Diabetes最新文献

{"title":"Ketone Bodies Derived From Medium-Chain Triglycerides Support Brain Metabolism and Function Under Hypoglycemia in Type 1 Diabetes Mellitus","authors":"Domenico Tricò, Lihong Jiang, Daniel Spicer, Kathleen Page, Renata Belfort de Aguiar, Sarita Naik, Mary Savoye, Donna M. Caseria, Jagriti Arora, Graeme F. Mason, Todd Constable, Douglas L. Rothman, Raimund I. Herzog","doi":"10.2337/db26-0293","DOIUrl":"https://doi.org/10.2337/db26-0293","url":null,"abstract":"Impaired cognitive function caused by insulin-induced hypoglycemia is a complication of type 1 diabetes mellitus (T1DM) for which no protective strategies are currently available. In this first-in-human mechanistic study using magnetic resonance spectroscopy, the direct contribution of the infused ketone β-hydroxybutyrate (BHB) to brain metabolism during clamped hypoglycemia was greater in participants with T1DM than healthy participants. In a randomized dietary intervention trial of participants with T1DM and recurrent hypoglycemia, receiving medium-chain triglycerides (MCTs) as a dietary ketone precursor was associated with higher working memory performance and greater regional brain activation during clamped hypoglycemia compared with an isocaloric standard diet. Counterregulatory hormone responses to hypoglycemia were not affected by MCT supplementation. We conclude that ketone bodies are well suited to support brain metabolism in persons with T1DM experiencing insulin-induced hypoglycemia. Dietary MCT supplementation raising BHB may represent a novel strategy to prevent hypoglycemia-induced brain injury in this vulnerable patient population. Article Highlights There are currently no strategies to prevent cognitive impairment caused by insulin-induced hypoglycemia in type 1 diabetes mellitus (T1DM). We examined whether β-hydroxybutyrate (BHB) supports brain metabolism during clamped hypoglycemia and whether dietary medium-chain triglycerides (MCTs), by raising BHB availability, elicit this protective effect. BHB contributed more to brain metabolism in participants with T1DM than in healthy control participants, and long-term MCT supplementation improved working memory and brain activation during hypoglycemia. Dietary MCT supplementation may protect against hypoglycemia-related cognitive deficits in T1DM.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"269 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the ADA/ADO Axis Rescues β-Cell Failure in Type 2 Diabetes","authors":"Yingxin Zhang, Ning Yu, Rui Fang, Simeng Chen, Xi Xu, Jianfa Zhang","doi":"10.2337/db26-0052","DOIUrl":"https://doi.org/10.2337/db26-0052","url":null,"abstract":"The progressive decline of functional β-cell mass is a hallmark of type 2 diabetes (T2D), yet no current therapies effectively halt this process. While chronic inflammation and metabolic stress contribute to β-cell dysfunction, the key signals integrating these pathways remain elusive. Circulating adenosine deaminase (ADA) elevation in people with diabetes is often viewed as a bystander effect, not a pathogenic component. Here, we show that this elevation reflects a failed compensatory response in a previously unknown purinergic pathway linking dyslipidemia to β-cell failure. Circulating lipids trigger rapid ATP release from erythrocytes, converted to adenosine (ADO). Accumulated ADO drives tissue-specific ADA upregulation in organs affected by diabetes complications, including spleen, kidney, and islets. When this defense fails, toxic ADO selectively causes apoptosis in macrophages, podocytes, and β-cells via defined mechanisms. We show that exogenous ADA performs systemic clearance and local decompression, boosting circulatory adenosine clearance, normalizing tissue ADA hyperactivity, and rescuing islet immunopathology and function. These findings redefine a fundamental pathogenic circuit in T2D and establish the restoration of ADO homeostasis as a therapeutic strategy capable of producing functional β-cell recovery, thereby positioning disease remission as a mechanistically grounded and attainable goal. Article Highlights Challenging the view that elevated circulating adenosine deaminase (ADA) is merely a secondary phenomenon, this study defines its pathogenic role in linking dyslipidemia to β-cell failure and establishes adenosine (ADO) homeostasis restoration as a disease-remitting therapy. We identify tissue-specific compensatory ADA upregulation that paradoxically fails to prevent systemic ADO accumulation, with elevated adenosine selectively inducing apoptosis in immune and pancreatic β-cells. We establish a novel systemic clearance-local decompression therapeutic mechanism in which exogenous ADA reduces circulating ADO, normalizes compensatory tissue ADA hyperactivity, and rescues islet function. This work redefines plasma ADA from a diagnostic marker to a therapeutic target, providing the rationale for an ADA-based therapy that uniquely combines immune modulation with metabolic correction to halt β-cell failure progression.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"62 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2054-P: Closing the Gap: A Qualitative Study of Provider Perspectives on Barriers to Glycemic Control in the Latinx Population","authors":"DIANA TORRES, SENXI DU, LESLIE NUNEZ, SYLVIA LAMBRECHTS, MATTHEW FREEBY","doi":"10.2337/db26-2054-p","DOIUrl":"https://doi.org/10.2337/db26-2054-p","url":null,"abstract":"Introduction and Objective: Among Latinx patients, diabetes prevalence is high with disproportionately elevated rates of poor glycemic control and diabetes-related complications nationally. Locally, we observe similar disparity gaps in our urban academic medical center, with Latinx patients having worse glycemic control than other groups. This qualitative study aimed to understand provider perspectives on barriers to glycemic control and opportunities to improve diabetes care for this high-risk population. Methods: We conducted nine semi-structured interviews with diabetes care providers across various ambulatory clinics. Interview transcripts were analyzed and coded using qualitative methods to identify common themes and system-level opportunities to improve diabetes care delivery within our health care system. Results: Participants included four endocrinologists, three primary care providers, and two diabetes educators who care for a high volume of Latinx patients with diabetes. Providers described multiple contributors to poor glycemic control, including structural and system-level barriers. Key themes included gaps in culturally tailored education, delays in diabetes education referrals, lack of standardized diabetes resources, and challenges with care coordination. Conclusion: Across interviews, we identified four system-level opportunities to improve diabetes care: (1) culturally tailored education, (2) enhanced integration and promotion of systemwide resources, (3) optimization of the diabetes education referral process, and (4) development of a multidisciplinary support team for high-needs patients. These findings highlight actionable system-level changes that are potentially applicable locally as well as beyond our own institution. We also plan to integrate our findings with patient-voice interviews to ensure future interventions are aligned with patients' needs and reduce disparities in glycemic outcomes. Disclosure D. Torres: None. S. Du: None. L. Nunez: None. S. Lambrechts: None. M. Freeby: Research Support; Ended; Fractyl Health, Inc., Novo Nordisk.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"14 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2067-P: Effect of Phentermine/Topiramate on BMI Reduction in Adolescents with Youth-Onset Type 2 Diabetes and Obesity","authors":"MEGAN O. BENSIGNOR, REBECCA FREESE, SILVA ARSLANIAN, KYLE RUDSER, AARON S. KELLY","doi":"10.2337/db26-2067-p","DOIUrl":"https://doi.org/10.2337/db26-2067-p","url":null,"abstract":"Introduction and Objective: First-line treatment (metformin ± insulin) for youth-onset type 2 diabetes (Y-T2D) does not reduce elevated adiposity, a primary risk factors for Y-T2D. The objective was to evaluate the effects of phentermine/topiramate (PHEN/TPM) versus placebo on body mass index (BMI) in adolescents with Y-T2D and obesity. Methods: A pilot, randomized 24-week placebo-controlled trial in adolescents, aged 12-20 years, with Y-T2D and obesity was conducted. Participants were randomized 1:1 to placebo or PHEN/TPM, a oral medication FDA-approved for youth ≥ 12 years with obesity. Participants initiated PHEN/TPM at 3.75 mg/23 mg once daily in the morning and increased every 2 weeks to a dose of 15 mg/92 mg after 8 weeks. Participants who were on metformin ± insulin therapy prior to enrollment remained on these medications. Linear regression model with an intent-to-treat population was used to compare the BMI percent change from randomization to week 24 between the groups, adjusted for baseline BMI. Results: Thirteen participants (mean age 15.5 ± 2.1 years, 38.5% female) were randomized. Mean baseline BMI was 40.3 ± 9.57 kg/m2. At the end of 24 weeks, the mean BMI change was -6.4% for those randomized to PHEN/TPM and 0.3% for the placebo group. When adjusted for baseline BMI, the placebo-subtracted BMI reduction was significant (-6.1; 95% CI [-10.93, -1.28]; p=0.019). Conclusion: In this pilot trial, PHEN/TPM significantly reduced BMI in adolescents with T2D diabetes and obesity compared with placebo. PHEN/TPM may be considered as adjuvant therapy for BMI reduction to first-line Y-T2D medications in youth with T2D and obesity. Disclosure M.O. Bensignor: Research Support; Current; Dexcom, Inc., Vivus Inc. R. Freese: None. S. Arslanian: None. K. Rudser: None. A.S. Kelly: Advisory Panel; Current; Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk. Research Support; Current; Vivus, Novo Nordisk. Funding NIH NIDDK (DK129721)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"10 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2062-P: Practice Patterns for CGM Initiation after Diagnosis of Type 1 Diabetes in Pediatric and Adult Settings: A T1D Exchange Quality Improvement Collaborative Study","authors":"RISA WOLF, SUSAN THAPA, FRANZISKA K. BISHOP, NESTORAS MATHIOUDAKIS, NICOLE RIOLES, ELIZABETH A. BROWN, DAVID MAAHS","doi":"10.2337/db26-2062-p","DOIUrl":"https://doi.org/10.2337/db26-2062-p","url":null,"abstract":"Introduction and Objective: Early CGM initiation is associated with improved HbA1c and patient satisfaction. We describe practice patterns of CGM initiation and remote-patient monitoring (RPM) across the T1D Exchange QI (T1DX-QI) consortium. Methods: The annual T1DX-QI survey was administered from August to October 2025 to collect data on frequency of communication with new onset patients, who performed the follow-up and state of RPM using CGM data. Results: Most centers (63/64, 98%) responded (67% pediatric, 33% adult centers). Follow-up was primarily managed by RN/CDCES in pediatric and by physicians in adult practices during the first month post diagnosis and by RNs in months 2-3 in both settings. Most (55%) pediatric practices started CGM within 3 days of diagnosis, compared to 29% of adult practices. Most practices (pediatrics 76% and adult 67%) connected PwT1D to the clinic CGM portals and were performing RPM. While most practices were billing for CGM interpretation at clinic visits (57% adult, 69% pediatric), few were billing for RPM between clinic visits (29% adult, 21% pediatric), despite frequent contact with PwT1D between visits. Standard protocols for RPM between visits were rare (5% adult, 17% pediatric). Conclusion: Despite widespread CGM portal connectivity and frequent between-visit contact, standardized RPM protocols and billing for between-visit care remain uncommon, highlighting opportunities to optimize care. Disclosure R. Wolf: Research Support; Current; Lilly Diabetes. Research Support; Ended; Novo Nordisk. Research Support; Current; Sanofi. Consultant; Current; Sanofi. S. Thapa: None. F.K. Bishop: None. N. Mathioudakis: None. N. Rioles: None. E.A. Brown: None. D. Maahs: Advisory Panel; Current; Abbott Diabetes, Sanofi, Medtronic, biospex, enable biosciences, kriya.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"283 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2096-P: Relationship of Liver Fat with Cardiovascular Risk in Youth of South Asian, White, and African American Ancestry: The CHARISMA Study","authors":"NOEMI MALANDRINO, ILA N. KACKER, IHAB KAMEL, GHAZAL ZANDIEH, ROBERT J. MCCARTER, PETER B. BARKER, STEVE C.N. HUI, IPEK OZDEMIR, ANDREA KELLY, STEPHANIE CHUNG, SHEELA N. MAGGE","doi":"10.2337/db26-2096-p","DOIUrl":"https://doi.org/10.2337/db26-2096-p","url":null,"abstract":"Introduction and Objective: Individuals of South Asian (SA) ancestry have greater liver fat (LF) and cardiovascular (CV) risk than African Americans (AA) or Whites (W). LF independently predicts CV disease in adults, but this association remains controversial in youth. We examined the relationship of LF with CV risk measures, i.e. arterial stiffness and the International Childhood Cardiovascular Cohort (i3C) combined-risk z-score, in SA, AA and W adolescents and young adults (AYA). Methods: A cross-sectional study of SA, AA and W AYA (12-21y) with BMI ≥80%ile (BMI ≥23 kg/m2 if ≥18y). %LF was measured by 1H-MRS. Arterial stiffness [pulse wave velocity (PWV, m/s), augmentation index at heart rate 75 (Aix75, %)] was obtained via tonometry. i3C scores were calculated using systolic blood pressure, BMI, smoking, total cholesterol, and triglycerides z-scores. Generalized robust linear regression models determined the relationship of LF with CV risk. Results: Of 87 AYA (mean±SD: 19.1±2.6y, BMI z-score 1.3±0.6 kg/m2), 54% were female, 28 SA, 29 AA, 30 W. SA AYA were 1.3y older and had the highest %LF (predicted marginal mean±SE: SA: 3.9±0.8, AA: 1.3±0.2, W: 1.7±0.4, p≤0.012). SA had higher Aix75 compared to W (SA: 16.9±3.4, AA: 18.1±2.6, W: 5.3±3.1; SA vs. W p=0.014). There was no difference in PWV (SA: 5.3±0.2, AA: 4.9±0.2, W: 5.5±0.2; SA vs. W p=0.51) or i3C score (SA: 0.23±.08, AA: 0.19±.08, W: 0.24±.09; SA vs. W p=0.87). Each 1-unit increase in %LF was associated with an increase of 3% in Aix75, 0.1 m/s in PWV, and 0.07-unit in i3C score, adjusting for age, sex, Tanner stage and ancestry (all p<0.01). The relationship of %LF with Aix75 and i3C score remained significant after adjusting for atherogenic lipids, lipoproteins and C-reactive protein. No effect modification by ancestry was detected. Conclusion: In SA, AA and W AYA, LF was related to CV risk measures independent of atherogenic lipids and inflammation. SA and AA AYA had higher Aix75 than W. Our study suggests that in SA AYA, increased Aix75 is related to higher LF, independent of slightly higher age. Disclosure N. Malandrino: None. I.N. Kacker: None. I. Kamel: None. G. Zandieh: None. R.J. McCarter: None. P.B. Barker: None. S.C. Hui: None. I. Ozdemir: None. A. Kelly: None. S. Chung: None. S.N. Magge: None. Funding National Institutes of Health (R01DK115648, DK019525), CTSA National Institutes of Health (UL1TR001079, UL1TR001878), Intramural Program of the National Institute of Diabetes & Digestive & Kidney Diseases.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"69 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2053-P: Estimation of HbA1c Using Demographic and Behavioral Adherence Metrics: A Machine-Learning Study in a Digital Diabetes Program","authors":"PRAJWAL NERKAR, ARATI K. JOSHI, ASMA ESSAT, MANSI MUNDRA, SUJIT CHAKRABARTY, PIYUSH SAMANT, GABRIEL TALBOT-LACHANCE, RAJ BARAI","doi":"10.2337/db26-2053-p","DOIUrl":"https://doi.org/10.2337/db26-2053-p","url":null,"abstract":"Introduction and Objective: HbA1c outcomes in diabetes vary widely due to differences in clinical characteristics and real-world adherence. This study aimed to develop and validate machine-learning models to predict HbA1c at 120 days using demographic, clinical, and behavioral adherence data from a digital diabetes platform. Methods: Data from 507 participants enrolled in the Lillia Care digital diabetes management platform were analyzed. The cohort had a mean age of 47 years, mean BMI of 26.7 kg/m², and mean diabetes duration of 6.2 years. Mean HbA1c improved from 8.74% at baseline to 7.31% at follow-up (mean reduction: 1.43%). Predictors included demographic and clinical variables, comorbidities, lifestyle factors, and adherence scores for nutrition, exercise, medication use, and platform engagement. Nutrition and exercise adherence varied widely, while medication adherence was consistently high (mean 96.3%). Multiple regression models were evaluated using cross-validation and held-out testing, with performance assessed using mean absolute error (MAE) and root mean squared error (RMSE). Results: Among all evaluated models, a Gradient Boosting regressor incorporating adherence metrics demonstrated the strongest predictive performance of HbA1c, achieving a cross-validation MAE of 0.62, test MAE of 0.63, and RMSE of 0.98. Tree-based ensemble models consistently outperformed linear, kernel-based, and neural-network approaches, highlighting nonlinear relationships between adherence behaviours and glycemic outcomes. Conclusion: Machine-learning models leveraging real-world adherence data can accurately forecast short-term HbA1c outcomes and support personalized diabetes care. Beyond risk stratification, the proposed model can serve as a motivational and educational tool by visually demonstrating adherence-driven glycemic outcomes, reinforcing the impact of improved nutrition, physical activity, and medication adherence on HbA1c trajectories and encouraging sustained behavior change. Disclosure P. Nerkar: None. A.K. Joshi: None. A. Essat: None. M. Mundra: None. S. Chakrabarty: None. P. Samant: None. G. Talbot-Lachance: None. R. Barai: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"44 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2093-P: HbA1c Trajectories and Risk of Impaired Glucose in Adolescents with Polycystic Ovarian Syndrome","authors":"KATRINA HOCH, KRISTEN CARLIN, ALISSA ROBERTS, BRYAN STRUB, ELAINE WALSH","doi":"10.2337/db26-2093-p","DOIUrl":"https://doi.org/10.2337/db26-2093-p","url":null,"abstract":"Introduction and Objective: Polycystic Ovarian Syndrome (PCOS) affects up to 12% of women of reproductive age and is associated with increased risk of insulin resistance and impaired glucose tolerance. This study evaluated baseline HbA1c levels and longitudinal HbA1c trajectories in adolescents with PCOS to identify characteristics associated with elevated or increasing HbA1c and to inform opportunities for enhanced screening and support. Methods: This retrospective cohort study used electronic health records from a free-standing pediatric hospital (January 2016-July 2025). Patients with a confirmed diagnosis of PCOS were included. Longitudinal HbA1c trajectories were evaluated using linear mixed-effects models with random intercepts and slopes, examining the impact of key demographic and clinical characteristics. Results: A total of 819 patients met inclusion criteria, with 0-7.2 years of follow-up. Mean HbA1c (5.4) across the population remained stable, but several factors were associated with increased HbA1c throughout the study period, including higher BMI (β=0.06, 95% CI=0.03, 0.09), older age at PCOS diagnosis (β=0.03, 95% CI=0.00, 0.05), Asian or unknown/declined race (β=0.18, 95% CI=0.05, 0.31 and β=0.25, 95% CI=0.04, 0.46, respectively) and acanthosis (β=0.18, 95% CI = 0.07, 0.28). Ethnicity moderated trajectories: HbA1c declined over time in non-Hispanic patients and increased in Hispanic patients (β=0.12, 95% CI=0.05, 0.20). Language also moderated patterns, with those with a language of care (LOC) of Spanish showing decreasing HbA1c relative to English and other LOC (β=-0.13, 95% CI=-0.23, -0.02). Conclusion: Early PCOS identification may help prevent rising HbA1c in higher-risk groups, including adolescents identifying as Asian or unknown/declined race. Patients from some groups may benefit from continued support after diagnosis. Language patterns suggest that culturally and linguistically aligned care may be protective for some patients. Disclosure K. Hoch: None. K. Carlin: None. A. Roberts: None. B. Strub: None. E. Walsh: None. Funding Lenssen Grant for Nutrition Research at Seattle Children's Research Institute","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"46 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2076-P: A Home-Learning Program for Improving Diet and Activity in Rural Children: The Kids PowerUP Pilot Study","authors":"SHECCID ONTIVEROS, TRACI BEKELMAN, JEANETTE M. STAFFORD, ALAN DELAMATER, KATHERINE SAUDER","doi":"10.2337/db26-2076-p","DOIUrl":"https://doi.org/10.2337/db26-2076-p","url":null,"abstract":"Introduction and Objective: Rates of childhood obesity and type 2 diabetes are rising in rural communities, yet traditional school-based interventions have had limited success. We utilized a multi-component, family-centered approach to support children through personalized engagement with a home-based learning program. Our objective was to assess reach, feasibility, and acceptability of the intervention and control programs, and of virtual data collection. Methods: We recruited children age 7 to 10 years living in rural Colorado and North Carolina using flyers, community events, social media outreach, and medical record messaging. The intervention provided 16 parent-guided activity kits and 9 virtual support sessions over 6 months. The control program provided 6 monthly STEM activity kits. Participants completed pre- and post-program surveys, self-measured anthropometrics, self-sampling of capillary blood, and accelerometry, and were invited to do a post-program qualitative interview. Results: We received 187 interest surveys; 72 participants consented, and 67 completed baseline data collection and were randomized (35 intervention, 32 control). Eleven intervention and five control participants withdrew during the program, and 44 completed post-program data collection thus far, including 14 qualitative interviews. Intervention participants completed a median of 14 kits (IQR 6-16) and 2 coaching sessions (IQR 1-4) over a median duration of 34 weeks. Qualitative data indicated that emphasizing family involvement would support engagement for both programs, and that reducing study duration and number of kits of intervention kits may further facilitate completion. Conclusion: This pilot study demonstrates that the home-based Kids PowerUP program and STEM control programs are feasible, with successful completion of remote data collection procedures. Disclosure S. Ontiveros: None. T. Bekelman: None. J.M. Stafford: None. A. Delamater: None. K. Sauder: None. Funding American Diabetes Association (7-22-ICTSN-06), The Center for Prevention Science in Child and Family Health at Wake Forest University School of Medicine (600191)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"26 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2102-P: High Risk of Disordered Eating Behaviors (DEBs) in Adolescents and Young Adults (AYA) with Type 1 Diabetes Using Diabetes Technology","authors":"MONICA V.D.M. SILVEIRA, LISA VOLKENING, SARAH HANES, AIKA K. SCHNEIDER-UTAKA, GRACE ORLOFF, JESSIE WONG, KOREY HOOD, LORI M. LAFFEL","doi":"10.2337/db26-2102-p","DOIUrl":"https://doi.org/10.2337/db26-2102-p","url":null,"abstract":"Introduction and Objective: DEBs are common in AYA with T1D and are linked to suboptimal outcomes. We examined if this finding holds in a sample with high use of diabetes technology. Methods: From 2 centers, 191 AYA, age 14-25, completed the Diabetes Eating Problem Survey-Revised (DEPS-R) and were categorized by DEB risk: low (DEPS<10), moderate (DEPS 10-19), high (DEPS ≥20). AYA provided demographic/clinical data & completed surveys on diabetes distress (DD), sleep quality, fear of hypoglycemia (FOH), global health (PROMIS), & exercise. Results: AYA (50% female) had mean age 19.8±3.4 yrs, T1D duration 11.4±5.4 yrs, A1c 8.0±1.2%, & TIR (70-180 mg/dL) 49±17%; 100% had CGM data (98% regular users); 77% used AID. Weight status was 51% normal weight, 27% overweight, & 22% obese. DEB risk rates spread evenly across 3 categories (table). Higher DEB risk rates were associated with older age, female/non-binary gender, & overweight/obesity. Those with higher DEB risk rates reported greater DD, poorer sleep quality, greater FOH, poorer overall health, & less exercise. For those with high DEB risk rates, 56% reported missing insulin multiple times weekly vs 46% with moderate & 38% with low risk rates (p=.05). Conclusion: DEBs were common in AYA with T1D using CGM and AID and tracked significantly with adverse person-reported outcomes. Even with diabetes technology use, monitoring for DEBs remains critical for AYA with T1D. Disclosure M.V. Silveira: None. L. Volkening: None. S. Hanes: None. A.K. Schneider-Utaka: None. G. Orloff: None. J. Wong: None. K. Hood: Consultant; Current; Sanofi, MannKind Corporation, Insulet Corporation. L.M. Laffel: Other - Travel support for scientific presentations; Ended; Boehringer Ingelheim International GmbH. Other - DSMB Chair; Ended; Janssen Pharmaceuticals, Inc. Consultant; Current; Dexcom, Inc. Advisory Panel; Current; Medtronic, Sequel, Tandem Diabetes Care, Inc. Consultant; Current; Roche Diabetes Care, Sinocare. Advisory Panel; Ended; Sanofi. Advisory Panel; Current; MannKind Corporation. Funding NIH (R01DK129479)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"28 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}