collaborative (T1DX-QI) is a learning health network sharing de-identified electronic medical record data for type 1 diabetes (T1D) care improvement.Objectives: To investigate trends in racial and ethnic inequities in glycemic outcomes in children (...)
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Background: Early research suggests during the COVID-19 pandemic there was an increase in new onset diabetes mellitus (DM) and greater severity at presentation. We examined pandemic related trends of new onset DM among patients at a pediatric diabetes center in New York, NY.Methods: We (...)
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Background: Continuous glucose monitoring (CGM) improves diabetes control by reducing HbA1c and decreasing rates of hypoglycemia. Despite clinical benefits and clear guidelines from the American Diabetes Association, 365 days of continuous eligibility were followed from their first (...)
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Rationale: Due to gaps in detecting subclinical cardiac abnormalities in T2D, we evaluated prevalence and clinical manifestations of early echocardiographic (echo) abnormalities in primary care in Mexico.Methods: Mexico cohort of the ongoing ‘Take CaRe of Me program’ enrolled 2760 people with T2D (...)
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Aim: To analyze the relationship between diagnosis of DM, Hyperglycemia of hospital admission and evolution of patients hospitalized for COVID-19 in the Sanatorium “Las Lomas” Asunción, Paraguay. Materials and methods: Observational, analytical, case-control, retrospective design. Total (...)
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Background: Insulinoma antigen-2 (IA2) is a major self-antigen in T1D with post translational modification (PTM) of the extracellular domain (IA2ec) by deamidation eliciting T cell responses in T1D patients. Yet the autoantibodies (Abs) to these IA2ec PTM epitopes in T1D has not been (...)
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Introduction: Disparities in health outcomes are well documented in the literature, with factors such as race, education and income increasing the risk of inequity. Mobile health (mHealth) may help bridge the health equity gap. This study investigates use and attitudes toward One Drop's mHealth (...)
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Features of type 1 diabetes (T1D) include loss of first-phase insulin secretion in response to glucose, declining c-peptide, and glucose intolerance; indicating ? cell dysfunction. Here, we investigate the mechanisms of this dysfunction with the hypothesis that immune dysregulation during the (...)
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Activation of fatty acid oxidation is a promising therapy for NAFLD. Lowering acetyl-CoA carboxylase (ACC) activity depletes malonyl-CoA, activates CPT1, and increases mitochondrial fatty acid delivery. ACC1/2 liver double KO mice (LDKO) are protected from hepatic steatosis and have elevated (...)
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Background: Individuals with Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) have both elevated triglyceride and glucagon levels, although glucagon suppresses the very-low-density lipoprotein-triglyceride (VLDL-TG) secretion in lean individuals. Therefore, we hypothesized that the (...)
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Background: Ectopic fat deposition resulting from impaired subcutaneous adipose tissue expandability may take center stage in the pathophysiological events linking low birth weight (LBW) with increased risk of developing Type 2 diabetes (T2D) . However, the extent to which adult LBW subjects (...)
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Introduction: While people with T1D report that blood glucose (BG) fluctuations affect their day-to-day functioning, these relationships are poorly understood. Using continuous glucose monitoring (CGM) , accelerometry, and momentary surveys and cognitive tasks, we sought to understand how (...)
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Introduction: Research links self-efficacy and diabetes distress to suboptimal diabetes self-care and blood glucose (BG) regulation. However, most studies rely on between-person comparisons that cannot rule out confounding by unmeasured variables or capture the dynamic interplay among these (...)
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Background and Methods: This cross-sectional study determined the prevalence of diabetic retinopathy (DR) in non-Hispanic African Americans (AA) with end-stage-kidney disease (ESKD) and their impact on quality of life. A total of 95 adults with type 1 (n= 10) and type 2 (n= 85) on dialysis (...)
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Aim: Adherence to offloading devices for diabetic foot ulcers (DFU) is poor and postural instability influences adherence. Prior research suggests an ankle-high removable cast walker (RCW) in tandem with a contralateral shoe lift might increase users’ balance relative to a traditional knee-high (...)
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Background: Peripheral arterial disease (PAD) affects more than 200 million people with an ever-increasing prevalence. Faced with this public health issue, it seems crucial to take an interest in PAD management. In this study, we evaluated the predictors of major adverse lower limb events (...)
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A health economic analysis was conducted to determine the cost-effectiveness of a real-time continuous glucose monitoring (rt-CGM) system versus self-monitoring of blood glucose (SMBG) in Type 2 diabetes (T2D) patients treated with insulin. The IQVIA CORE diabetes model was utilized for the (...)
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Defective neurocircuit activity within the hypothalamic arcuate nucleus (ARC) , a crucial brain area for the regulation of metabolism, is implicated in obesity pathogenesis. Perineuronal nets (PNNs) are extracellular matrix structures that regulate neurocircuit activity, and PNN loss can (...)
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Introduction: The COVID-19 pandemic had affected access to healthcare services around the globe. On February 24th, 2020, the first wave of the pandemic was announced. The government of Kuwait had implemented public health measures including curfews, nationwide lockdowns, and limited access to (...)
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The central nervous system (CNS) coordinates metabolic target organ function to optimize blood glucose levels, while dysregulation of this system leads to impaired glycemia. Attempts to improve glucose control through CNS targeting are hindered by a incomplete understanding of the specific (...)
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Diabetic ketoacidosis (DKA) is often the sentinel event to a diagnosis of clinical type 1 diabetes. Research studies involving antibody positive (AAB+) individuals at risk for developing type 1 diabetes have demonstrated that metabolic monitoring every 6 months with oral glucose tolerance (...)
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A key aspect of type 2 diabetes (T2D) is the failure of ?-cells to secrete sufficient insulin to tightly control blood glucose. Nutrient sensor mTORC1 balances cell growth and degradative process (autophagy) to maintain ?-cell health and function. Changes to mTORC1 activity and autophagy are (...)
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Insulin resistance in skeletal muscle is the major metabolic defect leading to the development of type 2 diabetes. The initiating dysfunction driving development of insulin resistance has not been disclosed. Recently, stabilization of hexokinase-2 (HK2) to proteolysis by increased glucose (...)
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CD36 transports fatty acids (FA) into adipocytes and is increased in white adipose tissue (WAT) in obesity. In rodents, however, it was shown that CD36 knock out is protective for diet induced adiposity. In humans a hypocaloric high fat diet decreased CD36 gene expression in WAT. This study (...)
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Introduction: With increased CGM use in youth with T1D, it is timely to assess diabetes-specific family conflict related to CGM use. We aimed to evaluate the psychometric properties of an updated DFC measure that includes CGM items.Methods: Youth with T1D and their parents completed youth and (...)
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There is mounting evidence supporting the benefits of hybrid closed loop systems for type 1 diabetes (T1D) management. However, published studies lack long-term evaluation of these technologies in ethnically diverse patients including patient-reported outcomes (PROs) assessing lived experiences (...)
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Emerging adults (EA) with type 1 diabetes (T1D) have multiple developmental stage-specific challenges in diabetes management, including the transition to financial independence. The recently validated Problem Areas in Diabetes-EA (PAID-EA) survey is the first measure of diabetes distress (DD) (...)
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Background: For teens with T1D, stress related to neighborhood disadvantage may exacerbate diabetes distress and contribute to disparities in care and outcomes.Objective: We explored associations among neighborhood disadvantage and clinical/psychosocial outcomes to identify patterns to inform (...)
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Objective: Health disparities exist in diabetes technology access for those youth with T1D who experience high social risk, despite likely benefits. Novel Interventions in Children’s Healthcare (NICH) , designed to improve health for youth with T1D experiencing such disparities, has previously (...)
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Objective: Open-source automated insulin delivery (AID) pre-dated the availability of commercial systems and is used by thousands of people with T1D despite no regulatory approval. Our objective was to examine efficacy and safety of open-source AID.Methods: A 24 week, multi-center RCT in (...)
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Background: Carb-counting is a significant burden for persons with diabetes who require insulin to mitigate postprandial hyperglycemia. A closed-loop (CL) system with auto meal-bolus that eliminates manual mealtime bolusing was studied in adults with T1D.Methods: The system included the (...)
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Background: We assessed whether improved glucose control with hybrid closed loop can preserve C-peptide secretion compared to standard insulin therapy in youth with T1D.Methods: In a multicentre, randomised, parallel trial, youth aged to DisclosureC.K. Boughton: Consultant; CamDiab Ltd. J. (...)
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Background: Women with prior gestational diabetes (GD) have times the risk of developing type 2 diabetes (T2D) as women without prior GD. Chinese immigrants in the US are disproportionately affected by GD and T2D. Physical activity (PA) is a modifiable lifestyle strategy to reduce the risk of (...)
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Background: The clinical benefits of cardiac rehabilitation (CR) are attendance related; hence, interruptions or cancellations (I/C) of CR sessions limit clinical effectiveness. However, data on the frequency of I/C in CR is sparse. In this study, we aim to characterize the prevalence and (...)
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Background: We have shown that 50% of cardiac rehabilitation (CR) patients have at least one exercise session interrupted or cancelled (I/C) . These disruptions were highly correlated with a diabetes mellitus (DM) diagnosis. The aim of this study was to characterize the frequency of I/C at the (...)
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Exercise studies involving people with type 1 diabetes (T1D) have tested young, fit, men. As such, current insulin adjustment and carbohydrate intake advice may not work for women. A recent secondary analysis found different blood glucose (BG) responses to a weight lifting protocol between male (...)
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Background: Exercise is an integral aspect for effective diabetes management. Supervised home-based exercise through exercise prescriptions customized based on a person's exercise status, pain complaints and fitness levels can help in better adherence and low risk of injury while reducing (...)
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Background: Intermittent fasting has gained substantial popularity in the past decade. The most popular form of intermittent fasting is time restricted eating (TRE) , which involves eating within a 4-to-10-hour window and water fasting for the rest of the day. Short-term studies (2 months) (...)
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Background: Low food security is associated with increased barriers to diabetes management, and COVID-has exacerbated food insecurity in the United States. This study assessed correlation between food insecurity and health outcomes among people with type 2 diabetes (T2D) during the first year (...)
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BCAAs are key ingredients of WPs with biomodulatory effects. We recently reported that a highly-concentrated low-dose (10g, 40 Cal) WP pre-meal drink (125 mL) , generated with novel micelle-technology (WP microgel [WPM]) , ingested 15 min ahead of a pizza-meal (622 Cal) , vs placebo (PBO) , (...)
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Aim: To examine the mechanisms responsible for the increase in glucose and ketone production caused by SGLT2 inhibition with empagliflozin in T2DM patients.Research Design and Methods: 12 T2DM subjects (Age = 53; BMI = 31.7; HbA1c = 7.4%) participated in two studies performed in random order. (...)
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Aim: To identify psychosocial factors in young adults (mean age 26 yrs) that predict medication adherence 1 year later in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY2) observational study.Methods: Validated psychosocial measures (attitudes, beliefs, self-efficacy, (...)
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Background: Diabetic kidney disease (DKD) is one of the leading causes of CKD and ESRD. Decline in eGFR represents an early marker of DKD that may precede microalbuminuria. The optimal eGFR formula during transition from adolescence into adulthood remains unclear.Objective: To assess (...)
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Aim: GFR and urine albumin excretion (UAE) are prevailing measures used to detect and monitor diabetic nephropathy (DN) . We tested whether serum kidney injury molecule-1 (KIM-1) and tumor necrosis factor receptor-1 (TNFR1) , markers of DN progression, are associated with DN renal structural (...)
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Levels of hyperglycemia below those for diagnosis of diabetes are associated with microvascular injury, though the duration required to induce these complications remains poorly understood. This is especially relevant in patients with GDM due to its transient nature, which can nevertheless (...)
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Background and aims: Regular physical activity and exercise represent a corner stone in the treatment of type 1 diabetes (T1D) , however, exercise-induced hypoglycemia remains the major barrier to a physically active lifestyle. Therefore, the ULTRAFLEXI-1 study compared two basal insulin (...)
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Objective: To determine perceptions of the impact of Control-IQ™ technology (CIQ) on psychosocial functioning and quality of life (QoL) in children/ youth with T1D and their parents, using patient and parent reported outcome measures (PROMs) .Research Design and Methods: Single-center (...)
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Background: Regular exercise improves insulin resistance and glycaemic control, but ‘real world’ programmes are not universally effective. Laboratory studies show that post-breakfast exercise improves postprandial glucose excursions with subsequent meals while pre-breakfast exercise augments (...)
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Growth and differentiation factor 15 (GDF15) is a stress-induced secreted protein whose plasma levels are increased in obese patients. Recombinant GDF15 reduces body weight (BW) and improves glycemia in obese models, which is largely attributed to central action of GDF15 to suppress feeding. (...)
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Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and renin-angiotensin system inhibitors (RASi) improve kidney outcomes in people with type 2 diabetes (T2D) . Both drugs favorably affect kidney hemodynamic function which is characterized an acute GFR drop (reflecting reduced (...)
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Progression of chronic kidney disease (CKD) is associated with increased risk of cardiovascular or renal events that contribute to increasing healthcare costs. The purpose of this study was to develop predictive models for rapid progression of CKD, days out of the home, and high costs for (...)
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We tested the Complement proteome’s prognostic accuracy for kidney outcomes in T1D using a machine learning (ML) approach.Methods: This prospective cohort study comprised 193 Joslin Kidney Study subjects with T1D and an overt diabetic kidney disease at baseline followed for years. We performed (...)
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Background: Mitochondrial DNA (Mt-DNA) copy number (mtDNA-CN) has been proposed as a marker of diabetic kidney disease (DKD) . Most studies are in type 2 diabetes. We determined mtDNA-CN in adults with type 1 diabetes vs. non-diabetic subjects, including associations with complications and risk (...)
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TG concentrations across lipoprotein subclasses associate with diabetic kidney disease (DKD) in adults with T1D, but little is known about this relationship in youth with T1D. We evaluated cross-sectional relationships among TG concentrations across lipoprotein subclasses, intraglomerular (...)
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Reliance on point-of-care (POC) blood glucose measurements for inpatient diabetes management can result in long between-measurement intervals, which contribute to undetected and untreated dysglycemia. The G6 real-time continuous glucose monitoring (RT-CGM) system (Dexcom) allows for remote (...)
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Introduction: My Dose Coach (MDC) is an app designed for basal insulin dose titration that has demonstrated its versatility in several clinical studies. We evaluated its effect on the maintenance of glycemic control for 28 weeks in patients with type 2 Diabetes.Objective: Compare the efficacy (...)
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This study aimed to compare the changes in vital variables pertaining to type 2 diabetes (T2D) using Sugarfit’s Diabetes Reversal Program (SDRP) and a group with NO personal coach assistance. This is a retrospective analysis of people with T2D who participated in SDRP compared with those who (...)
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Introduction: Deep learning methods, commonly called artificial intelligence (AI) , have been widely adopted in medical research. Reinforcement learning is a particularly promising AI tool that can generate optimal strategies based on non-optimized training data. The aim of the currentstudy was (...)
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Background: Continuous glucose monitors (CGM) provide clearer, more actionable data than self-monitoring of blood glucose and are associated with improved outcomes (e.g., reduced HbA1c) . Barriers to endocrinology care create disparities in CGM access. Expanding CGM use in primary care can (...)
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Continuous glucose monitoring (CGM) metrics and self-reported disease characteristics (severe hypoglycemic events [SHEs], HbA1c) warrant further description in people with T1D using CGM and pumps, including hybrid closed-loop systems (HCLS) . We conducted a one-time online survey of adults with (...)
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Hispanic/Latinos in the U.S. bear an excess burden of type 2 diabetes (T2D) . In type 1 diabetes and insulin-treated T2D, continuous glucose monitoring (CGM) is an established technology to guide therapy, yet CGM use and studies are rare in people with/at-risk of non-insulin treated T2D and (...)
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Background: Pancreatic islet remodelling in type 1 diabetes increases somatostatin (SST) expression, which inhibits glucagon counterregulation to hypoglycemia. Here, we characterized islet morphology and hormone composition in a rodent model of insulin-deficient type 2 diabetes (T2D) .Methods: (...)
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Innate immunity is directly associated with Type 1 diabetes (T1D) . Recently, N6-methyladenosine (m6A) has been shown to modulate human ?-cell biology and innate immunity. Here, we focused on the contribution of m6A in modulating T1D development. RNA-seq. in ?-cells revealed downregulation of the (...)
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SGLT2 inhibitors (SGLT2i) are increasingly prescribed to treat type 2 diabetes (T2D) given their cardiovascular benefits. However, SGLT2i are known to increase the risk of diabetic ketoacidosis (DKA) , a rare yet serious outcome. It remains unclear whether individual SGLT2i are associated with (...)
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SGLT2 inhibitors (SGLT2is) have been shown to reduce the risk of cardiovascular and mortality events in large cardiovascular outcome trials in patients with type 2 diabetes. However, their safety profile is controversial, with some trials reporting imbalances in bladder cancer events, all of (...)
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Hospitalization for diabetes-related foot disease adds considerable burden for people living with diabetes and often leads to lower extremity amputation. We evaluated trends in the incidence of foot disease related hospital admission, revascularization and amputation procedures among people (...)
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Objective: Since the COVID-pandemic began, instead of in-office care alone, many institutions implemented hybrid care (in-office + telemedicine) . It is not known if hybrid care is as effective as in-office visits in regards to achieving glycemic goals.Methods: Clinical characteristics of (...)
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The maternal body experiences drastic alterations in energy balance during pregnancy and lactation, but little is known about the long-term metabolic changes after this reproductive experience. Here we systemically compared the metabolic phenotypes in reproductive experienced (RE) female mice (...)
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In individuals with obesity, free fatty acids (FFA) are chronically raised resulting in ß-cell dysfunction, leading to type 2 diabetes (T2D) . Recent data implicate the role of inflammation in developing ß-cell dysfunction, which is in part mediated by nucleotide-oligomerization domain 1 (NOD1) , (...)
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In obese Blacks presenting with diabetic ketoacidosis (DKA) at new-onset of diabetes, intensive insulin treatment improves ?-cell function so that ˜70% achieve near-normoglycemia remission (HbA1c < 7%, fasting blood glucose [BG]3 months. It is unknown whether glycemic measures and insulin (...)
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Therapies that preserve ?-cell function and enhance glycemic control in type 2 diabetes are of great value. We examined ?-cell function in GRADE participants after one year of intervention with insulin glargine U-100, glimepiride, liraglutide or sitagliptin. Participants who remained on (...)
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Individuals with prediabetes can be classified by fasting and glucose tolerance status. Previously we observed that elevated fasting Free Fatty Acids (FFA) are associated with Impaired Glucose Tolerance (IGT) and decreased ?-cell function (quantified as Disposition Index (DI)) . Impaired Fasting (...)
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Polygenic scores (PS) for type 2 diabetes (T2D) associate strongly with disease status. Since T2D is heterogenous, using “partitioned” PS (pPS) that capture distinct etiological processes may improve clinical utility. A previous study in Europeans identified 6 pPS from genetic clusters (GCs) (...)
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Gestational diabetes mellitus (GDM) increases offspring obesity risk. GDM severity, treatment, glycemic control and postnatal feeding behaviors increase or alleviate child obesity risk. This study sought to evaluate GDM treatment (glyburide vs. diet) and glycemic control related to (...)
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Background: Nonalcoholic steatohepatitis (NASH) is considered the hepatic manifestation of insulin resistance. Therefore, we aimed to assess the association between biopsy-proven liver steatosis and long-term remission of type 2 diabetes (T2D) 8 years following different bariatric (...)
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As the COVID-19 pandemic has disrupted daily life, it is important to understand its effects on youth with T1D. The COVID-19 Exposure and Family Impact Survey (CEFIS) was used to examine COVID-19 effects on diabetes metrics in a pediatric T1D population.Parents of youth with T1D (n=108; mean (...)
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Background: Werner syndrome (WS) is a hereditary premature aging disorder in which various signs of accelerated aging develop after puberty. These signs include gray hair, cataracts, diabetes, myocardial infarction, and malignant tumors. Patients with WS frequently show severe insulin (...)
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Background: Insulin resistance (IR) and central obesity are common in PCOS, but pathomechanisms for IR in PCOS are not established. Circulating microRNAs (miRNAs) are non-invasive biomarkers of tissue gene expression that may contribute to the pathogenesis of IR and central adiposity in (...)
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Introduction: Pancreatic fat accumulation is a potential pathogenic factor in type 2 diabetes. Evidence from hypocaloric diet indicates that reduction of pancreatic fat could contribute to an improvement in ß-cell function. There is no established pharmacological approach to reduce pancreatic (...)
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Background: Diabetes is associated with greater risk of fracture. Our aim is to evaluate the correlation of different antidiabetic agents with the risk of fracture among subjects with type 2 diabetes.Methods: The literature search was conducted in PubMed, Embase, and ClinicalTrials.gov on 22 (...)
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Changes in sympathetic nervous system activity may contribute to beneficial effects of sodium glucose transporter (SGLT2) inhibition on cardiovascular outcomes. We hypothesized that SGLT inhibition with empagliflozin lowers sympathetic activity compared with hydrochlorothiazide (HCT) to discern (...)
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Background and aim: Parkinson's disease (PD) is a common neurodegenerative movement disorder. Treatment aims at symptoms control and prevention of complications. Although type 2 diabetes (T2D) is a well-established risk factor for cerebrovascular diseases, evidence is lacking with regards to (...)
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Mutations in hepatocyte nuclear factor 1-alpha (HNF1A) cause HNF1A-diabetes (or maturity-onset diabetes of the young type 3 (MODY3)) . Treatment of HNF1A-diabetes is primarily based on sulphonylureas (SU) and secondarily insulins, glucagon-like peptide 1 receptor agonists (GLP1-RA) and (...)
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In clinical practice, needing ? 200 units insulin/day is defined as severe insulin resistance. This study seeks to identify predictive characteristics of those with type 2 diabetes and severe insulin resistance (? 200 units insulin/day) vs. those using 200 units daily (high insulin users - HIU) (...)
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Improved differentiation protocols allow large-scale generation of induced pluripotent stem cell (iPSC) -derived islets. In order to make allogeneic “off-the-shelf” islets clinically useful and avoid rejection absent immunosuppression (IS) , they need to evade host immune responses, a property we (...)
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Introduction: Achieving optimal HbA1c in people with T1D requires good treatment acceptance and self-management.Methods: IDMPS is an international, observational study investigating care practices and clinical profiles of people with diabetes in developing countries. The present analysis of (...)
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The recent COVID-19 pandemic, which saw an increased risk of subsequent diabetes among persons with COVID-19 as well as greater casualties among persons with diabetes, has brought renewed attention to the role of lung function in diabetes. We tested the relationship of lung function and chronic (...)
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In type 1 diabetes (T1D) , T cells target and destroy pancreatic beta cells. T cells express T cell receptors (TCRs) which recognize peptide antigens, and each TCR is unique to a given T cell. To understand the TCR repertoire during T1D development, we used next generation sequencing to detect (...)
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Restoration of ?-cell mass by inducing proliferation of residual ?-cells represents an attractive therapeutic approach for diabetes treatment. Native and dispersed primary human islets undergo rapid loss of viability and function ex vivo, complicating their use in proliferation studies. Here, we (...)
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Introduction: Indirect evidence suggests iGlarLixi is as efficacious as basal insulin (BI) + rapid acting insulin (RAI) for management of type 2 diabetes (T2D) . However, there are no direct comparisons of iGlarLixi (once-daily [QD]) vs. a BI+RAI regimen (multiple daily injections [MDI]) . (...)
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Glucokinase maturity onset diabetes of the young (GCK-MODY) is caused by heterozygous inactivating mutations in GCK that is not responsive to conventional glucose lowering drugs. We investigated the effects of dorzagliatin, a novel allosteric activator of hepatic and beta-cell GCK on insulin (...)
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Background: Individuals underrecruited in diabetes studies include those not seen by an endocrinologist and those from rural, low socioeconomic, and racial/ethnic minority groups. Project ECHO Diabetes aimed to recruit historically excluded participants with insulin-requiring (...)
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While diabetes and admission blood glucose (BG) are established risk factors for adverse outcomes during hospitalization for COVID-19, reports on the impact of prior glycemic control have been variable. We examined the relationship between acute and chronic glycemia on risk of ICU admission, (...)
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Diabetes incidence is expected to increase following the COVID-pandemic due to widespread changes in physical activity, diet, and access to health care services. We used administrative health care databases from Ontario, Canada to examine monthly changes in diabetes screening during the (...)
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Background: Dexamethasone improves COVID-outcomes. Detailed glycemic profile for patients receiving dexamethasone for COVID-is lacking.Methods: Our hospital recommends routine blood glucose monitoring for patients with COVID-receiving dexamethasone 6mg daily. Subjects without prior history of (...)
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Type 2 Diabetes (T2D) affects one in four Veterans and often occurs with dyslipidemia, chronic kidney disease, and nonalcoholic fatty liver disease (NAFLD) . In a pilot program, the Veterans Health Administration partnered with Virta Health to provide carbohydrate restricted nutrition therapy (...)
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Introduction: Atrial fibrillation (AF) is a prevalent cardiovascular disease among patients with diabetes mellitus (DM) . Heart failure risk (HF) & In-hospital outcomes surrounding AF are poorly understood among diabetesMethods: We queried the National Inpatient Sample from 2016 to 2018 for (...)
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Background: The main reason for restenosis (RS) after percutaneous transluminal angioplasty is the excessive proliferation and migration of vascular smooth muscle cells (VSMCs) . C/EBP? plays an important role in the process of vascular remodeling. However, the role of C/EBP? in RS has not been (...)
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MLG is conducting a large-scale, Clinical Conversations Exchange series on type 2 diabetes (T2DM) inclusive of 25 case-based, collaborative workshops for cardiologists and primary care physicians (PCPs) . The education seeks to enhance HCPs ability to ability to determine the clinical (...)
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Prediabetes carries a risk of diabetes and cardiovascular disease (CVD) . Assessment of CVD risk in prediabetes is not as routine, as is assessment of diabetes risk. However, it is not less important. This can be done through conventional SCORE charts and through coronary artery calcium (CAC) (...)
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Mental health disorders like depression and anxiety are highly prevalent in people with diabetes and are associated with poorer outcomes. The current study investigated the effect of a novel online cognitive behavioural therapy (CBT) based intervention derived from Acceptance and Commitment (...)
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Purpose: Macular edema resulting from retinal vascular leakage is the leading cause of vision loss in diabetic retinopathy (DR) . The nuclear factor of activated T-cells (NFAT) family of transcription factors is known to upregulate inflammatory cytokines in response to high glucose. This study (...)
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Background: Lower-limb peripheral artery disease (PAD) is a prevalent and challenging complication of diabetes, requiring innovating therapies. Praliciguat is an orally available stimulator of soluble guanylate cyclase reported to have favorable effects on metabolic and hemodynamic endpoints in (...)
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Obesity and diabetes are associated with chronic inflammation induced by the elevated circulating levels of Palmitic acid (PA) and also result from impaired resolution of inflammation in macrophages. Here, we examined the role of PA-induced long non-coding RNAs (lncRNAs) in the resolution of (...)
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Restenosis following percutaneous transluminal angioplasty and stenting is increased in subjects with insulin resistance and diabetes. Our preclinical models of restenosis show that insulin treatment is vasculoprotective in insulin sensitive conditions but insulin's effect is diminished or lost (...)
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Introduction: Obesity is related to insulin resistance (IR) but not all obese individuals are IR. Differences in regional fat distribution and function contribute to the metabolic heterogeneity of obesity. miRNA is known to regulate mRNA and may play a role in mediating IR by modifying adipose (...)
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The G6PC2 locus, encoding the catalytic subunit of the islet-specific glucose-6-phosphatase enzyme, is an established risk locus for HbA1c and fasting glucose levels. A critical role of glycolytic flux in regulating glucagon secretion was established through manipulation of the activity and (...)
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Insulin is a principal metabolic hormone. It regulates a plethora of metabolic pathways in sensitive peripheral tissues. Recent studies show insulin signaling plays fundamental roles in the brain. Loss of insulin action in different neuronal and glial cells contributes to a variety of metabolic (...)
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Background and aims: PDN can lead to severe deterioration in quality of life. While published data demonstrate 10kHz SCS provides substantial refractory pain relief and neurologic improvement for PDN patients1, here we report durability of these outcomes.Methods: Prospective, multicenter, RCT (...)
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Introduction: Finerenone reduced risk of cardiorenal outcomes in patients with CKD and T2D in the FIDELIO-DKD and FIGARO-DKD studies. In FIDELIO-DKD the effects of finerenone on kidney and CV outcomes were consistent irrespective of glucagon-like peptide-1 receptor agonist (GLP-1RA) use, but (...)
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There has been growing interest in examining the link between individual/neighborhood stressors with T2D. Prior studies have not tested if inflammation (CRP) may mediate the associations between multi-level stressors and T2D. This study included baseline data from the Multi-Ethnic Study of (...)
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Prediabetes is a recognized entity but has been incompletely characterized in a contemporary context. We sought to characterize participants with prediabetes with extensive multi-dimensional clinical and laboratory data and to identify predictors of progression to diabetes. TheProject Baseline (...)
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Introduction: Whether environmental exposure to heavy metals is associated with long-term mortality in adults with diabetes remains controversial. We evaluated the associations of urinary metal levels (antimony [Sb], arsenic, barium, cadmium [Cd], cesium, cobalt [Co], lead [Pb], platinum [Pt], (...)
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Introduction: Whether environmental exposure to cadmium (Cd) is associated with long-term mortality in adults with and without type 2 diabetes (T2D) is unclear. We examined the association of urinary Cd level with risk of all-cause, cardiovascular disease (CVD) and cancer mortality in U.S. (...)
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Introduction: American Indians (AIs) have high rates of type 2 diabetes (T2D) and comorbidities. Mortality risk is increased by uncontrolled cardio-metabolic factors and significantly reduced by antihypertensive, glucose- and lipid-lowering medication adherence. Medication adherence is low (...)
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Background and Aim: Suboptimal representation of race/ethnic minorities in clinical research contributes to critical gaps in our knowledge of diabetes in these populations. We aimed to evaluate the participation of AA and Hisp youth in an observational study in diabetes to assess factors (...)
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There is growing evidence linking exposure to volatile organic compounds (VOC) in ambient air with metabolic disease in humans. Benzene is a prominent VOC present in water, food, detergents, vehicle exhaust, tobacco smoke, and e-cigarettes. However, a direct link between exposure to VOC and (...)
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Background: Oral DPP-4 inhibitors provide adjunctive therapy to insulin in hospitalized patients with blood glucose (BG) < 400 mg/dL. Results from trials comparing sitagliptin or linagliptin to basal-bolus insulin showed mixed results, with no head-to-head comparison between sitagliptin and (...)
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The use of SGLT2i and GLP-1RA in patients with T2D remains low despite their known CV benefits. This may be due in part to high drug costs. We sought to assess the association between out-of-pocket (OOP) costs and the likelihood of initiating these two classes in patients with T2D and (...)
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Background: Nonalcoholic fatty liver disease (NAFLD) increases risk for obesity-related insulin resistance and type 2 diabetes. Recent studies have demonstrated that stimulating pyruvate dehydrogenase (PDH) , the rate-limiting enzyme in glucose oxidation, can reverse obesity-induced NAFLD. (...)
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Aim: To examine how hypoglycemia while asleep impacts self-reported daily functioning among adults with type 1 diabetes (T1D) .Methods: On 70 consecutive mornings, 250 people with T1D wearing a continuous glucose monitor reported sleep quality, mood, and alertness via the Hypo-METRICS (...)
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People with diabetes have been profoundly impacted by the COVID-pandemic. Diabetes and its comorbidities are strong risk factors for severe, including fatal, COVID-disease. People with diabetes may also have limited or delayed routine and non-emergent medical services, potentially increasing (...)
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Background: COVID-public health measures may have impacted diabetes care through delayed care and reduced medication access. This study describes antihyperglycemic medication prescription patterns among adults with type 2 diabetes (T2D) before and during the COVID-pandemic in Canada.Methods: (...)
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The COVID-pandemic necessitated worldwide lockdowns in 2020, with restrictions on physical activity and changes in eating habits. We investigated temporal trends in BMI in three international T1D registries between 2018-2020. Data were extracted from DPV (Germany/Austria/Luxembourg/Switzerland) (...)
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Purpose: Alterations in retinal oxygen metabolism and hemodynamics are signs of impending diabetic retinopathy (DR) . The study aimed to investigate risk factors of the retinal oxygen metabolism and hemodynamics for non-proliferative DR (NPDR) .Method: The study included 166 eyes from 50 (...)
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We analyzed the efficacy of Twin Precision Treatment (TPT) : a novel whole-body digital twin enabled precision nutrition that utilises 174 health markers and 3000 daily data points from blood tests and connected devices that measure weight, physical activity, sleep and sensor glucose values, (...)
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Nonalcoholic steatohepatitis (NASH) is a major complication of obesity, and interferon-? (IFN?) is a key regulator of innate and adaptive immunity by priming macrophages and inducing an inflammatory response. We have recently generated mice with conditional deletion of IFN? receptor in myeloid (...)
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Patients with nonalcoholic fatty liver disease (NAFLD) have elevated fasting levels of glucagon (gcg) and amino acids (AA) . Gcg regulates hepatic AA catabolism by augmenting ureagenesis. We hypothesized that hepatic steatosis causes gcg resistance and impaired gcg-induced hepatic ureagenesis. (...)
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Introduction: Combination of therapies is a promising strategy for the treatment of NASH and liver fibrosis. Here we evaluated whether the Farnesoid X Receptor agonist obeticholic acid (OCA) combined with the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide (SEMA) would show (...)
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Metabolic dysfunction in patients with metabolic fatty liver disease (MAFLD) may increase the risk for diabetes development. The liver is essential for the postprandial control of our metabolism and hormonal response, yet most studies focus on fasting conditions. We therefore studied the (...)
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Redox balance is critical for numerous cellular functions, including substrate oxidation, biosynthesis, and antioxidant defenses. Redox homeostasis is dysregulated in many metabolic diseases, including obesity and Type 2 diabetes. In addition to its role in replenishing TCA cycle intermediates, (...)
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Nonalcoholic fatty liver disease (NAFLD) is associated with both type 2 diabetes mellitus (T2DM) and congestive heart failure (CHF) , and T2DM is highly prevalent in CHF patients, in particular among women. However, the single and joint associations of T2DM and CHF with NAFLD in women have not (...)
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Elevated pro-B type natriuretic peptide (pro-BNP) has been found to be a strong marker of cardiovascular risk in several high-risk populations. However, the power of pro-B type natriuretic peptide (pro-BNP) to predict major cardiovascular events (MACE) and mortality in patients with the (...)
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Diabetes impacts on mental health. We investigated patient characteristics of those most at risk and consequences for glycaemic control.Depression (PHQ-9) , Diabetes Distress Screening Scale (DDSS) and Quality of Life (EQ5D) on-line questionnaires were completed by people with diabetes and (...)
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Although inflammatory cytokines and vascular endothelial growth factor (VEGF) have been proposed to underlie the progression of diabetic retinopathy (DR) , there remains an important need to identify biomarkers for early stages of DR. Findings from the Joslin Medalist Study, composed of (...)
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Remnant cholesterol, which is calculated as total cholesterol minus LDL cholesterol minus HDL cholesterol has attracted interest as a marker of cardiovascular event risk. The power of remnant cholesterol to predict major cardiovascular events (MACE) in patients with established coronary artery (...)
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The waist circumference-to-body-mass-ratio (W/BMI-Ratio) has attracted interest as a predictor of cardiovascular risk. Its power to predict cardiovascular events in patients with established coronary artery disease (CAD) is not known and is addressed in the present study. We prospectively (...)
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Objectives: Diabetes self-efficacy (confidence in ability to perform diabetes self-care) and personal control (perceived ability to influence diabetes outcomes) have been associated with better T2D self-care and health outcomes. Social cognitive theory posits that both beliefs are necessary for (...)
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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 (...)
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People with comorbid end-stage renal disease (ESRD) and diabetes are more prone to poor clinical outcomes including increased mortality and hospitalization, poor treatment compliance and quality of life. Self-management of these coexisting conditions is challenging as the treatment regime is (...)
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Introduction: Persons with diabetes and COVID-have higher rates of morbidity and mortality than those without diabetes. Engagement in Diabetes Self-Management Education and Support (DSMES) services may improve diabetes self-management adherence. The purpose of this study was to determine (...)
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Objective and Methods: Eating behavior questionnaire issued by the Japan Society for the Study of Obesity was administered to 41 patients who received semaglutide injection (SI) and 52 patients who received oral semaglutide (OS) in our outpatient clinic. Changes in HbA1c levels, body weight, (...)
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Objective: YA use social media (SM) frequently. Diabetes-focused SM posts may offer support for those with T1D. This qualitative study sought to explore perspectives of YA with T1D on diabetes-focused SM posts.Methods: Semi-structured interviews were conducted through videoconferencing with YA (...)
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Aim: The TheraKey Diabetes 3.0 app supports people with diabetes (PwD) during diabetes diagnosis and in the further course of the disease by providing personalized content (e.g., information, graphics, educational videos, testimonials, worksheets, interactive elements) , knowledge and skills (...)
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Aims: Are there differences in the attitudes of physicians, parents and people with diabetes (PwD) towards digitalization and new technologies in diabetes and how do these change from 20- 2021?Methods: In 20 and 2021, PwD and diabetologists in Germany were asked via online surveys about their (...)
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Objective: Although following a healthy diet is a key aspect of diabetes self-care, few brief, validated dietary measures exist. The 8-item Starting the Conversation (STC) questionnaire shows promise but has limited validation, particularly among Latinos, who are disproportionately impacted by (...)
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Diabetes outcomes are affected by socioeconomic factors including health insurance. While some research has examined the impact of health insurance in people with type 1 diabetes (T1D) (e.g., disruptions in health insurance on health outcomes) , it is less clear whether health insurance type (...)
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Recently, continuous glucose monitors (CGM) have become increasingly available and affordable to support T2D management. Evidence to date supports CGM use in T2D to improve glycemic control and quality of life, across medication regimens and care settings. However, the rate and correlates of (...)
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Importance: Comorbid substance use disorder (SUD) is associated with poor clinical outcomes among people with diabetes, but limited research has examined targeted intervention strategies for patients with both conditions.Methods: We conducted a rapid literature review using PubMed to examine (...)
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Objective: A subset of youth with T1D experience ongoing challenges with diabetes self-management, often due to social risk. This 5-site study examined which social factors were associated with hemoglobin A1c (A1c) , specifically in youth with preexisting high A1c.Methods: Youth with T1D for (...)
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Objective: Novel Interventions in Children’s Healthcare (NICH) , a program for youth with T1D who experience high rates of avoidable health problems (e.g., DKA) , has been newly implemented in a second region. This study examines how youth with T1D referred for combined health problems and (...)
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A diagnosis of T1D can be overwhelming. Offering psychosocial support throughout the first year may facilitate family adjustment. To our knowledge, no interventions exist that promote psychosocial adjustment in families immediately following diagnosis. Family-based interventions are rarely (...)
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The transfer from pediatric to adult care for adolescents and young adults (AYA) with T1D is a challenging process during which AYAs are vulnerable to worsening metabolic outcomes, missed clinic visits, and increased ED and hospital admissions. This study investigated which modifiable (...)
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AIAN women have higher risk for GDM. Early preconception counseling (PC) about healthy lifestyle/weight and mothers’ support could reduce these risks. We describe and compare parallel measures of SS with RH/GDM risk: daughters’ perceived SS from mothers, and mothers’ perceived SS for daughters. (...)
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Observational studies link poor sleep and insomnia with worse cardiometabolic health. Few studies have examined the effect of insomnia treatment on cardiometabolic health. This systematic review of randomized controlled trials (RCTs) aims to assess the effectiveness of Cognitive Behavioral (...)
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Introduction: The lockdown imposed in Romania to limit the spread of COVID-infection has led to socio-psychological changes, especially stress affecting the endocrine system.Objectives: Monitoring the impact of the lockdown imposed in Romania on patients with type 1 diabetes (DM 1) and (...)
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Many studies suggest that there is a difference in perceived stress (PS) among genders in general population. Gender differences in patients with diabetes are uncertain. Descriptions of gender differences in PS during Covid lockdown in people with diabetes are lacking.Objectives: To assess the (...)
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Despite evidence that the Montana Diabetes Prevention Program halts the progression from prediabetes to type II diabetes, individuals who live in rural areas can face unique challenges associated with their rurality. The purpose of this study was to examine the relationships between readiness (...)
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Clinical trials indicate continuous glucose monitor (CGM) use in type 2 diabetes (T2D) can be beneficial across medication regimens and outpatient settings. CGM use in care for T2D is increasing rapidly, but little is known about predictors of CGM use in T2D. Adults (age 18-75) with T2D (...)
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Trials seeking to delay or prevent type 1 diabetes (T1D) continue to face multiple challenges, including both clinical endpoint (s) and cohort selection. While it is clear that individuals who possess islet cell autoantibodies (AAbs) are at elevated risk for developing T1D, it remains unclear (...)
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Background: Depression and anxiety are examples of states of emotion that are associated with poor adherence to treatment in pediatric type 1 diabetes mellitus (T1DM) . The relationship between perceived happiness and glycemic control is unknown. Resilience also influences perceived happiness (...)
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Background: There is an increasing appreciation of the interconnection between chronic illnesses such as type-2 diabetes and behavioral health conditions such as depression and anxiety, as well as more serious behavioral health conditions. The separation of practice and payment for medical and (...)
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Patients diagnosed with type 1 and type 2 Diabetes Mellitus (DM) are at increased risk for developing clinical disordered eating behaviors (DEBs) . Although research supports this higher incidence and the impact on health outcomes, few studies have assessed physicians’ knowledg,attitudes and (...)
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Diabetes management can be burdensome and stressful. Mindfulness-based Stress Reduction (MBSR) is a method that has shown to help mitigate stress. This qualitative study, as part of a larger study, examined the effects of MBSR on stress in persons with DM2 participating in an 8-week MBSR course (...)
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Treating PreDM with medications that target specific pathophysiologic defects can slow/prevent the progression to type 2 diabetes mellitus (T2DM) . While the preventive effects of Pioglitazone (PIO) and Metformin (MET) previously have been described in PreDM, the benefit of newer antidiabetic (...)
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Background: Even though lifestyle modifications and pharmacological interventions have been shown to be effective in patients who have impaired glucose tolerance (IGT) , the patients’ responses to lifestyle changes after receiving the diagnosis of IGT in Thai patients are lacking. Therefore, (...)
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Background: The 6-month multicenter randomized controlled ALERTT1 trial showed improvement of time in range (TIR; 70-180 mg/dL) , HbA1c, time DisclosureM.M.Visser: Other Relationship; Boehringer Ingelheim International GmbH, Dexcom, Inc., Dexcom, Inc., Novo Nordisk. N.Myngheer: Advisory Panel; (...)
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Evolution of CGM technology has equipped the market with different systems. This study compared two types of CGM devices, real-time (rt) CGM and intermittently scanned (is) CGM on clinical outcomes among persons with diabetes using intensive insulin therapy. A retrospective analysis was (...)