Basal Dose Research Articles

Eco-friendly cellulose hydrogels as controlled release fertilizer for enhanced growth and yield of upland rice

The effect of urea-loaded cellulose hydrogel, a controlled-release fertilizer (CRF) on growth and yield of upland rice were investigated in upland rice. As with the initial research, nitrogen (N) treatments were applied as CRF treatments; T2H (30 kg N ha−1), T3H (60 kg N ha−1), T4H (90 kg N ha−1), T5H (120 kg N ha−1) and recommended dose of fertilizer (RDF) at 120 kg N ha−1 RDF (T6U) in split application and T1 (0 N) as control. Results from this study indicated that applying CRF at the optimum N rate, T4H resulted in maximum grain yield, increasing by 71%. The analysis of yield components revealed that higher grain yield in T4H CRF was associated with an increase in panicle number and number of grains per panicle. Maximum grain N uptake of 0.25 g kg−1 was also observed in T4H CRF. In addition, T4H CRF recorded the highest harvest index (HI) and N harvest index (NHI) of 45.5% and 67.9%, respectively. Application of T4H CRF also recorded the highest N use efficiency (NUE) and N agronomic efficiency (NAE), 52.6% and 12.8 kg kg−1, respectively. Observations show that CRF with only 75% N applied (T4H) in soil improved grain yield when compared to CRF with 100% N and 100% RDF in farmers’ conventional split application. This suggested that CRF with a moderate N application might produce the highest potential yield and improved N efficiencies while enhancing crop production and further increase in N supply did not increase yield and N efficiencies. The results suggest that the application of T4H CRF for upland rice would enhance HI, N efficiencies and improve the yield of upland rice. Also, all growth parameters and yield were positively influenced by the application of CRF as a basal dose compared to split application of conventional urea fertilizers.

Plant growth promoting rhizobacteria application increased growth and yield of shallot supplied with NPK fertilizer

ABSTRACT Shallot (Allium cepa L. var. Aggregtum group) production fluctuates duo to use of synthetic fertilizer. The effect of how Plant Growth Promoting Rhizobacteria (PGPR) and NPK affect growth and yield of shallot in a pot experiment were examined. The first factor consisted of 0, 10, 20, and 30 mL·L−1 of PGPR, the second treatment consisted of 0.8, 1.2, or 1.6 g of NPK per pot. There was no interaction between PGPR and synthetic fertilizer on growth and yield. The PGPR increased growth and yield of shallot when PGPR doses rose. The 30 mL·L−1 basal dose of PGPR increased plant height (39.96 cm), number of leaves per plant (42.33), fresh bulb weight per plant (53.46 g), and number of bulbs per plant (9.78). The 1.8 g NPK increased number of leaves (42.17) and number of fresh bulbs per plant (9.25), which gradually decreased when doses were reduced. Increasing applied synthetic fertilizer produced improved growth and yield of shallot. Under sustainable crop management, PGPR application could further enhance growth and yield of shallot.

Soil Application of Sea Weed Extract Granules and Foliar Application of Nano ZnO to Bt Hybrid Cotton to Vertic inceptisols

Bt hybrid cotton was significantly benefitted by the soil application of Sagarika sea weed extract granules at 25 kg ha-1 yr-1 along with the recommended basal fertilizers dose or foliar application of nano ZnO 4% at 0.04% at squaring and flowering stages. These treatments significantly enriched index leaf residual P and Zn content beyond 20 μg g-1 fresh weight during boll development stage and this resulted in significant improvement in lint yield by 7.5% i.e. 35 kg lint ha-1 yr-1, C:B ratio by 5.0% and net returns to the tune of ₹. 5000 ha-1 over alone 100% RDF in eroded Vertic inceptisols deficient in N, Mg, S, Zn and B. Excess rains at seedling and vegetative stage followed by drought at reproductive stages in both years, reduced the economic viability of seed treatment with bio-stimulants and foliar applications besides soil and foliar application of Zn, S, B alone or together to Bt hybrid cotton.

Expected Basal Insulin Requirement during CSII therapy by Age Group, Sex and BMI, based on 25,718 Young People with Type 1 Diabetes in the DPV Registry.

Background Since the introduction of insulin pumps into the therapy of paediatric subjects, different approaches have been taken to find optimal basal rates. Previously, the DPV registry provided circadian basal rate patterns for different age groups. As the number of pump users has increased recently and short-acting insulin analogues are now predominant, we performed a new analysis with a larger data pool. Methods We included all recent basal profiles from T1D patients between 1 and 25 years from the DPV 2021 data pool. We excluded night-time-only pump users, human regular insulin users, and daily basal rates < 0.05 U/kgBW/d and >1.0 U/kgBW/d. Results In the analysis of profiles from 25,718 young persons with T1D, differences in the daily pattern of basal rates were found between age groups. In addition, we saw significant (p<0.001) differences in total daily basal dose between genders in all age groups except adults. In addition, the shape of the expected basal-rate pattern differed by BMI, HbA1c and use of continuous glucose monitoring. Discussion This analysis demonstrates multiple factors influencing basal patterns and insulin requirement, including age group, gender, overweight, HbA1c, bolus frequency and sensor use. As circadian basal rates are still mandatory for initiating insulin pump therapy with or without automation, a multimodal approach is necessary to estimate optimal basal rates.

Knowledge and practice of the management of breakthrough cancer pain among general practitioners providing palliative care in Shanghai, China: a cross-sectional survey

ObjectiveThis study examined knowledge and practice of breakthrough cancer pain (BTcP) management among general practitioners (GPs) providing palliative care in Shanghai.DesignCross-sectional study using a self-administered questionnaire.Setting and participantsA total of...

Enhancing Growth and Yield of Parching Sorghum through Organic Manure Application

Aims: The combination of various sources of organic manures along with liquid organic manures is important to maintain nutrient availability to crop and sustain higher level of soil fertility. The aim is to meet the nutrient demand of parching sorghum as per requirement at different stages through solid and liquid organic manures which can give greater productivity of crops.&#x0D; Study Design: The experiment was laid in Randomized Complete Block Design with 9 treatments replicated thrice.&#x0D; Place and Duration of Study: A field experiment was conducted at College of Agriculture, Vijayapur, during Rabi, 2020-21.&#x0D; Methodology: The treatments were T1-Ghanajeevamrutha based on 100% RDN (recommended dose of Nitrogen) as basal dose, T2-Vermicompost based on 100% RDN as basal dose, T3- T1 + foliar application of 10% vermiwash at 20 &amp; 45 DAS (days after sowing), T4- T1 + foliar application of 10% cow urine at 20 &amp; 45 DAS, T5- T1 + foliar application of 25% jeevamrutha at 20 &amp; 45 DAS, T6- T2 + foliar application of 10% vermiwash at 20 &amp; 45 DAS, T7- T2 + foliar application of 10% cow urine at 20 &amp; 45 DAS, T8- T2 + foliar application of 25% jeevamrutha at 20 &amp; 45 DAS and T9- Organic RPP of parching sorghum with SMJ-1 variety of parching sorghum.&#x0D; Results: The application of ghanajeevamrutha based on 100 per cent RDN as basal dose + foliar application of 25 per cent jeevamrutha at 20 and 45 days after sowing recorded significantly higher dry matter production (55.86 g plant-1), leaf area index (3.49), raw and roasted grain weight (39.49 g and 51.73 g respectively), raw and roasted grain yield (1063 kg ha-1 and 1505 kg ha-1 respectively) of parching sorghum (hurda) at harvest as compared to other treatments. In addition to improvement in the major plant nutrient uptake were recorded with incorporation of ghanajeevamrutha or vermicompost along with the liquid organic manure.&#x0D; Conclusion: The application of ghanajeevamrutha based on 100 per cent RDN as basal dose coupled with foliar application of 25 per cent jeevamrutha at 20 and 45 days after sowing recorded significantly higher growth, yield, quality and plant nutrient uptake by parching sorghum.

Effects of Different Levels of Potassium and Their Split Applications on Growth and Yield of Chilli (Capsicum annuum L.)

This research aimed to investigate the effects of split applications of potassium (K) fertilizer on the growth and yield characteristics of chilli (Capsicum annuum L.), as previous studies have primarily focused on single basal applications of K, leaving the effectiveness of split applications uncertain. The field experiment was conducted on Loamy sand soil with medium K status, evaluating six levels of K (0, 40, 80, 100, 120, and 150 kg ha-1) applied as full K basal dose, 2 splits, and 3 splits. The experiment followed a two-factorial randomized complete block design with three replications and eighteen treatments. Results showed that the three split applications, with 50% at basal dose, 25% at 25 days after transplanting (DAT), and 25% at 45 DAT, resulted in superior plant height, number of fruits per plant, fruit yield, root length, root fresh weight, and root dry weight. Consequently, it is recommended to employ split applications of K in two or three splits, depending on the initial soil K status and soil type, to enhance growth and maximize yield per unit of nutrient applied.

Influence of potassium and sulphur nutrition on quality of garlic (Allium sativum L.)

The field experiment was conducted at the Vegetable Research Farm and Biochemistry laboratory, PAU, Ludhiana during Rabi seasons of 2020-21 and 2021-22 to study the effect of potassium and sulphur on the quality of garlic. The experiment comprised of sixteen treatment combinations with four levels each of potassium (0, 20, 40 and 60 kg K /ha) and sulphur (0, 10, 20 and 30 kg S/ha). It was laid in a randomized complete block design and replicated thrice. Variety ‘PG-18’ was used as plant material. Potassium and sulphur were applied as basal dose at bed preparation. The results depicted that quality parameters were influenced by with these nutrients. Maximum allicin (12.19 and 12.64 mg/g), TSS (41.3 and 41.5%), ascorbic acid (21.64 mg/100 g dry weight and 21.81 mg/100 g dry weight) and total minerals (53.17 mg/100g dry weight and 53.56 mg/100g dry weight), dry matter (42.40 and 42.97%), total protein (120.8 and 112.1 mg/g) were recorded with application of 60 kg/ ha potassium and 30 kg/ ha of sulphur respectively. Maximum phenols (0.54 mg/g) and total sugars (182.2 mg/g) was recorded under the interaction of 60 kg/ ha potassium and 30 kg/ ha of sulphur.

Exogenous Application of Organic and Inorganic Nutrients and Their Impact on Agronomical Traits, Yield and Quality of Vegetable Cowpea [Vigna unguiculata (L) Walp

The study was undertaken on heavy black soil at Regional Horticulture Research Station, Navsari Agricultural University, Navsari, Gujarat (India) in order to analyze the effect of foliar application of organic and inorganic nutrients on growth, yield and quality of vegetable cowpea. The field was thoroughly ploughed and harrowed followed by land levelling using wooden plank. Basal dose of manure and fertilizer of 20:40:00 kg ha-1 was incorporated in the soil during land preparation. The seeds were planted 45 cm between rows and 30 cm between plants laid out in a Randomized Complete Block Design with nine treatments replicated three times. Treatments were as follows: Control (T1), 2% Panchagavya (An organic solution made from cow dung, cow urine, cow butter, cow curd and cow milk) (T2), 3% Panchagavya (T3), 0.5% Novel plus organic liquid nutrients (T4), 1% Novel plus organic liquid nutrients (T5), 1.5 % Novel plus organic liquid nutrients (T6), 0.5% Micronutrient grade IV (T7), 1% Micronutrient grade IV (T8) and 1.5% Micronutrient grade IV (T9). The observations were made at the intervals of 60 and 90 DAS and data was collected on plant growth, yield and quality parameters. Results showed that the application of 1% Novel plus organic liquid nutrients (NOVEL) (T5) exhibited maximum plant height (35.73 and 56.93 cm, respectively), number of leaves per plant (39.27 and 52.73, respectively) at 60 and 90 days after sowing (DAS) and increased leaf area (162.14 cm2). Substantial effect of foliar application of 1% Novel plus organic liquid nutrients (NOVEL) (T5) was detected in yield parameters viz., number of clusters per plant (12.07), number of pods per plant (58.00), marketable pod yield (6.04 kg/plot). Furthuer to this, 1% Novel plus organic liquid nutrients indicated notable effect on protein content of pods (24.04%), iron (Fe) content (220.12 ppm) and zinc (Zn) content (62.76 ppm) of cowpea pods at final harvest. Novel Plus organic liquid nutrient can play a major role in growth, yield and quality in vegetable cowpea production.

Efficacy and safety of faster aspart in insulin pumps in children and adolescents with type 1 diabetes mellitus: A single-center study with real-world data

AimsTo assess the efficacy and safety of faster aspart (FIAsp) in paediatric population with type 1 diabetes mellitus (T1DM) and insulin pumps in real-world settings. MethodsOf 44 patients, 20 used FIAsp, 16 of which switched from aspart to FIAsp and 24 used aspart/lispro. We performed within-groups and between-groups analyses in three time points for anthropometric data, % of 24-h time in range of 70–180 mg/dl (TIR), time < 70 mg/dl and <54 mg/dl and time > 180 mg/dl and >250 mg/dl, bolus and basal insulins doses (units/kg/day and %), total daily dose (TDD, units/kg/day), glycaemic variability, frequency of set changes, sensor wear per week and meals per day. ResultsUse of FIAsp over time increased TIR (P = 0.002) and TDD (P = 0.008 and P = 0.004, respectively for three months after the switch and recent use) and decreased time in hyperglycaemia (>180 P = 0.003 and > 250 mg/dl, P = 0.004). Frequency of set changes differ in the first 3 months (P = 0.042). Patients with FIAsp consumed more meals per day compared to those with aspart/lispro (P = 0.032). ConclusionReal-world data confirm that use of FIAsp in insulin pumps in paediatric populations improves glycaemic control long-term.

Effects of rice husk biochar charred at different time on soil chemical properties, rice growth and yield

Sustainable rice production in Sub-Saharan Africa especially in Nigeria faces serious constraints due to soil infertility. Recycling of rice residues through biochar production and applying it to the soil could be a possible approach to address the soil fertility constraints facing rice production. A pot experiment was conducted at Imo State University to investigate the effect of rice husk biochar on some selected soil chemical properties, growth and yield of rice. Four treatments evaluated in the pot experiment include rice husk biochar charred at 250oC for 60, 90 and 120 minutes together with control (no amendment). The treatments were replicated three times and laid out in completely randomized design (CRD). The soils in the pots were both treated with basal dose NPK (15:15:15) at 200kgha-1 while biochar was applied at the rate of 10tha-1 to the amendment soils. Application of biochar in this experiment appreciably increased the soil pH, available phosphorus, OC, TN, exchangeable cations, CEC and available silicon in biochar treated pots compare to control pots. The degree of soil improvement was proportional to the charring time. The rice husk charred for 120 minutes (RHB120) showed the highest effect on most of the soil chemical properties evaluated. Biochar amendment was found not to have much influence on the rice agronomical parameters except grain weight in which the highest value was found in soil treated with RHB120 (12.5gpot-1). Therefore, converting rice husk to biochar and applying it to the soil can improve soil fertility status and yield of rice in Nigeria. Keywords: Rice Husk Biochar, Soil Chemical Properties, Rice Growth, Rice Yield

Developing a tactical irrigation and nitrogen fertilizer management strategy for winter wheat through drip irrigation.

Agricultural activities in the North China Plain are often challenged by inadequate irrigation and nutrient supply. Inadequate and improper resource utilization may impose negative impacts on agricultural sustainability. To counteract the negative impacts, a deeper understanding of the different resource management strategies is an essential prerequisite to assess the resource saving potential of crops. We explored plausible adaptation strategies including drip irrigation lateral spacings of 40 and 80 cm (hereafter referred to as LS40 and LS80, respectively), irrigating winter wheat after soil water consumption of 20 and 35 mm (hereafter represented as IS20 and IS35, respectively), and nitrogen fertilization scheme of a) applying 50% nitrogen as a basal dose and 50% as a top-dressing dose (NS50:50), b) 25% nitrogen as a basal dose and 75% as a topdressing dose (NS25:75), and c) no nitrogen application as a basal dose and 100% application as a top-dressing dose (NS0:100). The consecutive 2 years (2017-2018 and 2018-2019) of field study results show that growing winter wheat under LS40 enhanced the water use efficiency (WUE), grain yield, 1,000-grain weight, and number of grains per spike by 15.04%, 6.95%, 5.67%, and 21.59% during the 2017-2018 season, respectively. Additionally, the corresponding values during the 2018-2019 season were 12.70%, 7.17%, 2.66%, and 19.25%, respectively. Irrigation scheduling of IS35 treatment improved all the growth-related and yield parameters of winter wheat. Further, treating 25% nitrogen as a basal dose and application of 75% as a top-dressing dose positively influenced the winter wheat yield. While NS0:100 increased the plant height, leaf area index (LAI), and aboveground biomass as compared to the other application strategies, but high nitrogen was observed in deeper soil layers. Regarding soil environment, the lowest soil moisture and nitrate nitrogen contents were observed in LS80 during both growing seasons. Overall, coupling the IS35 with NS25:75 under 40-cm lateral spacing is a suitable choice for sustainable winter wheat production in theNorth China Plain. The results of our study may be helpful in advancing the knowledge of the farmer community for winter wheat production. The findings can also aid in advancing new insights among scientists working on soil water and nitrogen distribution in drip irrigation for better productivity.

Basal and Bolus Insulin Distribution According to Treatment Modality: Data from SWEET Diabetes Registry

Background and Aims. The optimal basal and bolus insulin distribution in type 1 diabetes (T1D) is still controversial. Herein, we aimed to determine the variability of basal to total daily insulin dose according to treatment modality and diabetes technologies from the Better Control in Pediatric and Adolescent Diabetes: Working to Create Centers of Reference (SWEET) registry. Methods. The study cohort was generated by using the SWEET database. Patients with T1D for at least 2 years, aged between 2.5 and 18 years, with at least one clinic visit between June 2010 and June 2021, were included in the study. Four groups were composed according to treatment modality as follows: multiple daily injections (MDI) without continuous glucose monitoring (CGM); MDI with CGM; subcutaneous insulin infusion (CSII) without CGM; and CSII with CGM. Data of the participants were analyzed and compared for each treatment modality separately. Results. A total of 38,956 children and adolescents were included in the study. Of the study sample, 48.6% were female, the median (range) age was 15.2 (11.9–17.2) years, and the median diabetes duration was 6.0 (3.8–9.0) years. The distribution of treatment modality was as follows: MDI without CGM, 32.9%; MDI with CGM, 18.0%; CSII without CGM, 11.7%; and CSII with CGM, 37.3%. In unadjusted data, regardless of treatment modality, all the analyses revealed a significant association between basal dose to total daily insulin dose (BD/TDD) with male gender, younger age group, and lower HbA1c, which were all related to a decreased ratio of BD/TDD (all p &lt; 0.05 ). There was no association between BD/TDD and different diabetes technologies after the age, gender, and diabetes duration were adjusted. Conclusions. Herein, we showed that there was an association between lower proportions of basal to total insulin and lower hemoglobin A1c in a large cross-sectional cohort of children who had T1D. There was also an association between lower BD/TDD and younger age. There was no significant difference between BD/TDD ratios under different diabetes technologies (CGM and/or CSII).

Integrated Effect of Heavy Metal-Tolerant Rhizobacteria and Phosphorus on Maize Growth and Phosphorus Bioavailability in Contaminated Soil

Toxic metals significantly influence agricultural crop yields and adversely affect animals and humans. Hence, in the current study impact of different strains of phosphorus-solubilizing bacteria (PSB) and levels of phosphorus on the solubility of phosphorus and the stabilization of heavy metals in contaminated soil were studied in a greenhouse pot experiment in 2022. The PSB strains included Bacillus CUM6, Bacillus DUM7, and Bacillus PIS7. Phosphorus was applied at rates of 40, 60, and 80 kg P2O5 ha-1 using single superphosphate, with a basal dose of 120 kg N and 60 kg K2O ha-1. The experiment followed a randomized, two-factorial design. Maize plants (variety "Azam") were inoculated with the PSB strains. Consequently, combining Bacillus PIS7 with 80 kg P2O5 ha-1 significantly increased both fresh and dry maize biomass (35.33 and 24.56 g pot-1) compared to the control (unspiked soil). Phosphorus bioavailability (7.07 and 5.14 mg kg-1) significantly improved with 80 kg ha-1 phosphorus and Bacillus PIS7. Heavy metal concentrations in soil (Cd, Pb, Cr, and Ni) decreased significantly at 80 kg ha-1 phosphorus and Bacillus PIS7, and Cd concentrations in plants decreased to 3.31 mg kg-1 with Bacillus DUM7 and to 2.96, 0.42, and 1.33 mg kg-1 with Bacillus PIS7. The application of PSB strains and phosphorus fertilizer reduced heavy metal concentrations. Notably, 80 kg P2O5 ha-1 with Bacillus PIS7 showed the best performance. Phosphorus uptake increased significantly (0.106 mg pot-1), while heavy metal uptake (Cd, Pb, and Cr) decreased linearly with increasing phosphorus levels and PSB strains. Bacillus PIS7 with 80 kg P2O5 ha-1 had the lowest heavy metal translocation, doing better than the control and other PSB strains (Bacillus CUM6 and Bacillus DUM7). Soil characteristics indicated increased organic matter content (0.73%) and decreased pH (7.61) and electrical conductivity (0.17 dSm-1) with applied phosphorus and PSB strains, suggesting enhanced phosphorus bioavailability and reduced heavy metal concentrations. In conclusion, adding 80 kg P2O5 ha-1 with Bacillus PIS7 helps plants grow better when they are stressed by heavy metals and keeps Cd, Pb, Cr, and Ni stabilized in the soil.

Increasing basal dose of indole-3-butyric acid improve rooting and growth of different cutting types in Dahlia

Dahlias (Dahlia x hybrida) are an important flower crop that have been cultivated in a greenhouse in recent years. However, limited information is available on rooting potential of type of cuttings in response to varying indole-3-butyric acid (IBA) concentration. In the present study, the influence of IBA on the rooting and growth characteristics of Dahlia cuttings was analyzed. The Dahlia cuttings (with heel) were excised form the sprouted tubers and the cuttings without heel were taken from tender terminal shoots. Exogenously applied IBA (1500 mg L−1) for 5 s influenced the rooting characteristics with considerably earlier (17.5 days) root initiation with more number (6.7) and longer length (11.5 cm) of roots. The Dahlia softwood cuttings excised from tuberous shoots yielded better rooting when treated with IBA (1500 mg L−1). Authors suggest Dahlia nursery growers to undertake replicated trials before mass multiplication, to ascertain the varietal response of cuttings to rooting at varying IBA concentration.

275-OR: Association between Treatment Adherence and CGM Outcomes in People with T1D Using Smart Insulin Pens in a Real-World Setting

Adherence to insulin therapy can be challenging for individuals with T1D. This analysis explored how adherence to basal and bolus insulin injections influences glycemic outcomes. Data were collected from adults (≥18 years) administering basal insulin (degludec) and bolus insulin (aspart or faster aspart) using smart insulin pens with CGM; data were aggregated in 14-day periods. Treatment adherence was defined as the number of missed basal insulin doses (&amp;gt;40 hrs between doses), flex basal insulin doses (dosing time deviated &amp;gt;±6 hrs from previous day) and missed bolus insulin doses (meals with no bolus dose within -15 to +60 mins from meal onset). Glycemic outcomes included time in range (TIR), time below range, glucose management index (GMI), and coefficient of variation. Multinational data from 403 adults who had 3588 14-day periods with ≥70% CGM coverage were analyzed. Individuals with one missed basal dose per 14-days had a lower TIR (-4.04% [95% CI: -6.83; -1.26]) and higher GMI (0.20% [95% CI: 0.02; 0.38]) than individuals without missed basal doses; flex basal doses were not associated with TIR changes. Missed bolus insulin doses were also associated with lower TIR (Table). These real-world data confirm associations between missed basal and bolus insulin doses and impaired TIR, highlighting a need for digital tools such as smart insulin pens to help individuals manage their diabetes. Disclosure T.Danne: Research Support; Abbott Diabetes, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Dexcom, Inc., Eli Lilly and Company, Novo Nordisk A/S, Sanofi, Medtronic, Stock/Shareholder; DreaMed Diabetes, Ltd. N.V.Hartvig: Employee; Novo Nordisk A/S, Stock/Shareholder; Novo Nordisk A/S. A.Kaas: Employee; Novo Nordisk A/S, Stock/Shareholder; Novo Nordisk A/S. N.N.Knudsen: Employee; Novo Nordisk. J.K.Mader: Advisory Panel; Novo Nordisk A/S, Abbott Diabetes, Roche Diabetes Care, Eli Lilly and Company, Sanofi, Medtronic, Becton, Dickinson and Company, Pharmasense, embecta, Research Support; A. Menarini Diagnostics, Abbott Diabetes, Roche Diabetes Care, Dexcom, Inc., Profusa, Inc., Speaker's Bureau; Novo Nordisk A/S, A. Menarini Diagnostics, Abbott Diabetes, Roche Diabetes Care, Eli Lilly and Company, Sanofi, Boehringer Ingelheim Inc., Becton, Dickinson and Company, Ypsomed AG, Viatris Inc., Servier Laboratories, Medtrust, Stock/Shareholder; Decide Clinical Software GmbH. Funding Novo Nordisk A/S

807-P: Patient and Health Care Provider Experiences of Suboptimal Insulin Dosing in the United States

Objectives: This study described the frequency of suboptimal insulin dosing (missed and mistimed doses) and the factors underlying this behavior from the perspective of people with diabetes (PwD) and healthcare professionals (HCPs.) Methods: For this cross-sectional, multinational non-interventional study, 640 HCPs and 1150 PwD (300 with type 1 diabetes, 850 with type 2 diabetes) completed an online survey. A research vendor recruited adult PwD currently using a non-connected insulin pen (400 from US) and eligible HCPs (160 from US) via validated panels, referrals, list acquisition, and custom methods. Results are presented for US data. Results: Overall, 42% and 61% of PwD reported missing basal and bolus insulin doses in the past 30 days. The average number of missed basal and bolus doses were 3.1 (SD=3.81) and 5.0 (SD=10.30), respectively. PwD reported forgetting, being too busy/distracted, and out of my normal routine as key reasons for missed doses. Overall, 37% and 49% of PwD reported mistiming basal and bolus doses, respectively, in the past 30 days. This corresponded to an average of 3.1 (SD=3.29) mistimed basal and 4.9 (SD=6.28) mistimed bolus doses. Key reasons PwD reported for mistimed doses included being too busy/distracted, forgot or having an unexpected or earlier/later-than-expected meal. Conversely, the majority of HCPs reported ≤20% of their PwD missed/skipped a dose in the past 30 days. HCPs reported dosing reminders (90%), automatically recorded insulin doses and timing (92%) and having insulin and glucose data in one place (94%) as identified solutions. Conclusions: PwD are missing, skipping, or delaying their insulin doses, largely for preventable reasons. HCPs perceive PwD dosing adherence greater than PwD self-reported behaviors. Digital health solutions, such as connected insulin pens, may help PwD reduce missed and mistimed doses as well as help close the perception gap to further optimize insulin management. Disclosure M.B.Davidson: Employee; Eli Lilly and Company. F.Gelsey: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. J.Bower: None. E.Artime: None. E.Spaepen: Consultant; Eli Lilly and Company. R.Newson: Employee; Eli Lilly and Company. Funding Eli Lilly and Company

386-P: Inpatient Hypoglycemic Rate Reduction through the Implementation of Prescriber Targeted Decision Support Tools

Introduction: Hypoglycemia has been shown to increase mortality and length of hospital stay in patients with and without diabetes. The purpose of this study is to determine if the implementation of prescriber targeted decision support tools reduces the incidence of inpatient hypoglycemic events. Methods: This pre-post intervention study included adult patients who experienced an inpatient hypoglycemic event within 24 hours of insulin administration from October 2018 to December 2019. Pregnant women and patients receiving insulin infusions were excluded. Best Practice Alerts (BPAs) and banners were implemented in January 2019 to alert providers of patients at risk for hypoglycemia. Triggers for the BPAs and banners include use of sulfonylureas with reduced renal function, high weight-based basal doses, a previous episode of hypoglycemia during the admission, or concomitant use of fluoroquinolones and scheduled insulin. The primary outcome was to measure the incidence of hypoglycemia per 1000 patient days in pre- vs. post-intervention groups. Results: In total, 1186 hypoglycemic events in the pre-intervention group were compared to 5260 events in the post-intervention group. The implementation of EMR alerts significantly decreased hypoglycemia (glucose ≤ 70 mg/dL) from 22.91 events/1000 patient days to 18.27 events/1000 patient days (p&amp;lt;0.001). Severe hypoglycemia (glucose &amp;lt; 54 mg/dL) was not significantly reduced (1.65 events/1000 patient days vs. 1.79 events/1000 patient days (p=0.453)). The use of high weight-based basal insulin doses was reduced in the post-intervention patients with normal renal function, 23.0% vs. 16.7% (p&amp;lt;0.001), and patients with impaired renal function, 7.1% vs. 4.9% (p=0.017). Conclusion: The implementation of prescriber targeted decision support tools was successful in reducing the overall incidence of inpatient hypoglycemia. Disclosure R.Goldstein: None. J.M.Odom: None.

810-P: Do People Living with T1D Use the Dosing Flexibility of Degludec and Does This Depend on Patient Characteristics?

Flexibility in insulin degludec injection timing of 8-40 hrs between doses allows people with diabetes to adapt their treatment around daily life. This real-world multinational study explored flexible dosing (≥6hr difference in time of day [clock-time] between consecutive doses) in terms of prevalence and associated characteristics in 1136 people with T1D (mean [SD] age 31.3 [17.7] years, 54% male, median observation period 124 days [IQR 41, 234]) who were administering insulin degludec with smart pens. Of these participants, 14.4% regularly flexed dosing time (≥1 time every month). The probability of having ≥1 flexible dose in a given 2-week period was shown by a generalized linear mixed model (log link) with participant ID as a random effect and individual characteristics as fixed effects. Estimated LS-mean probability of ≥1 flexible dose in a given 2-week period was 25.0% (95% CI: 21.5%, 28.9%), with higher probability for young adults (aged 18-25), those who usually inject 9am-6pm, and those with a higher (&amp;gt;30 U/day) basal dose (all p&amp;lt;0.01). Probability decreased with time from smart pen initiation (p&amp;lt;0.01). In the subgroup of 455 adults with CGM data, flexibility in dosing time did not affect glycemic control. Overall, a group of people with T1D used the degludec dosing flexibility; these were most often young adults aged 18-25, those injecting 9am-6pm, and those requiring higher degludec doses. Disclosure Y.Winhofer: Speaker's Bureau; Abbott Diabetes, Amgen Inc., Boehringer-Ingelheim, Eli Lilly and Company, Novartis, Novo Nordisk, Medtronic, Sanofi-Aventis Deutschland GmbH, Daiichi Sankyo. A.Kaas: Employee; Novo Nordisk A/S, Stock/Shareholder; Novo Nordisk A/S. N.N.Knudsen: Employee; Novo Nordisk. J.H.J.Martiny: Employee; Novo Nordisk. C.Mathieu: Advisory Panel; Novo Nordisk A/S, Boehringer Ingelheim Inc., Eli Lilly and Company, Medtronic, Vertex Pharmaceuticals Incorporated, Roche Diabetes Care, Imcyse, Speaker's Bureau; Novo Nordisk A/S, AstraZeneca, Boehringer Ingelheim Inc., Eli Lilly and Company, Medtronic, Vertex Pharmaceuticals Incorporated. Funding Novo Nordisk A/S

805-P: Double-Blind Crossover Study of Ultra-Rapid AT247 Compared with NovoLog and Fiasp during Continuous Subcutaneous Infusion (CSII) Assessed by a Hyperinsulinemic Euglycemic Clamp

Background: AT247 is a novel insulin aspart formulation designed for ultra rapid absorption following subcutaneous injection to achieve optimal postprandial glycemic control. Method: Adults (29) with T1DM were randomized to 6 treatment sequences of AT247, Novolog (N), and Fiasp (F). Bolus (0.15 U/kg) and basal (0.02 U/kg/h) doses of insulin were administered via CSII for 3 days. PK and PD were assessed using euglycemic clamps on days (D) 1 and 3. Results: A higher early insulin exposure (AUCIns 0-30min mU/L/h) was observed for AT247 (16.7) vs N (6.3*) or F (13.0**) on D1, Fig 1A. The difference for AT247 was maintained on D3 (20.8) vs N (10.5*) but not vs F (19.2). A higher early glucose lowering effect (AUCGIR 0-60 mins mg/kg) was observed for AT247 (144.4) vs N (70.4*) but not vs F (145.8) on D1 only, Fig 1B. Time to early 50% Cmax insulin (h) occurred earlier for AT247 (0.18) compared to N (0.43*) and F (0.28**) on D1 and D3 (AT247 0.17; N 0.33**; F 0.22**). Statistical significance was p&amp;lt;0.05* or p&amp;lt;0.01**. AT247 was well tolerated with no significant adverse effects. Conclusions: The faster absorption of AT247 resulted in higher early insulin exposure than for F or N following bolus dose delivery during CSII. The demonstrated PK profile of AT247 supports further investigation into its potential to further improve automated insulin delivery. Disclosure M.Hompesch: Board Member; ProSciento, Consultant; Wiley-Blackwell, Employee; ProSciento, Stock/Shareholder; ProSciento. F.J.Lawrence: None. J.Jezek: None. D.J.Gerring: Employee; Arecor. T.Pieber: Advisory Panel; Arecor, Novo Nordisk A/S, Consultant; Lilly, Research Support; AstraZeneca, Novo Nordisk A/S, Sanofi, Speaker's Bureau; Roche Diagnostics.