Diabetes最新文献

{"title":"2122-P: Family-Based Behavioral Approach to Treating Overweight in Youth with Type 1 Diabetes (T1D)","authors":"TERESA QUATTRIN, ANDREW W. STROHMEIER, AMY L. BARCZYKOWSKI, COLLEEN K. KILANOWSKI, ALORA REIMER, MARCHELLE L.K. BROOKS, AUSTIN RESZEL, LUCY MASTRANDREA, GREGORY E. WILDING","doi":"10.2337/db26-2122-p","DOIUrl":"https://doi.org/10.2337/db26-2122-p","url":null,"abstract":"Introduction and Objective: Overweight affects over 1 in 3 patients with T1D. The aim of this pilot study was to adapt our successful evidence-based Family-Based Behavioral Treatment (FBT) to treat overweight in youth with T1D and overweight and their parents with overweight. Methods: Coaches delivered 10 in-person/virtual sessions over 12 weeks to children age 6-17 yrs, BMI≥85th%, T1D duration≥1 yr, using pump and CGM and having 1 parent with BMI≥25Kg/m2. We excluded those with other chronic/autoimmune diseases (except thyroiditis), eating disorders, and therapies affecting weight. Participants received a Bluetooth scale to check home weight twice/week and MyNetDiary app to log dietary intake. Data were expressed as mean±SD. Changes from baseline were evaluated using two-sided one-sample t-tests of within-subject change scores. Results: Participants included 11 dyads: children (age 12.4±3 yrs.) and parents (age 45±5 yrs.). Youth had a % overweight≥50 percentile (%OW) decrease from 55.4±21 to 50.7±225% (p<0.02). %OW was calculated as follows: (Child BMI-BMI@50th Percentile)/BMI@50th)x100. HbA1c and insulin dose were 7.7±0.5% and 1.00±0.2 U/Kg/day at baseline and remained stable at 12 weeks. Parents’ weight decreased from 243±41 lbs. to 237.5±39 (p=0.006) and did not correlate with change in %OW in children. The Diabetes Treatment Satisfaction Questionnaire score (range 1-72) was 48.5±4.8 at baseline and 55.3±4.9 (p=0.01) at 12 weeks in youth. Conclusion: FBT decreased %OW in children and weight in parents. The decrease in %OW in children and weight in parents are similar to those obtained in FBT implemented in primary care. The lack of correlation between parent and child weight changes suggests that parents did not model. Parents and children expressed satisfaction with the program, but reported difficulty affording healthy food. They checked their home weight but did not record dietary intake, being unwilling to add any additional duty to the already burdensome T1D. This needs to be considered in the approach to treating overweight in T1D. Disclosure T. Quattrin: Consultant; Ended; Provention Bio, Inc. Speaker's Bureau; Current; Sanofi. Advisory Panel; Current; Sanofi. Research Support; Current; National Center for Advancing Translational Sciences. A.W. Strohmeier: None. A.L. Barczykowski: None. C.K. Kilanowski: Employee; Current; Girls on the Run. Consultant; Current; Washington University. A. Reimer: None. M.L. Brooks: None. A. Reszel: None. L. Mastrandrea: Research Support; Current; Novo Nordisk, Rhythm Pharmaceuticals, Inc., Eli Lilly and Company. Research Support; Ended; Dompé. Research Support; Current; Cour. G.E. Wilding: None. Funding University at Buffalo Clinical and Translational Science Institute Pilot Studies Program. This program is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UM1TR005296 to the University at Buffalo, as well as: UB’s Office of","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"1 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286837","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":"2074-P: Community Voices: A Formative Evaluation of Sugary Drink Perceptions in Two School Communities","authors":"JULIE PIKE, KATIE HABERLIN-PITTZ, LUZ A. MACHUCA, NOHA EL YAMAN, TAMARA S. HANNON","doi":"10.2337/db26-2074-p","DOIUrl":"https://doi.org/10.2337/db26-2074-p","url":null,"abstract":"Introduction and Objective: Sugary drinks increase risk for type 2 diabetes, yet they remain a significant source of added sugars in the diet. School-based interventions are a promising approach to reduce SSB consumption. We partnered with two elementary-middle schools to characterize the knowledge, attitudes and behaviors related to sugary drinks with the future goal of co-designing school-based efforts to reduce SSB consumption in youth, their families and the school staff. This abstract presents caregiver findings. Methods: Participants completed surveys and participated in semi-structured focus groups. Quantitative data were analyzed using descriptive statistics, and qualitative data used a descriptive analysis design. Results: Caregivers (n=99) (74% F; 40% Black; 52% non-Hispanic; 30% high school/GED) completed surveys, and 17 participated in focus groups. Most report that it is important to avoid SSBs (72%) and are confident (63%) in their ability to do so, yet caregivers and their children regularly drink SSBs [caregivers (4.9 SSB/wk); students (7.7 SSB/wk)]. They express knowledge gaps about the role of SSBs in chronic disease risk and are interested in nutrition/disease prevention education. Factors such as price, taste preference and habit drive beverage choices. Conclusion: Public health and education efforts are urgently needed to address caregiver knowledge gaps regarding health risks associated with SSB. Disclosure J. Pike: None. K. Haberlin-Pittz: None. L.A. Machuca: None. N. El Yaman: None. T.S. Hannon: None. Funding The Lilly FoundationRiley Children's Foundation","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"65 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286852","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":"2088-P: Adiposity Trajectories from Birth to Adolescence by Maternal Prepregnancy Body Mass Index: The Healthy Start Study","authors":"MADELINE FARRON, DEBORAH GLUECK, WEI PERNG, CHLOE FRIEDMAN, CATHERINE C. COHEN, MEGAN KELSEY, DANA DABELEA","doi":"10.2337/db26-2088-p","DOIUrl":"https://doi.org/10.2337/db26-2088-p","url":null,"abstract":"Introduction and Objective: Childhood adiposity is a risk factor for chronic disease development. While maternal obesity has been linked to higher offspring body mass index, there is limited data on associations with adiposity trajectories. We assessed % fat mass (%FM) trajectories from birth to adolescence by maternal pre-pregnancy body mass index (ppBMI). Methods: We used data from 1,270 mother-child pairs in the Healthy Start Study, a Colorado pre-birth cohort. Maternal ppBMI values were categorized as pre-pregnancy healthy weight (<25 kg/m2), overweight (25-30 kg/m2), or obesity (≥30 kg/m2). Offspring %FM was measured with air displacement plethysmography at birth (~2 days), infancy (~5 months), early-childhood (~5 years), mid-childhood (~9 years) and adolescence (~11 years). Longitudinal mean response profile models, adjusted for maternal factors and child sex, were used to assess offspring %FM by ppBMI category. Results: Offspring of mothers with pre-pregnancy overweight or obesity had consistently higher mean %FM from early-childhood onward compared with offspring of mothers with pre-pregnancy healthy weight. Adiposity trajectories further diverged between groups over time (Figure). Conclusion: Maternal overweight and obesity are associated with higher offspring adiposity trajectories from early-childhood through adolescence. Efforts addressing maternal pre-pregnancy obesity status may reduce childhood adiposity. Disclosure M. Farron: None. D. Glueck: None. W. Perng: None. C. Friedman: None. C.C. Cohen: None. M. Kelsey: Research Support; Current; Rhythm Pharmaceuticals, Inc. D. Dabelea: None. Funding National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (R01DK076648, UH3OD023248/UG3OD023248, R01DK133235)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"29 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286864","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":"2123-P: Perspectives on Diabetes Technology in Minoritized Families: Findings from the BEAD-T1D Study","authors":"DANIEL GARFIAS SILVA, JAYLA DIXON, LAUREN FIGG, NAILAH L. ARTHUR, ANAISSA M. MEDINA, SARAH HANES, GARY M. SHAW, DIANA NARANJO, JENNIFER RAYMOND, DAVID MAAHS, KOREY HOOD, ANANTA ADDALA","doi":"10.2337/db26-2123-p","DOIUrl":"https://doi.org/10.2337/db26-2123-p","url":null,"abstract":"Introduction and Objective: Despite advances in diabetes technology (DT), minoritized youth with T1D continue to have lower DT use. Parents/guardians (PG) and youth are central to DT decision making and may have differing perceptions on barriers to DT adoption, particularly in minoritized families. Methods: Youth (n=21) and PG (n=21) participated in interviews/ focus groups in English or Spanish exploring experiences with DT. Transcripts were independently coded by a four-person multilingual team using an iterative process. Themes were compared across youth and PG to identify concordant and divergent perspectives on DT. Results: Three major themes with varying degrees of concordance emerged. Youth and PG diverged in expectations of responsibility: PG questioned youth readiness for consistent DT management, while youth emphasized autonomy and independence. While stigma was identified by youth and PG, it was interpreted differently. Youth emphasized peer perceptions and device visibility, PG focused on safety and social acceptance. Cost was a converging barrier. PG highlighted insurance and long-term affordability, and youth emphasized that cost restricts technology access limiting independence. Conclusion: With varying concordance, youth and PG identified stigma, responsibility, and cost as factors that shape DT use. These data offer strategies to address converging and diverging perspectives of minoritized youth and PG to equitable DT access. Disclosure D. Garfias Silva: None. J. Dixon: None. L. Figg: None. N.L. Arthur: None. A.M. Medina: None. S. Hanes: None. G.M. Shaw: None. D. Naranjo: None. J. Raymond: None. D. Maahs: Advisory Panel; Current; Abbott Diabetes, Sanofi, Medtronic, biospex, enable biosciences, kriya. K. Hood: Consultant; Current; Sanofi, MannKind Corporation, Insulet Corporation. A. Addala: None. Funding NIDDK (5K23DK131342)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"6 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286379","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":"2079-P: Continuous Glucose Monitoring (CGM) Wear Time and Sustained Use in Newly Diagnosed vs. Established Youth with Type 2 Diabetes (T2D)","authors":"AVANI NARAYAN, SOFIA I. WYSZYNSKI, MEGAN C. YUASA, ZACH PEREZ, CELINA TRUJILLO, HANNAH CHESSER, LAYA EKHLASPOUR, SHYLAJA SRINIVASAN, JENISE C. WONG","doi":"10.2337/db26-2079-p","DOIUrl":"https://doi.org/10.2337/db26-2079-p","url":null,"abstract":"Introduction and Objective: CGM use in youth with T2D remains limited, with sparse longitudinal data on engagement. Emerging evidence suggests early CGM initiation at diagnosis may support improved glycemic monitoring and reduced diabetes-related burden in youth with T2D. Our objectives were to compare CGM wear time and engagement in youth with a newer diagnosis of T2D compared to those with an established diagnosis (≥1 year). Methods: Twenty participants were randomized in a 2:1 ratio to use CGM (FreeStyle Libre 3) or blood glucose (BG) meters for 6 months. CGM use was assessed by % wear time over a four-week period. Youth with T2D randomized to the treatment arm were stratified by diabetes duration as newly diagnosed (ND, <1 year) or established diagnoses (ED, ≥1 year). CGM wear time was compared between groups using linear mixed effects models for group-by-time comparison, t-test, and Welch’s t-test for wear over time. Results: ND youth (n=4) exhibited a trend towards increased consistency of device wear with a mean wear time of 56% compared to ED youth, 44% (n=9, P=0.6). Despite higher mean wear in the ND group, consistent device wear varied substantially. Wear time among ND participants declined after month 2 by an additional 9.4% per month (P=0.01), indicating a decrease in sustained use. Participants with ED demonstrated lower initial CGM use but greater consistency over time. Conclusion: ND youth with T2D demonstrated greater early CGM engagement than those with established disease, though device use declined over time. Youth with ED showed a stable trend in CGM use although they had consistently lower median wear time. These findings support early CGM initiation at diagnosis while underscoring the need for targeted strategies to sustain long-term adherence in youth with T2D. Further studies are warranted to help identify barriers to consistent CGM use among youth. Disclosure A. Narayan: None. S.I. Wyszynski: None. M.C. Yuasa: None. Z. Perez: None. C. Trujillo: None. H. Chesser: Research Support; Current; BioMarin Pharmaceutical Inc. L. Ekhlaspour: Advisory Panel; Current; Abbott Diabetes. Research Support; Current; Abbott Diabetes. Consultant; Current; Tandem Diabetes Care, Inc. Research Support; Current; Tandem Diabetes Care, Inc. Consultant; Ended; Jaeb Center for Health Research. Advisory Panel; Current; MannKind Corporation. Research Support; Current; MannKind Corporation. Advisory Panel; Current; Medtronic. Research Support; Current; Medtronic. Advisory Panel; Current; Sequel. Speaker's Bureau; Current; Tandem Diabetes Care, Inc. Other - Received honorarium for a presentation at ADA; Current; Medtronic. Advisory Panel; Current; Sanofi. Other - Received honorarium for a Sanofi-sponsored grant for garndrounds; Ended; Med Learning Group. Advisory Panel; Current; Diabetes Center Bern. Speaker's Bureau; Ended; Insulet Corporation. Other - Rceived honorarium for presenting at an education event sponsored by MannKind; Current; Child","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"13 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286380","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":"2114-P: Artificial Intelligence–Assisted Identification of Severe Hypoglycemia Risk Factors in Pediatric Type 1 Diabetes","authors":"NATALI BORREGO, DANIEL PALACIOS, HU CHEN, ZHANDONG LIU, DANIEL J. DESALVO, REBECCA S. AGUIRRE, MARIA J. REDONDO, MUSTAFA TOSUR, MICHAEL L. FERM","doi":"10.2337/db26-2114-p","DOIUrl":"https://doi.org/10.2337/db26-2114-p","url":null,"abstract":"Introduction and Objective: Severe hypoglycemia (SH) is a life-threatening complication of type 1 diabetes (T1D), making accurate risk identification essential. We used artificial intelligence (AI)-based chart review to improve identification of factors associated with SH in children with T1D. Methods: We studied children (<18y) with T1D seen in endocrinology clinics at a large tertiary health center between April 2020 and April 2025 (n = 4,018). Clinicians were required to screen for SH at each visit using questionnaires built into the medical chart. Data scientists employed a hybrid AI-assisted and traditional approach to extract clinical, socioeconomic, and CGM data using PySpark transformations, ChatGPT 5.1 within Palantir Foundry, and custom Python scripts. Groups with and without SH were compared using Fisher's exact, χ² and Mann-Whitney tests. Select multivariate regressions were performed. Results: Clinician-documented SH occurred in 5% of patients (206/4018). Table 1 presents group comparisons. Controlling for insurance type, Black race was no longer significantly associated with SH (p=0.07). Conclusion: AI-assisted analyses of SH reflect established disparities in glycemic control and diabetes technology use, possibly associated with insurance coverage. Future AI-generated predictive models may improve risk assessment and guide focused interventions. Disclosure N. Borrego: None. D. Palacios: None. H. Chen: None. Z. Liu: None. D.J. DeSalvo: Consultant; Current; Dexcom, Inc., Insulet Corporation. Advisory Panel; Current; Sanofi. Research Support; Current; Medtronic. R.S. Aguirre: Advisory Panel; Ended; Sanofi. Research Support; Current; Sanofi. M.J. Redondo: Advisory Panel; Current; Sanofi. Other - Data Safety Monitoring committee; Current; Lilly. M. Tosur: None. M.L. Ferm: Advisory Panel; Ended; Rezolute Inc.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"11 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286808","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":"2113-P: Beyond Race and Ethnicity in Pediatric Diabetes: Genetic Ancestry and Social Determinants of Health in Diabetic Ketoacidosis","authors":"KATHRYN JONES, JACLYN M. HALL, XIAOFAN HUANG, CHARLES G. MINARD, SELORM DEI-TUTU, ASHLEY BUTLER, KYLIE HARRALL, MUSTAFA TOSUR, MICHAEL L. FERM, ALEJANDRO SILLER, REBECCA S. AGUIRRE, MARIA J. REDONDO","doi":"10.2337/db26-2113-p","DOIUrl":"https://doi.org/10.2337/db26-2113-p","url":null,"abstract":"Introduction and Objective: Diabetic ketoacidosis (DKA) is a major cause of morbidity in pediatric diabetes, with marked variation by race and ethnicity. However, race and ethnicity may not fully capture the biological and social determinants of health (SDoH) driving DKA risk. We studied whether post-diagnosis DKA reflects SDOH, genetic ancestry or both in diverse youth. Methods: We conducted a secondary analysis of a pediatric diabetes cohort (3-10 years’ duration; self-identified non-Hispanic Black [NHB] 28%, Hispanic/Latino [HS] 38% and non-Hispanic White [NHW] 25%). Social vulnerability indices were derived from American Community Survey data. Those with and without post-diagnosis DKA were compared with Chi-square, Wilcoxon rank-sum, or Fisher exact tests, and multivariable logistic regression identified DKA predictors. Results: Post-diagnosis DKA occurred in 38% of HS youth and 36% of NHB youth, compared with 10% of NHW youth. In multivariable logistic regression, genetic ancestry and SDoH were independently associated with DKA. African genetic ancestry and greater neighborhood poverty were significantly associated with increased odds of DKA (Table). Conclusion: Pediatric DKA risk reflects the joint influence of genetic ancestry and socioeconomic factors, supporting approaches that move beyond race/ethnicity to directly assess biological and social contributors to diabetic complications. Disclosure K. Jones: None. J.M. Hall: None. X. Huang: None. C.G. Minard: None. S. Dei-Tutu: None. A. Butler: None. K. Harrall: None. M. Tosur: None. M.L. Ferm: Advisory Panel; Ended; Rezolute Inc. A. Siller: None. R.S. Aguirre: Advisory Panel; Ended; Sanofi. Research Support; Current; Sanofi. M.J. Redondo: Advisory Panel; Current; Sanofi. Other - Data Safety Monitoring committee; Current; Lilly. Funding NIH NIDDK (R01 DK124395)","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":"148286814","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":"2121-P: “Burnout: It's the Moral Injury That Occurs”: Findings from the BEAD-T1D Study","authors":"ANAISSA M. MEDINA, JAYLA DIXON, NAILAH L. ARTHUR, DANIEL GARFIAS SILVA, LAUREN FIGG, SARAH HANES, GARY M. SHAW, DIANA NARANJO, JENNIFER RAYMOND, DAVID MAAHS, KOREY HOOD, ANANTA ADDALA","doi":"10.2337/db26-2121-p","DOIUrl":"https://doi.org/10.2337/db26-2121-p","url":null,"abstract":"Introduction and Objective: Clinicians play a crucial role in identifying and navigating disparities in T1D outcomes, compounded by inequities in healthcare access, resources, and systems of care. The BEAD-T1D study explores clinicians’ experiences delivering T1D care to better understand barriers to equitable management and identify opportunities to improve care for youth with T1D. Methods: Semi-structured interviews (n=12) were conducted with US pediatric clinicians (endocrinologists, diabetes educators, and nurse practitioners). Transcripts were analyzed inductively. A codebook was developed by a four-person coding team. Each transcript was independently double-coded, with discrepancies resolved by a third coder. Final themes were consolidated, and representative quotes were selected to identify key barriers and opportunities for improving equitable T1D care. Results: Clinician burnout significantly influenced T1D care delivery (Figure). Burnout was driven by the four interconnected levels of the Social Ecological Model spanning structural barriers in diabetes, social determinants of health, language and culture, and clinician burden. Conclusion: The cumulative burden experienced by clinicians contributes to disparities in the quality and consistency of T1D care for youth. Addressing these multilevel barriers, including expanding access to user-friendly diabetes technologies, is essential to promoting equitable and sustainable diabetes management. Disclosure A.M. Medina: None. J. Dixon: None. N.L. Arthur: None. D. Garfias Silva: None. L. Figg: None. S. Hanes: None. G.M. Shaw: None. D. Naranjo: None. J. Raymond: None. D. Maahs: Advisory Panel; Current; Abbott Diabetes, Sanofi, Medtronic, biospex, enable biosciences, kriya. K. Hood: Consultant; Current; Sanofi, MannKind Corporation, Insulet Corporation. A. Addala: None. Funding NIDDK (5K23DK131342)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"56 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286849","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":"2057-P: Implementation of an Automated Electronic Health Record Program to Support Very Low-Carbohydrate Nutrition Counseling","authors":"MADISON MARRAS, CASSIE D. TURNER, ELI W. CARTER, JOYCE LEE, MICHELLE SEGAR, RINA HISAMATSU, DINA GRIAUZDE","doi":"10.2337/db26-2057-p","DOIUrl":"https://doi.org/10.2337/db26-2057-p","url":null,"abstract":"Introduction and Objective: Very low-carbohydrate diets (VLCDs) support weight loss among overweight and obese individuals, but most general practices lack resources necessary to teach patients VLCDs. We developed and implemented Low Carb Journey (LCJ), a fully automated, EHR-embedded, 16-week program with 20 video modules and online resources. This study evaluates LCJ’s reach, adoption and effectiveness for patients with obesity. Methods: Participants in this retrospective evaluation were (1) primary care providers (PCPs) who practice in clinics affiliated with a large academic health system and (2) patients with obesity referred by PCPs to LCJ. PCPs were informed of LCJ and provided instructions for enrolling eligible patients. Enrolled patients received program content as tasks through their EHR portal, could choose to complete tasks based on their interests, and were asked to self-report weight and carbohydrate intake on a weekly basis. Primary outcomes were program reach (i.e. proportion of eligible patients enrolled, patient uptake rate), adoption (i.e. provider enrollment rate, mean number of patients enrolled), and effectiveness (i.e. patient weight and carb intake change). Results: From 9/27/2024 to 8/26/2025, 26% (92/350) of PCPs enrolled 3.3% (683/21011) of LCJ-eligible patients. On average, PCPs enrolled 7.4 patients (SD 13.8, range 1-87), with 11% (10/92) of PCPs making 59% (400/683) of all enrollments. Of enrolled patients, 69% (474/683) completed ≥ 1 program task and on average completed 18.9 tasks (SD = 25.4, range = 1-136). During the intervention, 18.7% (89/474) of patients completed ≥2 weight and/or carbohydrate intake reports, with -2.7 kg (-2.4%) weight change and -34.4 gram change in reported daily carb intake. Conclusion: LCJ achieved notable reach, adoption, and effectiveness, suggesting its potential as a scalable model for supporting very low carb dietary guidance. Additional evaluation is needed to understand program effectiveness and viable implementation strategies for scale up. Disclosure M. Marras: None. C.D. Turner: None. E.W. Carter: None. J. Lee: Research Support; Current; Lilly. Board Member; Ended; GoodRx. M. Segar: Consultant; Ended; Modify Health - I helped them with behavior change curriculum. R. Hisamatsu: None. D. Griauzde: Other - I received an honorarium for speaking.; Ended; American Diabetes Association. Research Support; Current; National Institute of Diabetes and Digestive and Kidney Diseases. Funding NIH/NIDDK (K23DK123416)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"9 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286856","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":"2120-P: Perioperative Automated Insulin Delivery (AID) Use in Youth and Young Adults (YYA)","authors":"ANGELA J. KARAMI, EMILY FIVEKILLER, LUKE GEISER, MONICA HOAGLAND, ALEXA M. JAEGER, SAMANTHA LANGE, AMY B. STEIN, BENNETT STEWART, KASSERINE TAYLOR, ERIN COBRY","doi":"10.2337/db26-2120-p","DOIUrl":"https://doi.org/10.2337/db26-2120-p","url":null,"abstract":"Introduction and Objective: Continuous glucose monitors (CGMs) and AID systems significantly improve glycemic control. As CGMs lack hospital indication, pediatric perioperative practices often disable automation for procedures under anesthesia. We compared glycemic outcomes in YYA with and without automation use. Methods: YYA using AID systems undergoing procedures with anesthesia were enrolled in a prospective study. Continuation of automation was determined by the patient and anesthesia team. CGM data was collected for standard glycemic metrics with between-group comparisons analyzed (Figure). Results: Of 26 procedures (mean age 12.6±4.3y, 61% female), 11 continued automation. The automated group had significantly lower average blood glucose during the pre- and intraoperative periods (135.5 vs 185.2 mg/dL and 134.8 vs 168.9 mg/dL, respectively, p<0.05). While TIR (70-180mg/dL) was higher in the automation group, it did not reach significance. Hypoglycemia (<70mg/dL) was also not significantly different between groups. (Figure). Conclusion: Perioperative use of automation improves glucose levels without increased hypoglycemia, suggesting that AID can be safe and effective during procedures under anesthesia. The study is ongoing to explore the effects of perioperative medications, CGM accuracy, and glycemic outcomes in a larger cohort. Disclosure A.J. Karami: None. E. Fivekiller: None. L. Geiser: None. M. Hoagland: None. A.M. Jaeger: None. S. Lange: None. A.B. Stein: None. B. Stewart: None. K. Taylor: None. E. Cobry: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"152 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286861","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}