High BG Research Articles

7540 Recognition of Need for Optimization of Diabetes Education for Children with Type 1 diabetes: Long term Provider Experience

Abstract Disclosure: J. Begum-Hasan: None. Title: Recognition of need for optimization of diabetes education for children with Type 1 diabetes: long term “On call provider experience “Janhanara Begum – Hasan, MD, PhD. Jacob school medicine. UBMD Pediatrics Context: Pediatric endocrinologist does provide on call service 24/7 to support patient care as needed for the family with children with diabetes. Complication of diabetes including DKA is preventable However, based on interaction with the family with children diabetes, the trend shows sub optimal education in this regard. Aim/Objective: To review case scenario and provide recommendation to optimize diabetes management with a goal of prevention of complications. Case discussion: 3 case scenarios are selected to review. Case 1: The father called at 2 am as his daughter’s (12 year F) Insulin pump is broken and BGs are elevated in upper 300s. Her urine is +ve for moderate ketone and she has nausea. He does not have any short acting pen or syringe to provide correction Insulin. He reports that he is not aware of her Insulin settings in the pump. Parents are separated and mother is more involved in her care. Short /long acting Insulin pen were prescribed with recommendations including correction dose as per weight with a plan for follow up. Case 2: The mother called at 9 pm and reported that by mistake, she did administer “Admelog” at 18 units instead of Basaglar, for her son, 11 year old with Type 1 diabetes. He was on Lantus and Humalog before. She gets confused with short and long acting Insulin particularly with changes. The mother was advised on close monitoring of BGs with recommendation of treatment of Hypoglycemia including Glucagon therapy. He was followed closely with stabilization of BGs with extra carbohydrate overnight. Case 3: The father calls to inform that his son, 14 year, with recent onset Typ1 diabetes, has been vomiting with high BG in 400s with large ketone. His Insulin dose was decreased recently as he was told to be in “Honeymoon phase” and planned for close follow up. However, the family missed endocrine FU >12 months now. His BGs have been high in upper 200s to 300s for last 2-3 months. The parents are in the process of divorce. He was sent to local ED with clinical impression of DKA. He was treated for his severe DKA as found after metabolic labs. He did well after 2 days hospitalization for management of his DKA. Conclusion: -Complications of Type 1 diabetes are preventable. The family needs further education on diabetes management including review of Insulin therapy when Insulin pump does malfunction, with a copy of written instruction of Insulin doses, differences in long and short acting Insulin along with psychosocial support to optimize care of children with Type 1 diabetes. Presentation: 6/2/2024

Manure application influences microbial stoichiometry and alters microbial life strategies to regulate phosphorus bioavailability in low-P paddy soil

Microbial stoichiometry is pivotal in the soil elements cycle within terrestrial ecosystems. However, the impact of microbial stoichiometry on the phosphorus (P) pool transformation in low-P paddy soil, especially with manure addition, remains poorly understood. This study aimed to elucidate the response mechanism of microbial stoichiometry in regulating P pool transformation in two low-P paddy soils during a 60-day flooding-drought incubation. The results demonstrated that pig manure and vermicompost application significantly increased soil Olsen-P by 202–309 %, and microbial biomass P (MBP) by 54.4–79.3 % compared to no fertilization. Additionally, vermicompost treatment increased moderately labile organic P (MLPo) by 133–257 % and decreased fulvic acidassociated organic P (FAPo) by 10.5–25.4 % in Acrisol-flooding, Acrisol-drought, and Ultisol-drought, indicating that manure application improved the transformation of FAPo to MLPo. The microbial biomass carbon (MBC)/MBP ratio was lowest under Acrisol-flooding and highest under Ultisol-drought, suggesting that microorganisms adjust high ratios for stoichiometric stability and enhanced MBP utilization under deficient resource conditions. Manure treatments increased alkaline phosphatase (ALP) by 5.33–12.9 % under flooding conditions, indicating microorganisms facilitate the mineralization of soil organic P (Po). Compared to Acrisol-flooding, both ALP and β-1,4-glucosidase (BG) significantly increased by 103 % and 259 %, respectively, under Ultisol-drought, along with a positive correlation between BG and MLPo, implying that microorganisms enhance soil organic matter mineralization in resource-limited conditions by increasing C-acquiring enzymes and releasing Po. Additionally, the microbial community composition shifted from r-strategists to K-strategists, primarily by decreasing Proteobacteria and increasing Acidobacteria under resource deficiency and drought. The r-strategists directly mineralize Po by maintaining a low MBC/MBP and high ALP, while K-strategists indirectly mineralize Po by maintaining a high MBC/MBP and high BG. The findings suggest that manure application altered the resource status of low-P paddy soils, changed microbial stoichiometry, and influenced soil P availability through adjustments in microbial activity and extracellular enzyme production.

Empirical evidence challenges the effectiveness of the enzymatic stoichiometry of glucosidase and phosphatase as an indicator of microbial C vs P limitation

The ratio of β-1,4-glucosidase (BG) to acid/alkaline phosphomonoesterase (AP) (BG:AP) is commonly employed as an indicator to assess the relative microbial limitations of carbon (C) and phosphorus (P), whereby a higher BG:AP ratio suggests stronger C limitations. This approach is based on the assumption that BG and AP can represent enzymes targeting C and P, respectively. Nevertheless, it is crucial to recognize that microbial C and P acquisition involves the participation of other enzymes alongside BG and AP, and thus, the capacity of BG and AP to accurately and comprehensively represent the entire spectrum of C and P acquisition is questionable. Here, analyzing previously published data, I present a piece of empirical evidence that challenges the suitability of the BG:AP ratio as an accurate indicator of microbial limitations concerning C vs P. P fertilization decreased BG:AP in up to 27 % out of the total 109 observations, which represents a clear contradiction, as this outcome is interpreted by the enzymatic stoichiometry approach as indicating an intensified P limitation arising from P fertilization. Furthermore, the effect of P fertilization on the BG:AP ratio did not show significant differences between experimental sites characterized by higher BG:AP ratios (indicative of lesser P limitation) and those with lower BG:AP ratios (indicative of greater P limitation). Consequently, I conclude that the BG:AP ratio inadequately reflects microbial C vs P limitations.

Three‐phase bio‐nanocomposite natural‐rubber‐based microfibers reinforced with cellulose nanowhiskers and 45S5 bioglass obtained by solution blow spinning

AbstractAiming at biomedical applications, the present work developed a new bio‐nanocomposite fibrous mat based on natural rubber (NR) reinforced with 45S5 bioglass particles (BG) and cellulose nanowhiskers (CNW), which reveals excellent mechanical properties, good biocompatibility and bioactivity properties. Analyses of the specimens were conducted by means of morphological observations (SEM) and thermal analysis (TG/DTG), as well as mechanical tests used to verify the effect of the incorporation of BG particles and CNW on the ultimate properties of these flexible NR‐CWN/BG fibrous membranes. An SEM analysis revealed that all filaments possessed a ribbon‐like morphology, with increasing diameters as the BG concentration increased. This likely results from an increased viscosity of the solution used for fiber blowing. In comparison with neat NR fibrous mats, the ultimate mechanical properties of bio‐nanocomposites were significantly improved due to the presence of CNW and BG particles dispersed in the NR matrix. According to the TG/DTG analysis, the specimens' thermal stability was unaffected by the high BG content, and the thermal profiles were similar, with isoprene chains decomposition of the NR occurring between 350 and 450°C. In‐vitro analysis on fibroblasts confirmed that the bio‐nanocomposite fibrous mats are noncytotoxic. It was found that fibrous mats enhanced cellular growth and hold great promise for tissue engineering applications.

3D printing of bioactive glass S53P4/sodium alginate sintering-free scaffolds

Bioactive glass S53P4 (BG S53P4) has been drawing attention as filling material to promote bone regeneration while also providing the treatment of bone infections. However, there are few reports that have explored this composition as material for scaffold manufacturing to be applied in bone tissue engineering. Scaffolds are known for having an optimal geometry to aid on bone regeneration, increasing the effectiveness of traditional filling materials. Aiming to preserve the glass non-crystalline structure, we report the production of a sintering-free BG S53P4/Na-alg (sodium alginate) scaffold by material extrusion 3D printing. The scaffolds were produced using a high BG S53P4 content (37 vol%) and submersed in calcium chloride to cross-link the sodium alginate as an alternative to the sintering process widely employed in ceramic scaffolds. This work addresses the physical and chemical characterization of the BG S53P4/Na-alg scaffold, as well as its antimicrobial properties against S. aureus, E. coli and C. albicans and the cytocompatibility of MC3T3-E1 cells towards the scaffolds. The BG S53P4/Na-alg ink showed high printability, resulting in scaffolds with a high resemblance to the computational model. The cross-linking process with calcium chloride led to the precipitation of sodium calcium carbonate in the scaffold surface, but the non-crystalline structure of the BG S53P4 was preserved. The scaffolds presented antimicrobial activity against S. aureus, E. coli and C. albicans. Viability of MC3T3-E1 cells grown in the presence of samples extracts increased from 61% after incubation with the 2-days extract to over 100% after incubation with 7 and 14 days extracts. Therefore, the combination of BG S53P4 and sodium alginate showed to be suitable to produce sintering-free scaffolds by material extrusion 3D printing, with promising results to the treatment of bone infections.

Characterization of lecithin liposomes prepared by polyol dilution method using 1,3-butylene glycol

Liposomes, which are formed from phospholipids, have been widely applied in cosmetics for skin enhancement. The polyol dilution (PD) method is commonly used to prepare liposomes in the cosmetic industry. An understanding of liposome physicochemical properties is essential for cosmetic-formulation design and application. However, there have been few studies on the characterization of liposomes prepared by the PD method (PD-liposomes). Here, we studied the effect of 1,3-butylene glycol (BG) on the formation of egg-yolk lecithin (EL)-based PD-liposomes. Furthermore, the use of BG to control the liposome structural and membrane properties was investigated. The use of BG enables particle-size control of liposomes and improves the dispersion stability. In the preparation of PD-liposomes, the structure of the molecular assembly in the EL/BG binary system prior to hydration is an important factor in determining the type of PD-liposome produced. The key step in the preparation of unilamellar and multilamellar vesicles is the formation of spherical vesicles with low BG concentrations, or a stacked planar lamellar structure with high BG concentrations in the EL/BG binary system followed by hydration to form liposomes, respectively. Various properties of liposomes can be readily controlled by changing the polyol concentration. Therefore, the PD method is superior to the conventional method not only in terms of process advantages such as simplicity, ability to achieve mass production, and the absence of toxic organic solvents, but also in terms of suitability for industrial applications.

Relevance of β-Glucan Molecular Properties on Its Suitability as Health Promoting Bread Ingredient.

The fate of β-glucan (BG) health promoting properties during food production is crucial, but not predictable yet. Therefore, high molar mass BG (hBG) and control BG (cBG) were extracted from two barley varieties, characterized and added to wheat breads at levels of 3% and 6%. Bread quality criteria, carbohydrate contents and BG content and structural properties were determined. Additionally, breads were subjected to an in vitro digestion. The BG content in the chyme, molar mass, molar ratio, viscosity and bile acid retention were determined. The hBG and the cBG decreased loaf volume and increased crumb hardness with increasing BG content. The reduction in BG content during bread making was similar for hBG and cBG, but the molar mass of cBG decreased to a greater extent. As a result, only 10% of cBG entering in vitro digestion were found in the chyme afterwards, while 40% of the ingested hBG were detected. Molar mass reduction was much more severe for cBG compared to hBG. The use of hBG showed higher viscosity and better bile acid retention, indicating cholesterol lowering properties, compared to similar or higher amounts of cBG. These results provide valuable knowledge on the criteria to select BG-rich raw materials for ideal health promoting properties.

100 years of insulin-enormous gratitude for my extra 65 years!

My name is Peter Davies, and with this year being the one hundredth anniversary of insulin, it is a tremendous honour to be invited to write this account of my life with Diabetes.

3D simulation of hybrid Fabry-Pérot for single mode fibre

3D modal simulation of Hybrid Fabry Pérot (H-FP) consisting of a Bragg grating (Bg) and a multilayer mirror between single-mode optical fibres shows that diffraction in their multilayer is negligible, but that multimode 3D S-matrix calculation is essential in the multilayer to determine the adequate thickness of the interface layer with the Bg. The single-mode approximation made in 1D calculation is justified for their sinusoidal profile Bg, but is not at the top of the transmission peak for their high step profile Bg. The study of manufacturing constraints shows that feasible H-FPs, with rejection broad of several hundred nanometers, provide access to bandpass widths as low as 15 fm, but that the control of the bandwidth shift remains delicate for the realization of large series. The principle of H-FP with a high refraction index step reflector and a low step one is also valid for integrated optics. All weak spectral oscillations in the rejection band of H-FPs have been interpreted. Finally, the simulation of H-FPs with Interleaved Fibre (IF) between their 2 mirrors makes it possible to deduce also for H-FPs without IF and for some of their properties a quantitative model of equivalent cavity filled with homogeneous medium and with localized mirrors equidistant by a fraction of the length of the Bg depending only on its reflection coefficient. This equivalent cavity is used to evaluate the line width. This model also applies to 2 Bg-FPs without IF with a double length of the equivalent cavity for the same grating.

Ecological Momentary Assessment of Positive and Negative Affect and Associations with Blood Glucose in Teens with Type 1 Diabetes.

Affect (i.e., emotions) can be associated with diabetes self-care and ambient glucose in teens with type 1 diabetes (T1D). We used momentary sampling to examine associations of daily affectwithblood glucose (BG) monitoring,BG levels,and BG variability in teens with T1D. Over 2 weeks, 32 teens reported positive and negative affect (Positive and Negative Affect Scale) and BG levels on handheld computers 4x/day, coordinated with planned daily BG checks. BG values were classified as: in-range (70-180 mg/dL); low (<70 mg/dL); severe low (<54 mg/dL); high (>180 mg/dL); severe high (>250 mg/dL). Daily BG variability was derived from BG coefficient of variation (BGCV). To determine associations of positive and negative affect with BG checks, BG levels, and BGCV, separate generalized estimating equations were performed, adjusting for demographic and diabetes-related variables, for the overall sample and stratified by HbA1c (≤8%, >8%). Teens (44% male, ages 14-18, 63% pump-treated, HbA1c 8.8 ± 1.4%) reported 51% in-range, 6% low (2% severe low), and 44% high (19% severe high) BG. In teens with HbA1c ≤8%, positive affect was associated with in-range BG (OR = 1.08, 95% CI = 1.04-1.13, P = .0002), reduced odds of very low glucose (OR = 0.35, 95% CI = 0.16-0.74, P = .006), and less daily BGCV (β = -0.9; 95% CI = -1.6, -0.2; P = .01). In teens with HbA1c >8%, negative affect was associated with less likelihood of checking BG (OR = 0.75, 95% CI = 0.64-0.87, P = .0003). Our findings shed light on individual differences in metabolic reactivity based on glycemic levels and the importance of incorporating affect into automated insulin delivery systems.

Relationships between stoichiometric characteristics of soil enzymatic activities and environmental factors in parallel valleys of western Yunnan, China.

The valleyes of Hengduan Mountains contain the landscapes with high heterogeneity as well as high diversity of climate and vegetation types. To explore the soil cycling of four elements (C, N, P, S) across the parallel valleys of Nujiang River, Lancang River, Jinsha River and Yuanjiang River in western Yunnan, we collected top soils (0-10 cm) in forests, grasslands, and croplands. The activities of soil enzymes, including β-glucosidase (BG), β-N-acetylglucosaminidase (NAG), acid phosphatase (AP), and sulfatase (SU), which drive the soil C, N, P and S cycling, were determined. We analyzed the relationships of soil enzymatic activities and their stoichiometric characteristics with environmental factors. The activities of both AP and NAG had significant difference among different basins and different land types. The activities of AP, BG, NAG and SU were significantly positively related with each other. From southeast to northwest, the activities of BG, NAG, and SU increased with the altitude. Across all basins, the ecoenzymatic ratios of soils always ranked as AP:SU > BG:SU > NAG:SU > BG:NAG > BG:AP > NAG:AP. Compared with forest and grassland soil, cropland soils in each watershed had a higher BG:NAG and a lower NAG:AP (except Yuanjiang River basin). Moreover, AP:SU, BG:SU and NAG:SU of cropland soils were lower than those of forest and grassland in Yuanjiang River basin. However, they were higher than forest and lower than grassland in both Lancang River basin and Jinsha River basin. Soil enzyme activities and enzymatic stoichiometry were affected by physicochemical properties of soil, climate, and location, with the most contribution from soil physicochemical properties. Agricultural land use significantly affected the stoichiometry of C:N:P acquiring enzymes in soils by reducing the activity of N-degrading enzymes relative, resulting in the increases of BG:NAG and the decreases of NAG:AP. Agricultural activities had limited effects on other enzymatic stoichiometries.

Application of the principal component analysis (PCM) as an innovative technology for assessing the morphological and functional state of agricultural poultry with diseases of bacterial genesis

The possibility of using the method of principal components (PCM) for analyzing the results of hematological studies of blood samples of broiler chickens has been studied. It was found that the graphs of the residual dispersion show a clear clustering of samples into the control and experimental groups after infection in the PC1-PC2 space. The graphs of the scores, built for the higher BG models, showed changes in the values for the GC1 spectrum of leukocytes, and for the GC2 of erythrocytes, hemoglobin. Thus, the use of PCM analysis of hematological blood data makes it possible to separate blood samples from healthy broiler chickens and those susceptible to infection with various infections. PCM is a promising approach for rapid assessment of hematological data.

Endotoxemia and circulating bacteriome in severe COVID-19 patients

BackgroundWhen severe, COVID-19 shares many clinical features with bacterial sepsis. Yet, secondary bacterial infection is uncommon. However, as epithelium is injured and barrier function is lost, bacterial products entering the circulation might contribute to the pathophysiology of COVID-19.MethodsWe studied 19 adults, severely ill patients with COVID-19 infection, who were admitted to King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between 13th March and 17th April 2020. Blood samples on days 1, 3, and 7 of enrollment were analyzed for endotoxin activity assay (EAA), (1 → 3)-β-d-glucan (BG), and 16S rRNA gene sequencing to determine the circulating bacteriome.ResultsOf the 19 patients, 13 were in intensive care and 10 patients received mechanical ventilation. We found 8 patients with high EAA (≥ 0.6) and about half of the patients had high serum BG levels which tended to be higher in later in the illness. Although only 1 patient had a positive blood culture, 18 of 19 patients were positive for 16S rRNA gene amplification. Proteobacteria was the most abundant phylum. The diversity of bacterial genera was decreased overtime.ConclusionsBacterial DNA and toxins were discovered in virtually all severely ill COVID-19 pneumonia patients. This raises a previously unrecognized concern for significant contribution of bacterial products in the pathogenesis of this disease.

Short-term impacts to the soil microbial population during grassland conversion to cropland

Land use conversion from grassland to cropland places unique constraints on ecosystem services and sustainability across the United States. In the northern Great Plains, this process is acute with marginal lands continuously cycling in and out of production. As this trend continues, it remains unclear what the short-term impacts of intermittent cropping are to soil biological properties. This study examines the short-term response of soil microbial biomass and activity during grassland conversion to cropland using conventional tillage (CT) and no-till (NT) practices in comparison to a grassland control. Long-term grassland was converted to cropland for three consecutive years. Following crop harvest, soil samples were gathered to measure the ‘first-year’ impacts to microbial biomass and enzyme activity (beta-glucosidase [BG], beta-glucosaminidase [BGA] and phosphomonoesterase [PHOS]). Conversion of grassland to small grain production did not produce a statistically significant trend for total microbial biomass or bacterial biomass. However, there were strong environmental effects due to yearly fluctuations in precipitation on total microbial biomass, total bacterial biomass and total fungal biomass. The effect of land conversion via CT on fungal biomass was strong and resulted in decreased fungal to bacterial biomass ratios. CT significantly decreased fungal populations over both the grassland and NT by 29 %. All three enzyme activities in the top 7.5 cm were significantly reduced by land conversion via CT during the study year with the highest precipitation. On average, BG and BGA activity in the CT plots were approximately 20 % lower than either the grassland or NT plots. Phosphomonoesterase activity under CT was significantly decreased by 28 % and 18 % compared to grassland and NT, respectively. In the 7.5–15 cm depth interval, BG and BGA activities in the grassland control and NT plots showed vertical stratification, with the CT plots having the highest BG and BGA activities with higher precipitation. There was no effect of land conversion on PHOS activity at the 7.5–15 cm depth. Significant declines in soil microbial biomass and enzyme activity may occur in the first year of grassland conversion to cropland, particularly with tillage, implying reduced C and nutrient cycling potentials. These effects were the strongest for fungal biomass and occurred under conditions of higher precipitation in the semi-arid study site.

5 - The Association of Exercise Blood Glucose on Postexercise Hypoglycemia in Type 1 Diabetes

Guidelines suggest that people with type 1 diabetes (T1D) start exercise with moderately high blood glucose (8-10 mmol/L) (BG) to reduce the risk of hypoglycemia; however, those fearing hypoglycemia often start higher. This study aimed to determine the impact of afternoon aerobic exercise with a higher BG on postexercise glycemia, as measured by continuous glucose monitoring (CGM). Eleven active T1D participants (8F/3M, 30[8] years, A1C 7.7[0.8]%, VO2peak 38.4[7.7] ml/kg/min) completed 2 exercise sessions in random order: 1) with BG between 8.0-10.0 mmol/L (MOD) and 2) with BG between 12.0-14.0 mmol/L (HI). Participants were asked to keep meal timing/composition and insulin doses consistent between sessions. Participants cycled 45 minutes at 60%VO2peak. Exercise intensity (respiratory exchange ratio, heart rate) was identical between sessions (p>0.05). CGM data (mean[SD]) were assessed between 6:00 pm - 12:00 am (6 hr) and 12:00 am - 6:00 am (nocturnal) after exercise. ANOVA revealed a main effect of condition for mean CGM glucose (MOD vs HI, 6 hr: 8.8[1.0] vs 10.5[2.6] mmol/L; nocturnal: 8.6[1.4] vs 9.8[2.8] mmol/L; p=0.03), percent time in range (MOD vs HI, 6 hr: 76[16] vs 48[28]%; nocturnal: 72[33] vs 58[33]%, p<0.01) and percent time in hyperglycemia (MOD vs HI, 6hr: 24[16]% vs 49[29]%; nocturnal: 27[31] vs 42[33]%, p<0.01). There were no differences with respect to hypoglycemia. Overall, higher exercise BG was not associated with any protection against hypoglycemia, but instead increased hyperglycemia and decreased time in range.

Canagliflozin, an SGLT2 inhibitor, corrects glycemic dysregulation in TallyHO model of T2D but only partially prevents bone deficits.

Higher fracture risk in type 2 diabetes (T2D) is attributed to disease-specific deficits in micro-structural and material properties of bone, although the primary cause is not yet established. The TallyHO (TH) mouse is a polygenic model of early-onset T2D and obesity analogous to adolescent-onset T2D in humans. Due to incomplete penetrance of the phenotype, ~25% of male TH mice never develop hyperglycemia, providing a strain-matched, non-diabetic control. Utilizing this model of T2D, we examined the impact of glucose-lowering therapy with canagliflozin (CANA) on diabetic bone. Male TH mice with or without hyperglycemia (High BG, Low BG) were monitored from ~8 to 20weeks of age, and compared to age-matched, male, TH mice treated with CANA from ~8 to 20weeks of age. At 20weeks, untreated TH mice with high BG [High BG: 687±106mg/dL] exhibited lower body mass, decrements in cortical bone of the femur (decreased cross-sectional area and thickness; increased porosity) and in trabecular bone of the femur metaphysis and L6 vertebra (decreased bone volume fraction, thickness, and tissue mineral density), as well as decrements in cortical and vertebral bone strength (decreased yield force and ultimate force) when compared to untreated TH mice with low BG [Low BG: 290±98mg/dL; p<0.0001]. CANA treatment was metabolically advantageous, normalizing body mass, BG and HbA1c to values comparable to the Low BG group. With drug-induced glycemic improvement, cortical area and thickness were significantly higher in the CANA than in the High BG group, but deficits in strength persisted with lower yield force and yield stress (partially independent of bone geometry) in the CANA group. Additionally, CANA only partially prevented the T2D-related loss in trabecular bone volume fraction. Taken together, these findings suggest that the ability of CANA to lower glucose and normalized glycemic control ameliorates diabetic bone disease but not fully.

Degradability and biocompatibility of bioglass/poly(amino acid) composites with different surface bioactivity as bone repair materials

AbstractBioglass (BG) possesses excellent bioactivity and has been widely used in the manufacture of biomaterials. In this study, a composite with different surface bioactivity was fabricated via in situ melting polymerization by incorporating BG and poly(amino acid) (PAA) at a suitable ratio. The structure of the composite was characterized by Fourier transform infrared spectroscopy and XRD. The compressive strength of the BG/PAA composites was 139 MPa (BG:PAA = 30:70). The BG/PAA composites were degradable, and higher BG in composite showed higher weight loss after 4 weeks of incubation in simulated body fluid. In addition, the BG/PAA composite maintained adequate residual compressive strength during the degradation period. The SEM results showed the differences in surface bioactivities of the composites directly, and 30BG/PAA composite showed thicker apatite layer and higher Ca/p than 15BG/PAA. in vitro MG‐63 cell culture experiments showed that the composite was noncytotoxic and thus allows cells to adhere, proliferate, and differentiate. This indicates that the composite has good biocompatibility. The implantations in the bone defects of rabbits for 4 and 12 weeks were studied. The composites had good biocompatibility and were capable of guiding new bone formation without causing any inflammation. The composite may be successfully used in the development of bone implants.

The Effect of Low and High Glycemic Load Diet on Muscle Fatigue of Young Soccer Athletes

Muscle fatigue in adolescent soccer athletes can degrade performance during a match. A low Glycemic Load (GL) diet before exercise is believed to improve soccer athlete performance because it can decrease carbohydrate oxidation during exercise and has a lower increase in lactic acid levels than a high GL diet. The study aimed to identify the effect of low and high glycemic load diets on muscle fatigue in adolescent soccer athletes. A quasi experimental with multiple series group design was conducted in November 2019 on 22 adolescent soccer athletes aged 15-17 at the Terang Bangsa Soccer School Semarang. The low GL group was given food with GL 9.15; while the high GL group contained GL 27.29. Diets given once in 2 hours before exercise. Each group was triggered by RAST (Running based Anaerobic Sprint Test) to cause anaerobic muscle fatigue. Muscle fatigue is measured using blood lactic acid, BUN (Blood Urea Nitrogen), and fatigue index. There were no significant differences in blood glucose, lactic acid, and BUN levels between the low GL and high GL groups (p&gt;0.05). Nonetheless, a low GL diet had a smaller increase in blood glucose levels (1.91 mg/dL vs 4.09 mg/dL) and lactic acid (4.5 mg/dL vs 4.7 mg/dL) after exercise than high BG diet. A low GL diet also has a lower fatigue index than a high GL. Keyword: glycemic load diet, muscle fatigue, lactic acid, blood urea nitrogen.

646-P: Dulce Digital-Me: An Adaptive M-Health Intervention for Underserved Hispanics with Diabetes

Hispanics have a 66% higher risk of developing type 2 diabetes (T2D), and exhibit worse outcomes than non-Hispanic whites. Many Hispanics lack access to diabetes self-management education and support (DSME/S) due to practical, cultural, and other barriers. Mobile health (mHealth) technology has the potential to circumvent such barriers and expand the reach of DSME/S. A 3-group, randomized controlled trial is currently underway to evaluate the effectiveness of mHealth DSME/S approaches in improving diabetes outcomes among predominantly low income, Hispanic adults with T2D and HbA1c ≥ 8% at a Federally Qualified Health Center in Southern California. Dulce Digital-Me (DD-Me) is an adaptive mHealth intervention that integrates educational text messaging with personalized goal-setting and feedback. Over 6 months, participants receive 2-3 messages/day, and are provided with a glucometer and pillbox that wirelessly transmit real-time data to a cloud. Ecological momentary assessment (EMA) gauges progress in healthful eating, exercise, and emotional well-being. Participants’ progress in lifestyle changes, medication adherence, and BG monitoring frequency and control is compared to pre-defined targets. Real-time feedback is delivered via automated, algorithm-driven messaging or by medical assistant Health Coach (n = 104 in each group). The control group (n = 207) receives educational text messages alone. Preliminary analyses (N = 163) showed higher BG monitoring frequency in the DD-Me Health Coach group (M = 7.02 ± 0.45 checks/week) versus the DD-Me algorithm-driven (M = 4.80 ± 0.49) and control groups (M = 5.25 ± 0.65), p &amp;lt;.01. Trends towards better medication adherence in the DD-Me groups (M = 6.78 ± 0.60 pillbox openings/week) relative to control (M = 5.40 ± 0.53) were also observed (p = 0.15). Focus groups revealed high satisfaction with the intervention. DD-Me will provide guidance on how to optimize digital health approaches for at-risk, underserved patients with diabetes. Disclosure A.L. Fortmann: None. A. Philis-Tsimikas: Advisory Panel; Self; Lilly Diabetes, Medtronic, Novo Nordisk A/S, Sanofi. Employee; Spouse/Partner; Ionis Pharmaceuticals, Inc. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc., Lilly Diabetes, Medtronic, Novo Nordisk A/S, Sanofi. S.R.S. Bagsic: None. D.G. Vital: None. J.A. Jones: None. H. Sandoval: None. K.L. Savin: None. T. Clark: None. K. Luu: None. J.G. Godino: None. L. Gallo: None. Funding National Institutes of Health (1R01DK112322)

393-P: Technology Use and Hypoglycemia in Type 1 Diabetes: Insights from the BETTER Registry

The BETTER registry launched in April 2019 aims to understand the burden (frequency, severity) of hypoglycemia from people with T1D’s perspective and to evaluate the role of technologies in its prevention and management. Methods: BETTER registry includes several online surveys and is being conducted in Quebec, Canada. Preliminary results of the 2ndsurvey about technology use, CSII and FGM/CGM, in relation to hypoglycemia are reported. Results: By Dec 2019, 457 persons with T1D (&amp;gt; 14 y.o.) have completed the 2ndsurvey (44.0±15.7 y.o., 67.2 % females, 48.0% CSII users, 80% FGM/CGM users in past 12 months). Main reasons for opting for technology: A) CSII (n=219): glucose control with exercise (72.6%), elevated HbA1c (42.9%), nocturnal hypoglycemia (35.2%) as well as overall hypoglycemia severity and frequency (26.0%). Interestingly, 65.3% reported less hypoglycemia after adopting CSII. B) FGM/CGM (n=365): easier to follow glucose levels (77.5%), stop/reduce capillary measurements (69%), easier glucose control with exercise (68.5%). Table1 shows comparisons between technology users vs. non users: CSII and FGM/CGM users reported better glucose control, more hypoglycemia episodes (probably due to better diagnosis) that are corrected at higher BG levels. Conclusion: This database will improve the understanding of technologies roles in hypoglycemia detection, prevention and treatment to optimize their use. Disclosure N. Taleb: None. K. Desjardins: None. S. Haag: None. M. Prevost: None. R. Rabasa-Lhoret: Advisory Panel; Self; AstraZeneca, Eli Lilly and Company, Insulet Corporation, Janssen Pharmaceuticals, Inc. Board Member; Self; Merck &amp; Co., Inc., Sanofi. Research Support; Self; Eli Lilly and Company, Novo Nordisk A/S, Novo Nordisk A/S, Sanofi. A. Brazeau: None. Funding Canadian Institutes of Health Research (JT1-157204); JDRF (4-SRA-2018-651-Q-R)