Diabetes最新文献

{"title":"48-PUB: Trends in Diabetes Mellitus and Chronic Obstructive Pulmonary Disease–Related Mortality among Older Adults in the United States from 1999–2020","authors":"RIJA SHAKIL, MARIUM O. MIRZA, MUSHTAQ AHMAD, HAMZA EHTESHAM, AHAD MOULVI, HANEEN KHAN","doi":"10.2337/db25-48-pub","DOIUrl":"https://doi.org/10.2337/db25-48-pub","url":null,"abstract":"Introduction and Objective: Diabetes Mellitus (DM) is the 8th leading cause of death in the United States, frequently co-existing with Chronic Obstructive Pulmonary Disease (COPD). The aim of our study was to evaluate mortality trends in DM and COPD-related deaths among adults aged 65 and above. Methods: For this study, we conducted an analysis of the CDC Wonder database, focusing on death certificate data from 1999 to 2020. Specifically, we examined DM and COPD-related mortality among adults aged 65 years and older. Age-Adjusted Mortality Rates (AAMRs) were calculated with 95% confidence interval (CIs), adjusting for variables including year, sex, race/ethnicity, and geographic location. Results: Between 1999 and 2020, there were 540,033 deaths among adults aged ≥ 65 affected by DM and COPD. The AAMR increased from 46.60 in 1999 to 61.30 in 2008 (APC: 3.0; 95% CI: 2.4 to 3.7) which was followed by a decline to 61.00 in 2018 (APC: -0.4; 95% CI: -0.9 to 0.2), and another increase in 2020 to 79.0 (APC: 13.2; 95% CI: 8.2 to 18.5). When stratified by sex, men had a higher overall AAMR than women (AAMR men: 78.6 vs women: 45.7). Non- Hispanic (NH) American Indian/Alaska Native populations had the highest AAMR (83.6), followed by NH White (61.3), NH Black (61.1), Hispanic or Latino (45.2), and NH Asian or Pacific Islander (26.5). A disparity was observed among census regions with the Midwest having the highest AAMR (67.2) followed by Southern (61.3), Western (56.4) and Northeast (48.3). The AAMR was higher in rural areas (78.2) compared to urban areas (54.8). Conclusion: After a notable decline in DM and COPD-related mortality in 2008, the overall mortality took a significant hike in the following years. Furthermore, notable disparities according to race, gender and region were revealed. Disclosure R. Shakil: None. M.O. Mirza: None. M. Ahmad: None. H. Ehtesham: None. A. Moulvi: None. H. Khan: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"25 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288581","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":"1183-P: Neighborhood Level Deprivation Is a Key Predictor of Glycemic Outcomes in Youth-Onset Type 2 Diabetes","authors":"MEGAN YUASA, ZACHARY D. PEREZ, JAYSÓN DAVIDSON, JENISE C. WONG, SHYLAJA SRINIVASAN","doi":"10.2337/db25-1183-p","DOIUrl":"https://doi.org/10.2337/db25-1183-p","url":null,"abstract":"Introduction and Objective: Residing in disadvantaged neighborhoods is linked to negative health outcomes. We aimed to assess if neighborhood disadvantage, measured by the area deprivation index (ADI), predicts glycemic outcomes and development of complications in youth-onset type 2 diabetes (T2D). Methods: We extracted data from 2014-2024 from the University of California (UC) Health Data Warehouse which includes electronic health records from six UCs. T2D diagnosis was identified using a validated algorithm (Teltsch et al, 2019) based on medications, device use, ICD and SNOMED codes. Zip codes informed ADI scores which were analyzed in quintiles. Mixed effects logistic regression, adjusting for age, A1c at diagnosis, race/ethnicity, and sex, was used to assess the relationship between ADI and A1c levels from diagnosis to year 5. We also examined the association of ADI with the development of diabetes-related neuropathy, nephropathy, and retinopathy. Results: The sample included 2322 participants diagnosed before age 21 (mean age 15.6 y; 55% female; 75% non-white), with 67% in the three most disadvantaged ADI quintiles. Mean A1c declined in the first year across all quintiles but increased over years 1-5. Only the least disadvantaged quintile maintained a mean A1c <7% at year 5. The odds of achieving an A1c of <7% for the most disadvantaged quintile were 50% lower (P<0.001), while odds of an A1c >8.5% were 120% higher (P<0.001) compared to the least disadvantaged quintile. At diagnosis, 91 participants had microvascular complications, 76% of which were in the three highest quintiles (P<0.05). Over five years, 136 additional participants developed complications, though incidence did not differ significantly by quintile. Conclusion: ADI is linked to lower odds of achieving glycemic targets and higher baseline complication prevalence, highlighting neighborhood deprivation as a key predictor of glycemic outcomes in youth-onset T2D. Disclosure M. Yuasa: None. Z.D. Perez: None. J. Davidson: None. J.C. Wong: Research Support; Abbott, Dexcom, Inc., Tandem Diabetes Care, Inc. S. Srinivasan: Research Support; Abbott.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"13 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288639","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":"640-P: Exploring Self-Management Practices and Education Needs among Low-Income Adults with Type 2 Diabetes Using the Information, Motivation, and Behavioral Skills Model","authors":"EYITAYO O. OWOLABI, MICHELLE BOAKYE, ADVAIT R. RAJAN, GABRIEL Q. SHAIBI","doi":"10.2337/db25-640-p","DOIUrl":"https://doi.org/10.2337/db25-640-p","url":null,"abstract":"Introduction and Objective: Individuals with low income face a disproportionate burden of type 2 diabetes (T2D). Engaging in diabetes self-management behaviors (SMB) is essential for optimal health outcomes. Guided by the Information, Motivation, and Behavioral Skills (IMB) model, we explored the SMB, motivations, challenges, and information needs of low-income adults living with T2D. Methods: We conducted semi-structured interviews with 17 adults recruited from the community and online. Data were analyzed using deductive and inductive thematic approaches guided by the IMB model. Results: Participants (11 females, 7 males) ages ranged from 24 to 73 years (mean: 44±18), and 100% earned <$50,000/year. T2D diagnosis duration ranged from 1-20 years. Three main themes related to SMB emerged: 1) self-directed behavioral changes amid challenges, 2) fear, support, and health aspirations drive SMB engagement, and 3) the need for tailored education and skill development for proficient self-management. Participants reported engaging in four common SMBs: dietary modifications, physical activity, medication use, and glucose monitoring using information from family, friends, the internet, and some healthcare professionals. These practices were carried out despite highlighted cultural, psychosocial, financial, and systemic barriers, including limited diabetes education and lack of insurance. Motivators included social support, a desire to improve their health, and the fear of complications, often influenced by observing severe diabetes-related complications in family and friends. Participants expressed the need to better understand T2D and more personalized, comprehensive self-management education. Conclusion: Interventions that increase access to health insurance and personalized diabetes education and strengthen social support networks may reduce disparities in low-income adults with T2D. Disclosure E.O. Owolabi: None. M. Boakye: None. A.R. Rajan: None. G.Q. Shaibi: None. Funding Arizona State University Institute of Social Science Research","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"42 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288645","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":"2117-LB: Comparing Computable Phenotypes for Identification of Diabetes in an Integrated Health Care System","authors":"HUI ZHOU, MATT M. ZHOU, DONALD MCCARTHY, TERESA HARRISON, MATTHEW T. MEFFORD, JENNY CHANG, NANA MENSAH, JOHN M. CHANG, KRISTI REYNOLDS","doi":"10.2337/db25-2117-lb","DOIUrl":"https://doi.org/10.2337/db25-2117-lb","url":null,"abstract":"Introduction and Objective: Conducting rapid diabetes surveillance across health systems using electronic health records (EHR) can potentially replace costly manual chart reviews. However, such surveillance requires a parsimonious case-finding algorithm with high predictive value. Our objective was to determine an algorithm with good performance using EHR. Methods: We conducted chart reviews of 627 Kaiser Permanente Southern California members age 18-44 years, randomly selected from a subgroup of 55,089 patients with presumed diabetes identified by any diabetes-related diagnosis code, medication, or abnormal laboratory result using EHR in 2018. With chart review as the gold standard, we compared the performance of several algorithms when defining diabetes computable phenotypes, indicated by sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Performance was examined overall and by diabetes type, sex and race-ethnicity. Results: Identifying diabetes with diagnosis codes alone produced the best performance with sensitivity, specificity, PPV, and NPV of 94% [95% Confidence Interval: 91%-95%]; 87% (78%-93%); 98% (97%-99%) and 69% (42%-76%), respectively. When requiring a diagnosis code plus an abnormal lab or a diagnosis code plus diabetes medication, sensitivity dropped to 39% (35%-44%) and 44% (40%-49%), respectively, but specificity increased to 100%. When using a less restrictive algorithm such as requiring an abnormal lab or antidiabetic medication with a diagnosis code, sensitivity increased to 98% (97%-99%) and 97% (95%-98%), respectively, while the specificity dropped to under 50% (range: 0%-48%). Using only a diagnosis code resulted in overall good performance in identifying both T1D and T2D but the sensitivity of identified T1D was lowest among Black individuals [63% (25%-92%)]. We observed no difference in performance by sex. Conclusion: A simple algorithm using a diagnosis code only from the EHR demonstrates good performance in identifying both T1D and T2D diabetes. Disclosure H. Zhou: None. M.M. Zhou: None. D. McCarthy: None. T. Harrison: None. M.T. Mefford: Research Support; Merck & Co., Inc. J. Chang: None. N. Mensah: None. J.M. Chang: None. K. Reynolds: Research Support; Merck & Co., Inc.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"44 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288322","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":"19-OR: Treatment and Outcomes in Paediatric Type 1 Diabetes across Countries with Different Gross Domestic Products—Results from the Sweet Initiative","authors":"CAROLINA MARTINEZ MATEU, SUNIL S. GUPTA, REGINA DUPERVAL, RASHA A. THABET, DALIA AL-ABDULRAZZAQ, MARIJA POGAJEPEC, OLGA KAMINSKA-JACKOWIAK, MARINA M. CAVALIN, SILVIA MUNOZ, CATHERINE SANON, SUZANNE SAP, REINHARD W. HOLL, DANIÈLE PACAUD, SWEET STUDY GROUP","doi":"10.2337/db25-19-or","DOIUrl":"https://doi.org/10.2337/db25-19-or","url":null,"abstract":"Introduction and Objective: Treatment choices and outcomes for children with T1D vary by country, but the influence of economic wealth is not well studied. Aim: To evaluate this association using SWEET registry data Methods: A cross-sectional analysis of 54,285 individuals with T1D under 25 years, diagnosed for > 3 months, from 130 SWEET centers (2022-2023). Subjects were stratified by country GDP in four groups. Key variables included HbA1c, BMI, insulin dose, use of CGM, insulin pumps, and AID. Height and BMI z-scores followed WHO references. Regression models adjusted for age, diabetes duration, and sex. Results: Height z-scores were lowest in the low GDP group (-0.44) versus +0.24 to +0.50 in higher GDP groups. BMI z-scores increased from +0.04 in the low GDP group to +0.89 in the high GDP group (p < 0.001). Insulin requirements were highest in the low GDP group (0.93 U/kg) versus 0.75-0.79 U/kg in other groups (p < 0.001). CGM use rose from 36% in the low GDP group to 91% in the high GDP group, insulin pump use from 17% to 70%, and AID systems from 11% to 38% (all p < 0.001). HbA1c was highest in the low GDP group (8.7%) and lowest in the lower-middle group (7.5%), followed by 7.7% (upper-middle) and 8.1% (high GDP). DKA was most frequent in the high GDP group, while severe hypoglycemia was most common in the low GDP group (both p < 0.001). Conclusion: A strong association exists between GDP and nutritional status, technology use, and metabolic outcomes in pediatric T1D. Best metabolic control was in countries with lower-middle or upper-middle income. High-GDP countries showed poorer control, higher BMI, and more frequent DKA. These findings stress the need for better resource allocation in pediatric diabetes care. Disclosure C. Martinez Mateu: Other Relationship; Sanofi-Aventis Argentina. S.S. Gupta: None. R. Duperval: None. R.A. Thabet: None. D. Al-Abdulrazzaq: None. M. Pogajepec: None. O. Kaminska-Jackowiak: None. M.M. Cavalin: None. S. Munoz: None. C. Sanon: None. S. Sap: None. R.W. Holl: None. D. Pacaud: Research Support; Medtronic, Novo Nordisk, Eli Lilly and Company.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"44 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278263","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":"2059-LB: Practice Insights on Continuous Glucose Monitoring (CGM) Utilization in Diabetes Care","authors":"XIAOFEI ZHOU, EMILY HUBBARD, KRISTEN D. BISHOP, EVAN JUN, NICOLE HERDZIK, SHAWN A. TRIVETTE, KAREN ONSTAD, CAROLINE BLAUM","doi":"10.2337/db25-2059-lb","DOIUrl":"https://doi.org/10.2337/db25-2059-lb","url":null,"abstract":"Introduction and Objective: Continuous Glucose Monitoring (CGM) is a critical tool for diabetes management, yet its utilization remains underreported. This study evaluates the feasibility of reporting CGM utilization rates among adults with diabetes, examining uptake, variations by diabetes type, and clinician differences. Methods: A mixed-methods design assessed CGM utilization among 11,270 patients (age 18-39: 8%, 40-75: 92%; type 1: 4%, type 2: 96%) managed by 79 clinicians in 12 sites. Quantitative data included aggregated clinician results and de-identified patient uptake from automated queries of EHRs and manual chart reviews in 2023. Uptake and clinician variations were calculated using aggregated data. Feasibility was evaluated by ranking data element identification via automated queries and qualitative insights about reporting challenges. Data validity was evaluated by pooling results across sites and comparing automated queries to manual reviews, assessing sensitivity, specificity, and predictive values Results: The CGM utilization rate was 5%. Utilization was highest for type 1 diabetes (30%), followed by type 2 diabetes with multiple daily injections, basal insulin or hypoglycemic events (28%). Clinician rates varied widely, with type 1 ranging from 0% to 100% (median 25%), type 2 showing similar medians but narrower variability. Feasibility assessments highlighted challenges in identifying continuous insulin infusion users, CGM metrics, and Ambulatory Glucose Profile reports, due to unstructured documentation and inconsistent EHR capture. Validity testing showed high specificity (99%) but low sensitivity (48%), emphasizing reliance on manual reviews to ensure comprehensive and accurate data. Conclusion: CGM utilization showed significant variability across clinicians and patient groups; low adoption points to gaps in implementation despite guidelines. CGM use among individuals with type 1 diabetes was low, even though strong evidence supports its benefit. Disclosure X. Zhou: None. E. Hubbard: None. K.D. Bishop: None. E. Jun: None. N. Herdzik: None. S.A. Trivette: None. K. Onstad: None. C. Blaum: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"7 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278266","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":"1999-LB: The Efficacy of Imeglimin and Metformin on Insulin Sensitivity and Secretion Using Oral Minimal Model—Subanalysis of a Randomized Controlled Trial","authors":"RYOTA USUI, YOSHIYUKI HAMAMOTO","doi":"10.2337/db25-1999-lb","DOIUrl":"https://doi.org/10.2337/db25-1999-lb","url":null,"abstract":"Introduction and Objective: Imeglimin shares structural similarities with metformin, prompting investigation into the similarities and differences between the two drugs. We have previously demonstrated the difference in the effects on insulin and incretin secretion; however, the effect on insulin sensitivity during glucose loading requires further exploration. Methods: Patients with type 2 diabetes were randomized to imeglimin group (IME) or metformin group (MET), and OGTT was performed before and after 12 and 24weeks. Insulin sensitivity was assessed by sensitivity index (SI) calculated using the oral glucose minimal model. For beta-cell function, Φb, Φd, Φs, and Φ were calculated using the oral C-peptide minimal model. Results: SI was significantly increased in both IME and MET at 24 weeks and 12 weeks, respectively. In IME, Φs and Φ were significantly increased, while only limited changes were observed in MET. Furthermore, in IME, no correlation was found between change in Φ and baseline parameters. On the other hand, in MET, change in Φ at 24 weeks was negatively corelated with baseline Φ (ρ=-0.54, p=0.01). Conclusion: Imeglimin enhanced both insulin secretion and sensitivity regardless of patients’ background, while metformin primarily improved insulin sensitivity and exerted heterogeneous effects on beta-cell function, highlighting the distinct mechanisms of action between the two drugs. Disclosure R. Usui: Speaker's Bureau; Sumitomo Dainippon Pharma Co., Ltd, Abbott, Novo Nordisk. Y. Hamamoto: Research Support; Sumitomo Dainippon Pharma Co., Ltd. Speaker's Bureau; Novo Nordisk, Sumitomo Dainippon Pharma Co., Ltd, Merck Sharp & Dohme Corp. Funding Research grant from Sumitomo Pharma Co.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"22 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278317","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":"1253-P: Barriers and Facilitators to Sleep Health among Chinese Americans with a History of Gestational Diabetes Mellitus","authors":"SHUYUAN HUANG, JOSEPHA CABRERA, YUJIE BAI, GAIL D. MELKUS, SONIA V. LANDER, BEI WU, TANYA SPRUILL, JASON FLETCHER, DENA SCHULMAN-GREEN","doi":"10.2337/db25-1253-p","DOIUrl":"https://doi.org/10.2337/db25-1253-p","url":null,"abstract":"Introduction and Objective: Sleep is key to prevention of T2D, yet little is understood about sleep health among Chinese Americans with a history of GDM, a group disproportionately affected by GDM but still understudied and underserved. To address this gap, we explored barriers and facilitators to sleep health among this high-risk group. Methods: For this qualitative descriptive study, we conducted 45-minute semi-structured in-depth interviews with Chinese Americans living in NYC 0.5-5 years after GDM between November 2023-May 2024 until data saturation. We used thematic analysis to analyze data. Results: Participants’ (n=17) mean age was 37.9 years, 41% were 3-4 years postpartum, and 18% were breastfeeding. Most reported prolonged poor sleep after birth with insufficient sleep duration, poor quality, and/or interrupted sleep. Barriers were psychosocial (e.g., stress, anxiety), cultural (prolonged co-sleeping with kids, mom as pacifier), and environmental (e.g., noise). Facilitators included family support, a quiet living environment, and exercise. Conclusion: We found that cultural sleeping practices became major barriers to sleep health, and poor sleep health was predominant and prolonged among the study population. A culturally tailored sleep intervention that addresses cultural practices, enhances family support, reduces psychosocial and environmental barriers is needed to improve sleep health and decrease risk of T2D. Disclosure S. Huang: None. J. Cabrera: None. Y. Bai: None. G.D. Melkus: None. S.V. Lander: None. B. Wu: None. T. Spruill: None. J. Fletcher: None. D. Schulman-Green: None. Funding NIH/NIMHD (1P50MD017356-01); NIH/NCATS (UL1 TR001866); NIH/NCATS (1UL1 TR001445); Rockefeller University Heilbrunn Nurse Scholar Award","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"30 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288186","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":"1432-P: Lowering Food Insecurity and Improving Diabetes with Financial Incentives—A Randomized Controlled Pilot Study","authors":"REBEKAH J. WALKER, JENNIFER A. CAMPBELL, LEONARD E. EGEDE","doi":"10.2337/db25-1432-p","DOIUrl":"https://doi.org/10.2337/db25-1432-p","url":null,"abstract":"Introduction and Objective: Test preliminary efficacy of income supplementation and financial incentives intervention in reducing HbA1c for food insecure adults with type 2 diabetes. Methods: 150 adults with poorly controlled type 2 diabetes were randomized into one of three groups: 1) unconditional basic income supplementation of $100 per month, 2) income supplementation plus reimbursement of up to $100 per month conditional on healthy food purchases, or 3) income supplementation plus healthy food incentives and incentives at 6-months for dropping HbA1c ($150 for a drop of 2%+, $100 for a drop of 1%-1.9% or $50 for a drop of 0.5%-0.9%). All participants received monthly diabetes education/skills training mailings. Longitudinal mixed models with treatment, time, and treatment x time interactions for change in HbA1c from baseline were run within each group. Results: Sample characteristics include mean age 52(sd=13), 61% female, 53.0% Black, 8.1% Hispanic, 25% making <$10,000 per year, 3.3% with no insurance and 51% with Medicaid. We found statistically significant differences within all three groups with HbA1c at 6-months 0.67% lower for group 1, 0.78 lower for group 2, and 0.78 lower for group 3. See Figure 1. Conclusion: Income supplementation and financial incentive interventions provided to food insecure adults with diabetes resulted in clinically meaningful reductions in HbA1c with higher drops in multiple component incentive structures. Disclosure R.J. Walker: None. J.A. Campbell: None. L.E. Egede: None. Funding American Diabetes Association (1-19-JDF-075); National Institute of Diabetes and Digestive Kidney Disease (R01DK118038, R01DK120861, PI: Egede), National Institute for Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker).","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"13 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288244","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":"2161-LB: Caloric Restriction Ameliorates MAFLD by Upregulating CREB1-Dependent GSTM3 Expression and Enhancing Mitochondrial Function","authors":"XIAOSI HONG, SHANSHAN CHEN, JIABIN LIN, MENG REN, LI YAN, WEI WANG","doi":"10.2337/db25-2161-lb","DOIUrl":"https://doi.org/10.2337/db25-2161-lb","url":null,"abstract":"Introduction and Objective: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a prevalent chronic liver disease linked to obesity and metabolic disorders. Caloric restriction (CR) and intermittent fasting (IF) improve metabolic health, but their effects on MAFLD and underlying mechanisms are unclear. This study compared CR and IF regimens in MAFLD models and explored the role of glutathione S-transferase Mu3 (GSTM3) in mediating these effects. Methods: MAFLD was induced in db/db and HFD/STZ-treated C57 mice. Animals underwent ad libitum feeding, CR, or EODF for 56 days. Metabolic parameters, liver pathology, and mitochondrial function were assessed. Transcriptomics identified GSTM3 as a key target, validated by RT-qPCR, Western blot, and immunofluorescence. CREB1 regulation of GSTM3 was confirmed by ChIP assays. Liver-specific GSTM3 overexpression was evaluated in mouse models. Results: Under matched caloric restriction conditions, both CR and EODF similarly improved body weight, liver lipid deposition, inflammatory levels, and glucose metabolism in MAFLD mice. Both CR and EODF significantly upregulated the expression of GSTM3 in the liver, mediated by the transcription factor CREB1. GSTM3 expression was reduced in MAFLD patients and animal models, while overexpression of GSTM3 significantly alleviated liver lipid accumulation, inflammation, and insulin resistance, improved mitochondrial function, and promoted fatty acid oxidation. Mechanistically, GSTM3 localized to the mitochondria, scavenged reactive oxygen species and lipid peroxides, and protected mitochondrial function. Conclusion: The intensity, rather than the type, of caloric restriction plays a key role in ameliorating MAFLD. CR upregulates GSTM3 expression in a CREB1-dependent manner, enhances mitochondrial function, and promotes fatty acid oxidation, thereby effectively improving the pathological state of MAFLD. GSTM3 may serve as a potential therapeutic target for MAFLD Disclosure X. Hong: None. S. Chen: None. J. Lin: None. M. Ren: None. L. Yan: None. W. Wang: None. Funding National Natural Science Foundationof China (U20A20352), Guangdong Basic and Applied Basic Research Foundation (2023A1515030079)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"547 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288381","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}