Diabetes最新文献

{"title":"1092-P: Effectiveness of a Hybrid Care Model for Type 2 Diabetes —A Three-Month Evaluation","authors":"IHSAN ALMARZOOQI, HALA ZAKARIA, MILENA CACCELLI, CIGDEM OZKAN, JESTONI BANGAYAN, MIRABELLE C. DANDAN, DIANNE JANE DIVINO, SOFIA ALEABOVA, YOUSEF SAID, ALI HASHEMI","doi":"10.2337/db24-1092-p","DOIUrl":"https://doi.org/10.2337/db24-1092-p","url":null,"abstract":"Continuous monitoring in diabetes care enhances access, convenience, adherence, and glycemic control. Challenges in digital-only solutions include trust-building and limitations in face-to-face interactions, along with the lack of engagement by care teams outside the clinic setting. A hybrid model where providers incorporate both remote data monitoring and engagement with in-person visits would address these challenges. The aim of this study is to evaluate the impact of implementing the hybrid care approach on patients with T2D on glycemic control and clinical outcomes. A retrospective case-control observational study over 3 months by a hybrid provider (GluCare.Health) in the UAE included patients with T2D (n=262). The case group had both in-clinic visits and bi-weekly virtual engagements via an app that included a range of caregivers (physicians, dietitians, educators and coaches, n=162). The control group only conducted in-clinic visits without virtual engagement mimicking traditional, episodic care (n=100). Engagement data included dietary, lifestyle, medication, exercise and continuous glucose monitoring interactions. The case group (hybrid model) showed significant HbA1c improvements (-2.19%) (-25%) compared to the control group (-0.10%). Patients with higher baseline HbA1c (≥ 9.0%) experienced greater reductions (-3.67%) (-34%). The case group also showed improvements in weight (-6%), BMI (-6%), LDL (-21%), total cholesterol (-17%), and CVD risk (-41%). The control group had smaller improvements (p >0.05). Engagement strongly correlated with better outcomes; patients with ≥11 interactions (over 90 days) showed significant reductions in HbA1c (-2.38%) and weight (-6.00 kg) in comparison with those <11. The GluCare.Health hybrid model demonstrates promising outcomes in Type 2 diabetes management with a strong correlation between the number of remote engagement and outcomes in comparison to results seen in the physical-only (traditional-care like) control group. Disclosure I. Almarzooqi: None. H. Zakaria: None. M. Caccelli: None. C. Ozkan: None. J. Bangayan: None. M.C. Dandan: None. D. Divino: None. S. Aleabova: None. Y. Said: None. A. Hashemi: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"5 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730615","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":"336-OR: Females Undergoing Islet Transplantation with CNI-Based Immunosuppression May Be at Higher Risk of Renal Function Decline","authors":"ALICE L.J. CARR, BRAULIO A. MARFIL-GARZA, ANNA LAM, BLAIRE L. ANDERSON, DOUG O'GORMAN, TATSUYA KIN, DAVID BIGAM, A.M. JAMES SHAPIRO, PETER A. SENIOR","doi":"10.2337/db24-336-or","DOIUrl":"https://doi.org/10.2337/db24-336-or","url":null,"abstract":"Islet transplantation (ITx) is an established treatment for recurrent, severe hypoglycemia in type 1 diabetes, however, requires lifelong immunosuppression (IS) which can be nephrotoxic. We conducted a risk regression to identify factors associated with progression to Stage 3 CKD (S3CKD) or worse post-ITx. We used data from adults undergoing ITx alone at the University of Alberta Hospital between March 11 1999 and Oct 1 2019 with >1 year follow up. IS included tacrolimus and sirolimus/mycophenolate. We identified episodes of irreversible S3CKD as eGFR <60 ml/min/1.73m2 for ≥90d in addition to a final 12m average eGFR below threshold. We conducted multivariable competing risk (death) regression with the covariates: baseline eGFR, age at first ITx, diabetes duration, total ITx count, mean tacrolimus trough levels in year 1 post-ITx, number of acute kidney injury (AKI) events in year 1 post-ITx, sex, baseline hypertension and sirolimus exposure. We identified 199 adults (41% M followed for a median 76.1m [IQR 38.0-131.6]), of which 47.7% progressed to S3CKD within a median 28m [IQR 9-57]. Female sex and more AKI events substantially increased the risk of progression to S3CKD (HR 1.50, [95% CI 1.31,1.80, p =0.004; HR 1.21, [95% CI 1.02, 1.45, p=0.028] respectively). Older age at first-ITx, lower baseline eGFR and longer diabetes duration had modest effect of significance on the risk of progression. Mean tacrolimus level in the first year post-ITx, number of ITx, baseline hypertension and exposure to sirolimus were not significant predictors for the risk of progression to S3CKD. No sex differences were found in risk for Stage 4 or 5 CKD. IS may put female ITx recipients at greater hazard of progressing to S3CKD, independently of other potential risk factors. Further study is required to elucidate this association, which could translate into sex-specific strategies to manage IS post-ITx. Effective IS regimens without nephrotoxicity remain an important goal. Disclosure A.L.J. Carr: None. B.A. Marfil-Garza: None. A. Lam: None. B.L. Anderson: None. D. O'Gorman: None. T. Kin: None. D. Bigam: None. A. Shapiro: Consultant; Vertex Pharmaceuticals Incorporated, Betalin Therapeutics, Hemostemix Inc, ViaCyte, Inc., Aspect Biosystems. P.A. Senior: Consultant; Abbott, Bayer Inc., Dexcom, Inc., Eli Lilly and Company, GlaxoSmithKline plc, Insulet Corporation, Novo Nordisk Canada Inc., Sanofi, Vertex Pharmaceuticals Incorporated. Speaker's Bureau; Abbott, Dexcom, Inc., Insulet Corporation, Novo Nordisk Canada Inc. Research Support; Novo Nordisk Canada Inc.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"5 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730470","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":"346-OR: Hypothalamic Gliosis Is Associated with CVD Risk Factors in the Framingham Heart Study (FHS)","authors":"JUSTIN LO, SUSAN J. MELHORN, KELSEY OLERICH, ALYSSA HUANG, SARAH KEE, ALEXA BEISER, SUDHA SESHADRI, CHARLES DECARLI, ELLEN SCHUR","doi":"10.2337/db24-346-or","DOIUrl":"https://doi.org/10.2337/db24-346-or","url":null,"abstract":"Introduction: Hypothalamic gliosis is linked to obesity and insulin resistance in rodent models and humans. We tested associations between a radiologic measure of hypothalamic gliosis and clinically relevant cardiovascular disease (CVD) risk factors, as well as prevalent coronary heart disease (CHD). Methods: Using brain MRI images from FHS participants (n=867), T2 signal intensities were extracted bilaterally from the region of interest in the mediobasal hypothalamus (MBH) and reference regions in amygdala (AMY) and putamen (PUT). T2 signal ratios were created in which greater values suggest gliosis. The primary measure compared MBH to AMY (MBH/AMY); a positive control ratio (MBH/PUT) also assessed MBH whereas a negative control (PUT/AMY) did not. Outcomes were BMI, HDL-C, LDL-C, triglycerides, and the presence of hypertension (HTN; n=225), diabetes mellitus (DM; n=66), or metabolic syndrome (MetS; n=254). Prevalent CHD (n=22) was adjudicated by FHS. Linear and logistic regression models included age, sex, smoking, treatment status (e.g., lipids), and BMI (for outcomes except BMI and MetS). Results: Mean age was 54.9±8.8 y; 54.9% were female. Greater MBH/AMY ratios were associated with higher BMI (P<0.001). MBH/AMY ratios were associated with higher triglycerides, presence of HTN, and lower HDL-C, and the latter two were independent of BMI (both P<0.05). Results were consistent for the MBH/PUT ratios (all P<0.05). Findings for DM were mixed and attenuated by adjusting for BMI. MetS was strongly associated with MBH/AMY and MBH/PUT ratios (P<0.001). PUT/AMY ratios were unrelated to any outcome. No T2 signal ratio was associated with prevalent CHD (P>0.05), and confidence intervals were wide. Conclusion: Using a well-established study of CVD development, we found evidence linking hypothalamic gliosis to multiple CVD risk factors, independent of adiposity. Our results highlight the need to consider neurologic mechanisms in efforts to understand and improve cardiometabolic health. Disclosure J. Lo: None. S.J. Melhorn: None. K. Olerich: None. A. Huang: None. S. Kee: None. A. Beiser: None. S. Seshadri: None. C. DeCarli: None. E. Schur: Consultant; Amgen Inc. Funding National Institutes of Health (K24 HL144917; R01 DK089036; R01 DK117623; R01 DK098466; P30 DK035816)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"15 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730477","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":"1020-P: Evolution over Time of the Discrepancy between HbA1c and Glucose Management Indicator—Findings from a Franco-Belgian Cohort of 347 Patients","authors":"JEAN-PIERRE RIVELINE, GAETAN PREVOST, ANAIS ANDRIEU, MICHAEL JOUBERT, PHILIPPE ORIOT, ALFRED PENFORNIS, JEAN-CHRISTOPHE PHILIPS, JEAN-BAPTISTE JULLA, EMMANUEL COSSON","doi":"10.2337/db24-1020-p","DOIUrl":"https://doi.org/10.2337/db24-1020-p","url":null,"abstract":"A discrepancy between laboratory-measured HbA1c and Glucose Management Indicator (GMI), estimated from continuous glucose monitoring, is frequently encountered in clinical practice. However, its evolution over time is not yet known. Methodology: We conducted a multicenter retrospective study (9 centers) that collected pairs of HbA1c and GMI (calculated over 90 days) at T0, T1 year, T2 years of follow-up in patients with diabetes, all users of FreeStyleLibre®. The primary study endpoint was the analysis of the mean HbA1c-GMI differences at the 3 time points. Glucose data, clinical parameters, and complications were also analyzed. Patients were classified based on the HbA1c-GMI discrepancy: positive (PosD, HbA1c-GMI>+0.3%), neutral (NullD, HbA1c-GMI from -0.3 to +0.3%), negative (NegD, HbA1c-GMI< -0.3%) at each time point, and with the average differences over the 3 time points. Group comparisons were assessed using ANOVA. Result: We included 347 patients (82% type 1 diabetes), mean age of 51±17 years, diabetes duration 20±13 years, HbA1c 7.6±1.0%, 90±9% CGM data collected, Time in Range 70-180 mg/dl (TIR) 57±17%, GMI 7.4±0.8%. The mean HbA1c-GMI differed over time (T0: 0.27%, T1 year: 0.16%, T2 years: 0.04%, P<0.0001). Considering the mean HbA1c-GMI differences over the 3 time points for all patients, PosD individuals were statistically older, had higher BMI and HbA1c compared to NegD patients. At T0, the patients were distributed as follows: 168 PosD (48.4%), 129 NullD (37.2%), 50 NegD (14.4%). The 121 patients (only 34.8% of the cohort) who stayed in the same group at the three time-points were 44.6% PosD, 38% NullD and 17.4% NegD. Conclusion: In only 1/3 of patients does the difference between HbA1c and GMI appear to be stable over time. This should be taken into account when analyzing the supposed poor prognosis associated with PosD. Disclosure J. Riveline: Board Member; Abbott, Novo Nordisk A/S, Sanofi, Eli Lilly and Company, Medtronic, Dexcom, Inc., Insulet Corporation, Air Liquide, AstraZeneca. G. Prevost: Board Member; Abbott. A. Andrieu: None. M. Joubert: Consultant; Abbott, Medtronic, Dexcom, Inc. P. Oriot: Research Support; Abbott. A. Penfornis: Speaker's Bureau; Sanofi, Dexcom, Inc., Diabeloop SA. Board Member; AstraZeneca. Speaker's Bureau; Novo Nordisk, Lilly Diabetes. Board Member; Novo Nordisk, Bayer Inc. Advisory Panel; Abbott, Sanofi. J. Philips: Consultant; Sanofi, Novo Nordisk, Abbott, Avazzia, Boehringer-Ingelheim, Eli Lilly and Company. J. Julla: Speaker's Bureau; Lilly Diabetes, Novo Nordisk. Board Member; Sanofi. E. Cosson: Advisory Panel; Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk, Sanofi, Roche Diagnostics, Novartis AG, Amgen Inc. Funding Abbott Diabetes Care","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"60 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730479","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":"1248-P: Association of Oxidative Stress Markers with Incident Hyperglycemia in Gestational Diabetes Mellitus—Impact of a Diabetes Prevention Program","authors":"MONICA L. RUIZ, RITA A. GOMEZ-DIAZ, ADRIANA LETICIA VALDEZ GONZALEZ, SELENE ÁNGELES MEJÍA, MARGARITA DIAZ-FLORES, RICARDO C. SALDAÑA ESPINOZA, MARY F. DÍAZ, LUZ ANGELICA RAMIREZ GARCIA, NIELS H. WACHER","doi":"10.2337/db24-1248-p","DOIUrl":"https://doi.org/10.2337/db24-1248-p","url":null,"abstract":"Introduction & Objective: Gestational Diabetes (GDM) poses risk for developing type 2 diabetes (T2D). The role of oxidative stress in GDM and its association with incident diabetes remains unclear. This study aimed to assess the link between oxidative stress markers and incident hyperglycemia in women with and without GDM. Methods: Prospective cohort. Pregnant women with GDM (n=201) or without GDM (n=50) undergoing cesarean section participated in an 18-month postpartum prevention program. The program emphasized healthy practices, physical activity, and psychosocial support. Oxidative stress markers [malondialdehyde (MDA), reduced glutathione (GSH), antioxidant capacity (DPPH), carbonylated proteins], and adiponectin were measured at the end of pregnancy and at 18 months later. A control group (CG) (n=57) received standard care. Multiple linear regression identified intervention-related differences. Results: Baseline GDM women exhibited elevated oxidative stress markers and adiponectin compared to non-GDM counterparts. Antioxidant capacity was lower in GDM (40 vs. 67.8%, p=<0.001). Post-intervention, GDM cases showed a greater reduction in MDA and adiponectin (-37.55 vs-34.08 nmol, p=0.021; -751.54 vs-210.31 pg/mL, p<0.001 respectively) and antioxidant capacity increased (in both groups: 1.0 - 0.28%, vs CG -7.23 p=0.009). At follow-up, 6% progressed to T2D, and 37.3% to prediabetes. Basal malondialdehyde concentrations, pregestational BMI, and HbA1c positively correlated with incident hyperglycemia. Conversely, the change in carbonylated proteins concentrations inversely correlated with incident hyperglycemia. Conclusion: Oxidative markers are associated with T2D risk in GDM. The diabetes prevention program effectively reduced malondialdehyde and adiponectin levels. These findings highlight the role of oxidative stress in GDM prevention strategies. Disclosure M.L. Ruiz: None. R.A. Gomez-Diaz: None. A. Valdez Gonzalez: None. S. Ángeles Mejía: None. M. Diaz-Flores: None. R.C. Saldaña Espinoza: None. M.F. Díaz: None. L. Ramirez Garcia: None. N.H. Wacher: None. Funding Fundación Gonzalo Río Arronte, Institution of Private Assistance (S.0634), and the Coordinación de Investigación en Salud (R2022-785-057)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"79 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730487","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":"121-OR: Safety, Tolerability, and Metabolic Effects of Once-Weekly GL0034 (Utreglutide) in Individuals with Obesity—A Multiple Ascending Dose Study","authors":"RAJAMANNAR THENNATI, VINOD S. BURADE, MUTHUKUMARAN NATARAJAN, PRADEEP SHAHI, RAVISHANKARA NAGARAJA, SUDEEP K. AGRAWAL, THIERRY DUVAUCHELLE, ADOLFO GARCIA-OCANA, GUY A. RUTTER, RICHARD E. PRATLEY, BERNARD THORENS, TINA VILSBØLL","doi":"10.2337/db24-121-or","DOIUrl":"https://doi.org/10.2337/db24-121-or","url":null,"abstract":"Introduction & Objective: GL0034 (GL), a once weekly glucagon-like peptide 1 receptor agonist, previously demonstrated significant reductions in body weight (BW) up to Day 22 in a single ascending dose study in individuals with obesity. This phase 1 study assessed the safety, tolerability and metabolic effects of GL after multiple ascending doses. Methods: Individuals with BMI ≥28 kg/m2 (N=24) were randomized (9:3) to subcutaneous GL, fixed doses (4 × 680 µg; cohort 1); or increasing doses (680, 900, 1520, 2000 µg; cohort 2) or placebo, once weekly for four weeks. Safety, tolerability and key metabolic parameters were assessed. Results: Most common adverse events (AE) were gastrointestinal (GI) with dose-dependent nausea, decreased appetite and vomiting. One individual with a GI related serious AE rapidly recovered upon treatment with intravenous rehydration. On Day 23, reduction was observed in all parameters from baseline (BL) with significant reductions in glucose area under the curve and HbA1c in both groups. In cohorts 1 & 2, BW reduction versus BL was 2.9 kg and 4.6 kg respectively on Day 29 (Table). Conclusions: In individuals with obesity, once weekly GL dosing for four weeks, demonstrated clinically relevant reductions in glucose, insulin, HbA1c, lipids and BW with an overall good tolerability. Disclosure R. Thennati: None. V.S. Burade: None. M. Natarajan: None. P. Shahi: None. R. Nagaraja: None. S.K. Agrawal: None. T. Duvauchelle: Consultant; Sun Pharmaceutical Industries Ltd. A. Garcia-Ocana: Consultant; Sun Pharmaceutical Industries Ltd. G.A. Rutter: Advisory Panel; Sun Pharmaceutical Industries Ltd. R.E. Pratley: Other Relationship; Bayer AG, Dompé, Endogenex, Inc., Gasherbrum Bio, Inc., Hengrui (USA) Ltd., Intas Pharmaceuticals Ltd., Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk, Novo Nordisk, Pfizer Inc., Rivus Pharmaceuticals Inc., Sun Pharmaceutical Industries Ltd. Consultant; AbbVie Inc., AstraZeneca. Other Relationship; Bayer HealthCare Pharmaceuticals, Inc., Biomea Fusion, Carmot Therapeutics, Inc., Corcept Therapeutics, Fractyl Health, Inc., Genprex. Consultant; Getz Pharma. Other Relationship; Lilly USA LLC, Sanofi. Consultant; Scholar Rock, Inc. B. Thorens: Advisory Panel; Sun Pharmaceutical Industries Ltd. T. Vilsbøll: Consultant; AstraZeneca. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Mundipharma. Advisory Panel; Novo Nordisk, Lilly Diabetes, Sanofi. Speaker's Bureau; Bayer Inc., Gilead Sciences, Inc. Advisory Panel; Sun Pharmaceutical Industries Ltd. Research Support; Lilly Diabetes.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"60 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730496","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":"1113-P: Utilizing a Novel Telemedicine Clinic for Managing Type 2 Diabetes—A Six-Month Pilot Study","authors":"FIORELLA SOTOMAYOR, CHIKARA GOTHONG, REYNIER HERNANDEZ, MONICA Y. CHOE, GARRETT I. ASH, WILLIAM H. SCOTT, LILLIAN PINAULT, FERNANDO GOMEZ-PERALTA, LAKSHMI G. SINGH, JOHN D. SORKIN, ILIAS (ELIAS) SPANAKIS","doi":"10.2337/db24-1113-p","DOIUrl":"https://doi.org/10.2337/db24-1113-p","url":null,"abstract":"Introduction & Objective: RCT aimed to assess if a Diabetes Advanced Telemedicine (DAT) clinic leads to improvement in glycemic control compared to standard of care (SoC). Methods: Patients with type 2 diabetes (T2D) randomized to DAT or SoC. DAT used continuous glucose monitoring devices, smart insulin pens, telecommunication (i.e. video visits) with physical activity (PA) counseling by an exercise physiologist. SoC used glucometers, traditional insulin pens, in-person visits and PA counseling by providers. Primary outcome was change in HbA1c. Secondary outcomes were time in range (TIR) 70-180 mg/dl, time above range (TAR)>180 mg/dl, TAR>250 mg/dl and time below range (TBR)<70 mg/dl. ANCOVA was used, adjusted for baseline value to determine the relation between group and outcome, and report p-values of the interaction term, group*time. Exercise was evaluated by senior fitness test and assessed by Hedge’s g effect size. Results: Twenty-four patients with T2D completed the trial. Non-statistically significant reductions in glucose metrics were seen. HbA1c decreased by 2.2% (DAT) vs 1.1% (SoC) (-1.1%, [-0.2, -1.8], p=0.076). TIR 70-180 mg/dL increased 17.3% vs 15.4% (+1.9%, [-16.1,15.5], p=0.984), TAR>180 mg/dL decreased 20.5% vs 17.9% (-2.6%, [-21.5,10.5], p=0.756), TAR>250 mg/dL decreased 17.1% vs 6.0% (-11.1%. [-20.3,2.7], p=0.375), TBR changed 0.41% vs -0.88% (+0.47, [-0.16,1.37], p=0.054), DAT vs. SoC, respectively. Fitness tests, completed by 60% of participants, showed improvements in medium strength (bicep curls g=0.90 /p=0.06, chair stands g=0.63/p=0.18), daily physical function (g=0.56/p=0.20), aerobic performance (6min walk test g=0.24/p=0.61), agility/flexibility (timed up and go g=-0.30/p=0.49, back stretch g=-0.51/p=0.26). Conclusions: T2D patients managed by DAT had non-significant improvement in glucose control driven by decreased hyperglycemia > 250 mg/dl. Non-significant modest increase in PA observed. Disclosure F. Sotomayor: None. C. Gothong: None. R. Hernandez: None. M.Y. Choe: None. G.I. Ash: None. W.H. Scott: None. L. Pinault: None. F. Gomez-Peralta: Advisory Panel; Abbott. Speaker's Bureau; Abbott. Advisory Panel; Eli Lilly and Company. Speaker's Bureau; Eli Lilly and Company. Advisory Panel; Insulcloud S.L. Speaker's Bureau; Medtronic. Advisory Panel; Novo Nordisk. Speaker's Bureau; Novo Nordisk. Advisory Panel; Sanofi. L.G. Singh: None. J.D. Sorkin: None. I. Spanakis: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"79 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730546","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":"345-OR: Beyond Size Matters—The Impact of Pancreatic Volume and Pancreatic Fat on Type 2 Diabetes","authors":"HAJIME YAMAZAKI, SHIN-ICHI TAUCHI, MITSURU DOHKE, NAGISA HANAWA, YOSHIHISA KODAMA, AKIO KATANUMA, SHUNICHI FUKUHARA, KATSIARYNA PRYSTUPA, JULIA HUMMEL, ROBERT WAGNER, MARTIN HENI","doi":"10.2337/db24-345-or","DOIUrl":"https://doi.org/10.2337/db24-345-or","url":null,"abstract":"Introduction & Objective: Individuals with type 2 diabetes (T2D) are thought to have a smaller pancreas; however, whether this is cause or consequence of T2D is unclear. We investigated the association between pancreas volume and T2D risk and whether this association was modified by pancreatic fat. Methods: Using magnetic resonance imaging from the UK Biobank, 25,389 individuals were classified into four groups based on the median values of pancreas volume (60 cm3) and pancreatic fat (8%). Odds ratios (ORs) for prevalent T2D were estimated using logistic regression. Additionally, we conducted a 6-year case-cohort study in an independent Japanese cohort using computed tomography during health examinations. Hazard ratios (HRs) for incident T2D were estimated using weighted-Cox regression in 658 randomly-selected individuals and 146 incident T2D cases among 2,168 individuals without diabetes. The regression models in both studies were adjusted for age, sex, body mass index, daily alcohol intake, current smoking, liver fat, and visceral fat. Results: In the UK Biobank, individuals who had fat accumulation in a smaller pancreas exhibited the highest likelihood of T2D. Compared with large/low-fat pancreas, the adjusted ORs (95%CI) of T2D were 1.63 (1.36-1.97) in small/high-fat pancreas, 1.09 (0.89-1.33) in large/high-fat pancreas, and 1.08 (0.85-1.37) in small/low-fat pancreas. This finding was prospectively validated in the Japanese cohort with 6.27-year median follow-up. The adjusted HRs (95%CI) of incident T2D were 3.12 (1.40-6.96) in small/high-fat pancreas, 1.00 (0.59-1.69) in large/high-fat pancreas, and 0.74 (0.26-2.14) in small/low-fat pancreas. Conclusion: Fat accumulation in an already smaller pancreas appears to be a key determinant of elevated T2D risk and might therefore be a novel target for preventive interventions. Disclosure H. Yamazaki: Other Relationship; AstraZeneca, Janssen Pharmaceuticals, Inc., Mitsubishi Tanabe Pharma Corporation, Kowa Company, Ltd., Kyorin Pharmaceutical Co. Ltd, Takeda Pharmaceutical Company Limited, Takeda Pharmaceutical Company Limited, Magmitt Pharmaceutical Co. S. Tauchi: None. M. Dohke: None. N. Hanawa: None. Y. Kodama: None. A. Katanuma: None. S. Fukuhara: None. K. Prystupa: None. J. Hummel: None. R. Wagner: Speaker's Bureau; Sanofi. Advisory Panel; Lilly Diabetes. Speaker's Bureau; Boehringer-Ingelheim, Novo Nordisk. M. Heni: Research Support; Boehringer-Ingelheim. Advisory Panel; Amryt Pharma Plc. Speaker's Bureau; Amryt Pharma Plc. Advisory Panel; Boehringer-Ingelheim, Boehringer-Ingelheim. Speaker's Bureau; Lilly Diabetes, Novartis AG, Novo Nordisk, Sanofi. Funding Japan Society for the Promotion of Science KAKENHI grants (JP22K15685); Deutsche Forschungsgemeinschaft (DFG, German Research Foundation: 518749683)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"48 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730548","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":"229-OR: Orforglipron Improves Markers of Beta-Cell Function and Insulin Sensitivity in Type 2 Diabetes","authors":"JULIO ROSENSTOCK, DEBORAH A. ROBINS, KEVIN L. DUFFIN, JONATHAN M. WILSON, KIEREN J. MATHER, HIYA BANERJEE, YANZHU LIN, SARAH EYDE, CHRISTOF M. KAZDA, MANIGE KONIG","doi":"10.2337/db24-229-or","DOIUrl":"https://doi.org/10.2337/db24-229-or","url":null,"abstract":"Orforglipron (OFG), an oral, non-peptide GLP-1 receptor agonist, demonstrated significantly greater glycemic control and weight loss at doses ≥12 mg vs placebo (PBO) or dulaglutide (DU) 1.5 mg in a 26-week phase 2 study of adults with type 2 diabetes (T2D) (Table). These exploratory analyses investigated mechanisms by which OFG improved glycemic control in T2D by analyzing exploratory biomarkers. Participants with T2D (mean age, 58.9 years; baseline HbA1c, 8.1%; weight, 100.3 kg) treated with diet and exercise, with/without metformin, were randomized to PBO, DU 1.5 mg, or once-daily OFG 3, 12, 24, 36, or 45 mg. Biomarkers of β-cell function and insulin sensitivity were analyzed by mixed model repeated measures, excluding data after study drug discontinuation or rescue drug initiation. Biomarkers of β-cell function were improved by OFG at 26 weeks from baseline (Table). HOMA-B significantly increased with OFG at doses ≥12 mg vs PBO or DU. HOMA-IR (computed with insulin) significantly decreased from baseline with OFG at doses ≥24 mg but was not significantly different vs PBO and DU. Fasting glucose-adjusted glucagon significantly decreased with OFG at doses ≥12 mg vs PBO and with OFG 12, 24, and 45 mg vs DU. These analyses suggest improved glycemic control with OFG vs DU may be partly explained by improved β-cell function and insulin sensitivity. Additional studies are ongoing to understand these mechanisms. Disclosure J. Rosenstock: Research Support; Biomea Fusion, Inc. Other Relationship; Lilly Diabetes. Research Support; Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Corcept Therapeutics. Other Relationship; Novo Nordisk. Research Support; Pfizer Inc. Other Relationship; Sanofi, Boehringer-Ingelheim. Research Support; Shionogi & Co., Ltd. Other Relationship; Structure Therapeutics, Inc. Advisory Panel; Terns Pharmaceuticals, Zealand Pharma A/S. Other Relationship; Applied Therapeutics, Hanmi Pharm. Co., Ltd., Oramed Pharmaceuticals. Advisory Panel; Scholar Rock. D.A. Robins: None. K.L. Duffin: Employee; Eli Lilly and Company. J.M. Wilson: Employee; Eli Lilly and Company. K.J. Mather: Employee; Eli Lilly and Company. H. Banerjee: None. Y. Lin: Stock/Shareholder; Eli Lilly and Company, Pfizer Inc., AstraZeneca. S. Eyde: None. C.M. Kazda: Employee; Eli Lilly and Company. M. Konig: None. Funding Eli Lilly and Company","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"35 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730554","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":"1308-P: A Voice-Based AI Algorithm Can Predict Type 2 Diabetes Status—Findings from the Colive Voice Study on U.S. Adult Participants","authors":"ABIR ELBEJI, MÉGANE PIZZIMENTI, GLORIA A. AGUAYO, AURELIE FISCHER, HANIN AYADI, FRANCK MAUVAIS-JARVIS, JEAN-PIERRE RIVELINE, VLADIMIR DESPOTOVIC, GUY FAGHERAZZI","doi":"10.2337/db24-1308-p","DOIUrl":"https://doi.org/10.2337/db24-1308-p","url":null,"abstract":"Introduction: Reducing undiagnosed type 2 diabetes (T2D) cases worldwide is an urgent public health challenge. Most current screening methods are invasive, lab-based, and costly. Meanwhile, there is a growing focus on noninvasive T2D detection through advanced artificial intelligence (AI) and digital technology. This study explores the feasibility of using a voice-based AI algorithm to predict T2D status in adults, a preliminary step toward innovative screening tools. Objective: To develop and assess the performance of a voice-based AI algorithm for T2D status detection in the adult population in the US. Methods: We analyzed text reading voice recordings from 607 US participants from the Colive Voice study, adhering to the CONSORT AI standards. We trained and cross-validated algorithms with BYOL-S/CvT embeddings for each gender, evaluating them on accuracy, precision, recall, and AUC. Performance of the best models was stratified by age, BMI, and hypertension, and compared to the American Diabetes Association (ADA) score for T2D risk assessment using a Bland-Altman analysis. Results: We analyzed 323 females and 284 males; Females with T2D (age: 49.5 years, BMI: 35.8 kg/m²) vs without (40.0 years, 28.0 kg/m²). Males with T2D (47.6 years, 32.8 kg/m²) vs without (41.6 years, 26.6 kg/m²). The voice-based algorithm achieved good overall predictive capacity (AUC=75% for males, 71% for females) and correctly predicted 71% of male and 66% of female T2D cases. It is enhanced in females aged 60 years (AUC=74%) or older but also with the presence of hypertension for both genders (AUC=75%). We observed an overall agreement above 93% with the ADA risk score. Conclusion: This study demonstrates the feasibility of detecting T2D using exclusively voice features. It is the first step toward using voice analysis as a first-line T2D screening strategy. While the findings are promising, further research and validation are necessary to specifically target early-stage T2D cases. Disclosure A. Elbeji: None. M. Pizzimenti: None. G.A. Aguayo: None. A. Fischer: None. H. Ayadi: None. F. Mauvais-Jarvis: None. J. Riveline: Board Member; Abbott, Novo Nordisk A/S, Sanofi, Eli Lilly and Company, Medtronic, Dexcom, Inc., Insulet Corporation, Air Liquide, AstraZeneca. V. Despotovic: None. G. Fagherazzi: Speaker's Bureau; Sanofi. Advisory Panel; Timkl, SAB Biotherapeutics, Inc., Vitalaire, Roche Diabetes Care.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"43 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730541","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}