Higher Rates Of Diabetes Research Articles

Early experience with critically ill patients with COVID-19 in Montreal.

PurposeMontreal has been the epicentre of the coronavirus disease (COVID-19) pandemic in Canada. Given the regional disparities in incidence and mortality in the general population, we aimed to describe local characteristics, treatments, and outcomes of critically ill COVID-19 patients in Montreal.MethodsA single-centre retrospective cohort of consecutive adult patients admitted to the intensive care unit (ICU) of Hôpital du Sacré-Coeur de Montréal with confirmed COVID-19 were included.ResultsBetween 20 March and 13 May 2020, 75 patients were admitted, with a median [interquartile range (IQR)] age of 62 [53–72] yr and high rates of obesity (47%), hypertension (67%), and diabetes (37%). Healthcare-related infections were responsible for 35% of cases. The median [IQR] day 1 sequential organ failure assessment score was 6 [3–7]. Invasive mechanical ventilation (IMV) was used in 57% of patients for a median [IQR] of 11 [5–22] days. Patients receiving IMV were characterized by a moderately decreased median [IQR] partial pressure of oxygen:fraction of inspired oxygen (day 1 PaO2:FiO2 = 177 [138–276]; day 10 = 173 [147–227]) and compliance (day 1 = 48 [38–58] mL/cmH2O; day 10 = 34 [28–42] mL/cmH2O) and very elevated estimated dead space fraction (day 1 = 0.60 [0.53–0.67]; day 10 = 0.72 [0.69–0.79]). Overall hospital mortality was 25%, and 21% in the IMV patients. Mortality was 82% in patients ≥ 80 yr old.ConclusionsCharacteristics and outcomes of critically ill patients with COVID-19 in Montreal were similar to those reported in the existing literature. We found an increased physiologic dead space, supporting the hypothesis that pulmonary vascular injury may be central to COVID-19-induced lung damage.

Wellness Wheel Mobile Outreach Clinic: A Community-Led Care Model Improving Access to Care in Indigenous Communities.

Chronic diseases disproportionately affect indigenous people in Saskatchewan, with high rates of HIV, hepatitis C, and diabetes. Concentration of health care services in urban centers and minimal in-community health care service delays access to diagnostic testing and treatment for those residing in

Healthy Pacific Islands Grandparents: ‘Putting your best foot forward’

Abstract Background People of Pacific ethnicity are characterised as at 'high risk' of poor lower limb health by podiatric care professionals, likely due to a high rate of diabetes within the NZ Pacific community. Foot care maintenance is identified as an ongoing health challenge by Pacific elders with seemingly simple tasks, such as regular trimming of toenails, often found to be difficult due to reduced physical flexibility, and a lack of knowledge of appropriate foot health maintenance. A research collaboration between a cohort of older Pacific people and a research team was developed to design and implement a programme to address podiatric health for this vulnerable population group. Methods This research project was based in Auckland, NZ, where 70% of the total NZ Pacific population is resident. The team adopted a Participatory Action Research (PAR) process, placing participants in a leadership role where they are co-researchers involved in the research design and implementation of recommendations. Talanoa - a Pacific-designed qualitative interview method, was used to raise, discuss and identify strategies for healthy ageing among Pacific older people in NZ. Results A total of 78 Pacific Islands elders had their foot health assessed, and participated in footcare information sessions. Overall, lower limb health was good, 21 required follow-ups primarily for thickened toenails and minor issues such as dry skin. 2 participants were referred to their general practitioner for treatment of suspected melanoma underneath their nails. Conclusions The PAR process empowers older Pacific co-researchers to identify their own priority health issues, and determine how they could be more effectively addressed. In view of this, the provision of healthcare assessments in ethnic-specific community settings is a more effective approach for addressing podiatric health and preventing further serious complications. Key messages Utilising appropriate Indigenous research approaches is necessary to ensure more effective and sustainable outcomes for these minority communities. Participatory Action Research is an effective way for facilitating collaboration and innovative strategies to address the health needs of older minority groups.

The impact of chronic steroid use on early postoperative complications in shoulder surgery

ABSTRACT Objectives Chronic steroid use has been associated with poor healing and worse long-term outcomes in patients undergoing orthopedic surgery, but the specific risk profile and short-term complications related to chronic steroids in patients undergoing outpatient shoulder surgery are inadequately defined. The purpose of this study is to characterize the effects of chronic steroids on 30-day post-operative complications following arthroscopic and open shoulder surgery. Methods The American College of Surgeons National Surgical Quality Improvement Program was used to identify patients who underwent arthroscopic and open rotator cuff repair, shoulder stabilization, and associated procedures from 2011 to 2018. Patients on chronic steroids were compared with patients not on chronic steroids. Demographic data and 30-day postoperative complications were analyzed. Multivariable logistic regression was used to isolate the effects of chronic steroid use on postoperative complications. Results We identified 99,970 patients who underwent shoulder surgery during this period, of which 1.7% (1,662 patients) were on chronic steroids. Patients on chronic steroids were older (58.3 ± 0.30vs52.1 ± 0.05 years, p < 0.01), had higher average BMI (30.6 vs 30.1, p = 0.02), and were more likely to be female (54.9%vs38.0%, p < 0.01) and white (76.2%vs73.1%, p < 0.01). Patients on steroids had a higher American Society of Anesthesiologists class, and higher rates of diabetes, CHF, COPD, hypertension, bleeding disorders, and functionally dependency (all P < 0.01). Patients on chronic steroids were less likely to smoke (P < 0.01). Multivariable logistic regression revealed that chronic steroid use was an independent risk factor for major (OR 2.20[1.51–3.21], p < 0.001), minor (OR 2.32[1.13–3.2], p < 0.001), and infectious complications (OR 1.90[1.13–3.2], p = 0.01). Conclusions Preoperative chronic steroid use is independently associated with increased odds of major, minor, and infectious complications after open and arthroscopic rotator cuff repair, shoulder stabilization, and associated procedures. Patients on chronic steroids should be counseled about their increased risk for these complications, and both preoperative risk stratification and optimization should be employed to minimize perioperative risk.

Online Surveys of Stakeholders’ Willingness to Implement a Structured Daily Physical Activity Programme in Trinidad and Tobago’s Secondary Schools

Studies have shown that being overweight kills, primarily by promoting heart disease, diabetes, stroke, and many cancers. Physical inactivity and diet have long been recognized as the two principal causes of obesity in most people. The earlier the tendency to inactivity is reversed the better may be the sustainability of healthy lifestyle choices. Trinidad and Tobago has very high rates of both Cardiovascular Disease (CVD) and Diabetes and must try to minimize their prevalence. This article explores the feasibility of introducing into the secondary school curriculum a mandatory, no-credit programme of daily structured physical activity at all levels. Three proprietary structured surveys were administered online, one specific to each of Principals, Teachers, and Students in secondary schools throughout Trinidad and Tobago. These instruments probed the respondents’ awareness of and concern for the problem of overweight and related illnesses in young children and even in the adult population of Trinidad and Tobago; the perceived importance of physical activity; the willingness on the part of both the students and the teachers to participate in such a programme; and the optimum possible structure for the programme, in terms of its duration, its period placement on the timetable, and the frequency of its delivery. There was strong consensus among Teachers for the introduction of the programme into the curriculum and for the hiring of more P.E. teachers and the supply of more equipment to support it. Students showed an impressive awareness of the benefits from physical activity, scoring strongly the features of improved health and fitness, reduced obesity, better discipline, greater motivation, more self-confidence, and better socialization skills, among other positives.

Demographic, behavioral, and cardiovascular disease risk factors in the Saudi population: results from the Prospective Urban Rural Epidemiology study (PURE-Saudi)

BackgroundCardiovascular disease (CVD) is the major cause of death in Saudi Arabia. We aimed to assess associated demographic, behavioral, and CVD risk factors as part of the Prospective Urban Rural Epidemiology (PURE) study.MethodsPURE is a global cohort study of adults ages 35–70 years in 20 countries. PURE-Saudi study participants were recruited from 19 urban and 6 rural communities randomly selected from the Central province (Riyadh and Alkharj) between February 2012 and January 2015. Data were stratified by age, sex, and urban vs rural and summarized as means and standard deviations for continuous variables and as numbers and percentages for categorical variables. Proportions and means were compared between men and women, among age groups, and between urban and rural areas, using Chi-square test and t-tests, respectively.ResultsThe PURE-Saudi study enrolled 2047 participants (mean age, 46.5 ± 9.12 years; 43.1% women; 24.5% rural). Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% dyslipidemia, 30.3% hypertension, and 25.1% diabetes. In addition, 12.2% were current smokers, 15.4% self-reported feeling sad, 16.9% had a history of periods of stress, 6.8% had permanent stress, 1% had a history of stroke, 0.6% had heart failure, and 2.5% had coronary heart disease (CHD). Compared to women, men were more likely to be current smokers and have diabetes and a history of CHD. Women were more likely to be obese, have central obesity, self-report sadness, experience stress, feel permanent stress, and have low education. Compared to participants in urban areas, those in rural areas had higher rates of diabetes, obesity, and hypertension, and lower rates of unhealthy diet, self-reported sadness, stress (several periods), and permanent stress. Compared to middle-aged and older individuals, younger participants more commonly reported an unhealthy diet, permanent stress, and feeling sad.ConclusionThese results of the PURE-Saudi study revealed a high prevalence of unhealthy lifestyle and CVD risk factors in the adult Saudi population, with higher rates in rural vs urban areas. National public awareness programs and multi-faceted healthcare policy changes are urgently needed to reduce the future burden of CVD risk and mortality.

Low methyl-esterified pectin protects pancreatic β-cells against diabetes-induced oxidative and inflammatory stress via galectin-3

Insufficient intake of dietary fibers in Western societies is considered a major contributing factor in the high incidence rates of diabetes. The dietary fiber pectin has been suggested to be beneficial for management of both Diabetes Type 1 and Type 2, but mechanisms and effects of pectin on insulin producing pancreatic β-cells are unknown. Our study aimed to determine the effects of lemon pectins with different degree of methyl-esterification (DM) on β-cells under oxidative (streptozotocin) and inflammatory (cytokine) stress and to elucidate the underlying rescuing mechanisms, including effects on galectin-3. We found that specific pectins had rescuing effects on toxin and cytokine induced stress on β-cells but effects depended on the pectin concentration and DM-value. Protection was more pronounced with low DM5 pectin and was enhanced with higher pectin-concentrations. Our findings show that specific pectins might prevent diabetes by making insulin producing β-cells less susceptible for stress.

Clinical efficacy and safety of radiofrequency catheter ablation for atrial fibrillation in patients aged ≥80 years

To evaluate the clinical safety and efficacy of radiofrequency catheter ablation for atrial fibrillation (AF) in patients aged ≥80 years. A total of 333 AF patients aged ≥60 years were enrolled, who underwent contact force-guided radiofrequency catheter ablation with uninterrupted anticoagulation. All patients were followed-up for at least 12 months. Success was defined by the absence of episodes of AF/atrial tachycardia lasting more than 30 seconds after a 3-month blanking period, without antiarrhythmic drugs. Compared to patients aged 60-79 years (Group 2, n=244), patients aged ≥80 years (Group 1, n=89) were presented with higher rate of diabetes (36.0%vs 22.1%, P=.011), lower body mass index (23.4 ± 3.1vs 24.9 ± 3.4kg/m2 , P=.001), lower creatinine clearance (56.9 ± 16.5vs 83.3 ± 24.5mL/min, P<.001), higher CHA2 DS2 -VASc score (4.3 ± 1.3vs 3.3 ± 1.4, P<.001), and HAS-BLED score (2.2 ± 0.8vs 1.8 ± 0.8, P<.001). Wide antral pulmonary vein isolation was achieved in all patients, and there was no significant difference in procedure time, ablation time, fluoroscopy time, and complications rate between two age groups (P>.05). After a mean follow-up of 24.4 ± 9.6 months, the overall success rate was 78.2% in Group 1 and 78.9% in Group 2 (P=.622). Radiofrequency ablation with contact force sensing catheters for AF is safe and effective in selected patients aged ≥80 years.

Direct and indirect effects of COVID-19 on perinatal outcomes in low- and middle-income countries

Similar to previous outbreaks, the coronavirus disease 2019 (COVID-19) pandemic will have both direct and indirect effects on perinatal outcomes, especially in low- and middle-income countries. Limited data on the direct impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy shows women who are Black, obese and with co-morbidities are at higher risk of hospitalisation due to COVID-19. Younger age groups in Africa and South Asia have shown increased COVID-19 mortality. Indigenous pregnant women in Pacific Island countries are likely to be high risk for severe outcomes from COVID-19 due to high rates of diabetes and obesity. It is important to involve pregnant women in research, especially with regards to vaccine development and therapeutics.

Ventricular assist devices and middle age reduce heart transplantation rates for waitlist candidates.

Ventricular assist devices (VADs) are commonly employed as a bridge to transplantation for heart failure. The full effects of VADs on transplantation rates are not fully understood. We sought to compare transplantation rates stratified by age and VAD status. Using the Organ Procurement and Transplantation Network (OPTN) database, we investigated the impact of age and VAD status on heart allocation rates among all transplant-eligible patients from January 2005 to September 2018. Patients were grouped based on the presence (+) or absence (-) of a VAD as well as age (<45, 45-65, and >65 years). Demographics were compared with a multivariate competing risk analysis that yielded risk-adjusted subdistribution hazard ratios (SHR). Among the 50 602 total waitlist candidates, 18 271 patients with a VAD had higher rates of diabetes and cerebrovascular disease at waitlist entry. Multivariate analysis found statistically significant lower rates of transplantation for all (+)VAD groups compared with age-matched (-)VAD counterparts, with the 45- to 65-year-old (+)VAD group having the lowest transplantation rate (SHR = 0.62; P < .0005). Among (-)VAD patients, transplantation rates increased with increase in age. There is a statistically significant reduced rate of transplantation for patients with a VAD compared with those without a VAD, with the lowest rate among those of ages 45 to 65 years with a VAD. The increasing prevalence of this demographic and the deprioritization of VADs in the new heart allocation criteria have the potential to further exacerbate this difference.

Strong Men, Strong Communities: Design of a Randomized Controlled Trial of a Diabetes Prevention Intervention for American Indian and Alaska Native Men.

Type 2 diabetes is a serious global epidemic that disproportionately affects disadvantaged populations. American Indians and Alaska Natives (AIs/ANs) have the highest rates of diabetes in the nation with a prevalence of 14.7% in 2018, more than twice that of non-Hispanic Whites. AI/AN men have the highest prevalence of diagnosed type 2 diabetes (14.5%) compared to non-Hispanic Black (11.4%), non-Hispanic Asian (10.0%), and non-Hispanic White (8.6%) men. Several landmark clinical trials have shown that lifestyle interventions can effectively prevent or delay the onset of diabetes among those at risk, including in AIs/ANs. Despite positive outcomes for AIs/ANs in these studies, very few were men. To date, there have been no concerted efforts to recruit and retain AI/AN men in interventions that promote weight loss and healthy lifestyles to prevent diabetes, and they remain underrepresented in these types of studies. This article describes the design and methods of the first randomized controlled trial of a diabetes prevention program with a study sample comprised entirely of AI/AN men. Research to date has demonstrated suboptimal patterns of recruitment and retention of AI/AN men, resulting in their virtual absence in health and intervention research. Effective methods to recruit and retain AI/AN men, and potential benefit gained from participation in diabetes prevention research, are unknown for this population who experience a high prevalence of type 2 diabetes. The study design presented in this article offers promising insights to help remedy these important shortcomings in the science of recruitment and retention of AI/AN men in research.

P17 Health and Diabetes Perspectives of Mexican-Origin Males at Risk for Type 2 Diabetes (HD-MxOM): A Qualitative Study

<h3>Background</h3> The combination of rapid population growth and diabetes prevalence disparities convey an alarming health trajectory for the Hispanic population. Hispanics represent the largest minority group in the United States, with current trends expected to double the Hispanic population to 111 million by 2060. The prevalence of diabetes among Hispanics is 16.4%, second only to non-Hispanic blacks, and Hispanics hold the third highest prevalence of prediabetes at 31.7%. Furthermore, males of Mexican descent have the highest rates of diabetes (14.2%), overweight (80%) and obesity (43%) across all ethnic groups. <h3>Objective</h3> Explore the perspectives on diabetes, nutrition, and health among native Spanish-speaking, Mexican origin males at risk for type 2 diabetes (T2D). <h3>Study Design, Setting, Participants</h3> The present qualitative study utilized audio-recorded, semi-structured interviews of Spanish-speaking, Mexican-origin males, between the ages of 40 and 64 at risk for T2D. At risk for T2D was defined as >40 years of age, (BMI >27), and formal exercise less than 3 times per week. <h3>Measurable Outcome/Analysis</h3> Data collected included clinical (height, weight, waist circumference, blood pressure) and demographic (time living in the US, marital status, employment, income, educational attainment, and physical activity). The audio data from the 15 participants were transcribed and underwent 3 cycle coding for categorization and thematic analysis. <h3>Results</h3> Barriers to health behavior among Mexican-origin males include: poor understanding of diabetes and nutrition knowledge, unreliable sources of health information, medical machismo, and socioeconomic status. Novel findings include perspectives of intense diabetes severity, personal responsibility for health, and sociocultural barriers such as pediatric health formation. <h3>Conclusions</h3> HD-MxOM represents the first, theory-based study for the exploration of diabetes perspectives among Mexican-origin males. The emergent themes include a poor understanding of diabetes and nutrition, inhibitory sociocultural forces such as medical machismo and valemadrismo, and low health prioritization. These findings provide educators and clinicians essential information for optimization of program development and clinical interaction with Hispanic men.

Utilizing Webs to Share Ancestral and Intergenerational Teachings: The Process of Co-Building an Online Digital Repository in Partnership with Indigenous Communities

Indigenous knowledge and wisdom continue to guide food and land practices, which may be key to lowering high rates of diabetes and obesity among Indigenous communities. The purpose of this paper is to describe how Indigenous, ancestral, and wise practices around food and land can best be reclaimed, revitalized, and reinvented through the use of an online digital platform. Key informant interviews and focus groups were conducted in order to identify digital data needs for food and land practices. Participants included Indigenous key informants, ranging from elders to farmers. Key questions included: (1) How could an online platform be deemed suitable for Indigenous communities to catalogue food wisdom? (2) What types of information would be useful to classify? (3) What other related needs exist? Researchers analyzed field notes, identified themes, and used a consensual qualitative research approach. Three themes were found, including a need for the appropriate use of Indigenous knowledges and sharing such online, a need for community control of Indigenous knowledges, and a need and desire to share wise practices with others online. An online Food Wisdom Repository that contributes to the health and wellbeing of Indigenous peoples through cultural continuity appears appropriate if it follows the outlined needs.

Outcomes of kidney transplantation from elderly deceased donors of a Korean registry

To overcome organ shortage, expanded criteria donors, including elderly deceased donors (DDs), should be considered. We analyzed outcomes of kidney transplantation (KT) from elderly DDs in a nationwide study. In total, data of 1049 KTs from DDs using the database of Korean Organ Transplantation Registry (KOTRY) were retrospectively analyzed based on the age of DDs: age ≥60 years vs. <60 years. Clinical information, graft status, and adverse events were reviewed in DDs and recipients. The mean age of the 1006 DDs was 51.04±10.54 years, and 21.5% of donors were aged ≥60 years. Elderly DDs had a significantly higher prevalence of diabetes and hypertension and higher Kidney Donor Risk Index (KDRI) and Kidney Donor Profile Index (KDPI). The mean age of the recipients was 47.45±14.87 years. Patients who received KT from elderly DDs were significantly older (53.12±15.14 vs. 45.88±14.41, P<0.001) and had a higher rate of diabetes (41.9 vs. 24.4%, P<0.001). Graft outcomes were not significantly different. Renal function was similar between the groups at the time of discharge and at 6 months, 1 year, and 2 years after KT. The rate of delayed graft function (DGF) was not significantly different. Risk factors of DGF were significantly different in DDs aged ≥60 years and <60 years. In the multivariable model, male sex (odds ratio: 3.99, 95% confidence interval: 1.42–11.22; P = 0.009) and KDRI (12.17, 2.23–66.34; P = 0.004) were significant risk factors for DGF in DDs aged ≥60 years. In DDs aged <60 years, thymoglobulin induction (2.62, 1.53–4.48; P<0.001) and continuous renal replacement therapy (3.47, 1.52–7.96; P = 0.003) were significant factors. Our data indicated that graft outcomes, including renal function and DGF, were similar for elderly DDs and DDs aged <60 years. Elderly DDs might be considered tolerable donors for KT, with active preoperative surveillance.

2141-PUB: Advanced Age, Higher FPG, and Conservative Treatment Increases in Hospital Mortality Risk in Female Patients with Acute Myocardial Infarction: A Retrospective Study

Background: previous researches demonstrated that gender affected the in-hospital prognosis of acute myocardial infarction (AMI). Recent studies showed conflicting results. This study aimed to investigate the influence of gender, age, glycemia, treatment, and some risk factors on the in-hospital mortality after a first AMI. Method: Consecutive patients admitted with AMI from 2002 to 2018 were included in this study. Analysis were conducted with the SPSS 25.0 software. Results:1607 cases were enrolled in this study. Female patients had worse outcome, higher rate of cardiac shock, heart failure, Unadjusted in-hospital mortality was higher in women. Beides, female was older than male , had higher rate of diabetes, and preferred to take conservative treatment. Even though different gender had significant different outcome after AMI attack, logistic analysis revealed that gender itself was not the risk factor of AMI mortality. It showed that FPG≥7.0mmol/l,conservative treatment and age≥75 years-old were the risk factor of AMI mortality. Previous studies considered that gender is the important factor that affects the mortality rate of AMI, our study found it was not gender itself made that difference, it related to age, treatment and glycemia. Disclosure S. Luo: None. G. Luo: None. L. Wang: None. Y. Zhan: None. T. Li: None. L. Pang: None. H. Lu: None. Funding Five &amp; Five Youth Talent Scientist Programme

4517 Gender Disparities: Heart Failure in Puerto Rican Women

OBJECTIVES/GOALS: Women within the ages of 65-75 have a lower incidence of heart failure than men.However,after the age of 75, the incidence of HF in womentriples,matchingthat of men.(Lloyd-Jones etal., 2002)Overall, women with heart failure live longer at the expense of presenting moresevere symptoms and poorer perceived quality of life.Generally, women with heart failurereceive suboptimal treatment throughout their lifetime. In fact, women are more likely todevelop heart failure after myocardial infarction. This trend is, in part, because physicians areless strict when treating them.(Chou et al., 2007)Studies in heart failure by ethnicity have shown that, despite equal access to healthcare, Hispanic women have higher rates of readmission than Non-Hispanic-white (NHW) women. (Durstenfeld, Ogedegbe, Katz, Park, &amp;Blecker, 2016)One study in Boston demonstrated that Puerto Rican Women have higher rates of diabetes, obesity, and chronic kidney disease compared to blacks and NHW women.(Todorova, Tejada, &amp; Castaneda-Sceppa, 2014)These are cardiovascular risk factors that warrant further study in Puerto Rican women living on the island, but data are lacking. Objective: The purpose of this study is to evaluate the gender disparities in presentation, management, and outcomes in Puerto Rican Hispanic hospitalized for heart failure METHODS/STUDY POPULATION: To this end, we will perform a secondary analysis of data from the PR CardiovascularSurveillance Study (PRCSS). We will extract personal data from 4,461 medical records of patients admitted with heart failure (ICD-9 Codes 428) at 21 hospitals in Puerto Rico, during theyears2007, 2009 and 2011. For statistical methods, we will implement chi-square and t-tests at a significance level of 0.05. RESULTS/ANTICIPATED RESULTS: We expect to find that women will have: fewer interventions, less optimized heart failure medication, higher BNP, older age of diagnosis, but paradoxically better outcome than male counterparts of the same age. DISCUSSION/SIGNIFICANCE OF IMPACT: With this study, we would like to raise awareness about gender-specific health disparities Puerto Rican Hispanic women with heart failure experience while hospitalized.

1365-P: Type 2 Diabetes after Gestational Diabetes, a High-Risk Population

Aboriginal and Torres Strait Islander women have high rates of gestational diabetes (GDM). The Pregnancy And Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study is a prospective longitudinal cohort of women with type 2 diabetes (T2D), GDM or normoglycemia in pregnancy in the Northern Territory, Australia. In this analysis we report progression to prediabetes and T2D at 2.5 years [range 2.1, 3] postpartum in a subgroup of Aboriginal and Europid women with GDM and normoglycemia in pregnancy (n=337). Women with pre-existing T2D were excluded. Data were analysed using Fisher’s exact tests. Among Aboriginal women with GDM we assessed predictions for progression using multivariate logistic regression. Aboriginal women with GDM (n=111) were younger than Europid women with GDM (n=104) (29 years (SD 5.9) vs. 32 (5.6) p&amp;lt;0.01), with similar first trimester BMI (28.9 kg/m2 (SD 7.2) vs. 28.5 (6.7) p=0.64). Of Aboriginal women with GDM, 24 (22%) progressed to T2D and 12 (11%) to prediabetes. Of Aboriginal women with normoglycemia (n=60), 1 (2%) progressed to T2D and 1 (2%) to prediabetes (p&amp;lt;0.01 for combined outcome vs. GDM women). Of Europid women with GDM, none progressed to T2D and 4 (4%) to prediabetes and of those with normoglycemia (n=62) none progressed to diabetes or prediabetes (p=0.09 vs. GDM women). Among Aboriginal women with GDM, factors associated with postpartum diabetes or prediabetes were age (OR 1.11, 1.03-1.2) and, after adjusting for age: severity of GDM (higher fasting plasma glucose (per 1 mmol/L OR 2.11, 1.23-3.62), use of insulin (OR 3.20, 1.35-7.6)) and higher first trimester BMI (per 3 kg/m2 OR 1.22, 1.01-1.47). Not smoking was protective (OR 0.35, 0.14-0.90), although any breastfeeding at 6-months postpartum was not (OR 0.95, 0.36-2.47). To our knowledge this is the only prospective study of Aboriginal and Torres Strait Islander women with GDM. We report the highest rates in the world of T2D after GDM at 2.5 years postpartum, highlighting a need for targeted interventions in this high-risk population. Disclosure A. Wood: None. J. Boyle: None. F. Barzi: None. E.L. Barr: None. M.J.I. Hare: None. A. Titmuss: None. E. Death: None. M. Kirkwood: None. A. Simmonds: None. E.M. Moore: None. J. Oats: None. D. McIntyre: Other Relationship; Self; Novo Nordisk A/S. P.Z. Zimmet: None. A.D. Brown: None. J.E. Shaw: Advisory Panel; Self; AstraZeneca, Merck Sharp &amp; Dohme Corp., Mylan, Sanofi. Research Support; Self; AstraZeneca. Speaker’s Bureau; Self; Eli Lilly and Company, Mylan. L.J. Maple-Brown: None.

Abstract A026: Effects of values-based messaging and an ecological approach to communicate about sugar as a strategy to prevent cancer among Latinas

Abstract Introduction: An important aspect of Latino cancer prevention is reducing consumption of the sugar sweetened beverages (SSB) that account for many of the excess calories consumed and contribute to high rates of diabetes, obesity and other cancer risks. SSB consumption is powerfully influenced by social context, including targeted advertising and marketing, yet health promotion approaches focus on individual behavior, ignoring the social determinants of health (SDOH). Social justice based empowerment approaches suggest that literacy empowers people both to make better individual behavioral choices and to engage in activities that result in improved health for the overall community. Such approaches lend themselves to messaging about SDOH consistent with an ecological approach to health. Moreover, recent research in cancer communication has suggested that values-based appeals may increase receptivity to and engagement with messages, which then improve literacy and empowerment. This approach may be particularly useful for addressing disparities populations like Latinos. Aim: We tested the efficacy of messages about SDOH that invoke the values of social justice, standing up to exploitative authority, and familism, three values held strongly by young adult Latinos. We hypothesized that values-based SDOH messages would be more effective than traditional fear-based individual messaging. Methods: An unbalanced experimental design with Mexican-American women aged 18-29 (N=434). Control condition (N=73): A typical fear-based appeal on the individual harms of obesity. Experimental condition (N=361): 5 distinct values-based messages on the social determinants of obesity and diabetes. Main Outcomes: Receptivity to and acceptance of the messages. Secondary Outcomes: Public health literacy, SSB media literacy, empowerment. Analyses: Simple and multiple linear regression models accounting for the unbalanced design. Results: Consistent with hypotheses, the values-based messages communicating an ecological model of public health were more effective than the traditional fear appeal individual behavior message: Participants were more receptive to (p&amp;lt;.001) and accepting of (p&amp;lt;.01) values-based messages relative to control. Values-based messages increased SSB media literacy (p&amp;lt;.05) and the perceived efficacy of civic actions such as boycotting SSB (p&amp;lt;.05) and using social media to advocate about SDOH and sugar (p&amp;lt;.001). Values-based messages appear to work by engendering identification (p&amp;lt;.001) and activating social justice values (p&amp;lt;.05). Conclusion: Values-based messages about the individual harms and social causes of SSB overconsumption resonate more than the traditional health communication approach among young adult Latinas who are at increased risk of diet-related cancer. An ecological approach to cancer communication incorporating SDOH and individual behavior holds considerable promise for addressing cancer disparities among Latinos. Citation Format: Deepti Chittamuru, Susana Ramirez. Effects of values-based messaging and an ecological approach to communicate about sugar as a strategy to prevent cancer among Latinas [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A026.

Treatment of In-Stent Restenosis Using Excimer Laser Coronary Atherectomy and Bioresorbable Vascular Scaffold Guided by Optical Coherence Tomography

The rate of in-stent restenosis (ISR) has become increasingly prevalent with the exponential growth in stent implantation due to an aging population and a higher life expectancy, in addition to the high rates of obesity and diabetes. In this prospective, single operator, all-comer study, we sought to analyze the performance of ELCA followed by bioresorbable vascular scaffold (BVS) placement in patients undergoing percutaneous coronary intervention (PCI) for ISR. A total of 13 patients had ISR treated with a combination of ELCA and BVS, with 9 patients having matched OCT pre, post ELCA and post BVS. Mean age was 65 ± 11.22 and 83% of the patients were male. Hypertension and dyslipidemia were present in 100% of the patients and smoking and diabetes in 50%. After the procedure, we did not detect residual stenosis over 10% in any patient, resulting in a technical success of 100%. No patients had MACE during their hospital stay or within the next six months, resulting in a procedure success of 100%. The mean lumen area increased 0.35 mm2 from pre procedure to post ELCA and 3.58 mm2 from post ELCA to post BVS. The final difference, from pre procedure to post BVS, was a 3.93 mm2 lumen area gain. The mean lumen diameter increased 0.11 mm from baseline to ELCA, 0.95 mm from post laser to BVS implantation and 1.06 mm from pre procedure to post BVS. The NIH area reduced 0.48 mm2 from pre to post ELCA, 1.13mm2 from post ELCA to BVS implantation and 1.61 mm2 from baseline to post BVS implantation. We conclude that ELCA is a safe and feasible debulking method to approach ISR, with high rates of post-procedural BVS success, within six months follow-up.

Placental-related disorders of pregnancy and IVF: does placental histological examination explain the excess risk?

What are the clinical characteristics of pregnancies complicated by fetal growth restriction (FGR) and preeclampsia in patients who have undergone IVF, and what is the correlation between these complications and histopathological placental findings in such pregnancies. A retrospective cohort of patients who had delivered their babies at our institution who had been diagnosed with preeclampsia, whose babies had been diagnosed with FGR, or both. Deliveries in which the placenta was sent for histopathological examination were included. Computerized files and pathological reports were reviewed, and maternal, obstetric, neonatal outcomes and placental histopathological reports were compared between pregnancies conceived by IVF and controls. Placental lesions were classified according to the Amsterdam criteria. Between December 2008 and December 2018, the placentas of 1114 singleton babies who had received a diagnosis of FGR, whose mothers had received a diagnosis of preeclampisa, or both, were examined. A total of 105 patients conceived with IVF and 1009 were conceived spontaneously. The IVF group was older, of lower parity and had a higher rate of diabetes and chronic hypertension. Deliveries occurred at an earlier gestational age, although birth weight was not significantly different between the groups. The rate of neonatal adverse composite outcome among IVF deliveries was significantly lower (59.0% versus 76.7%; P < 0.001). On placental examination, placental weight, maternal and fetal vascular malperfusion lesions were similar between the groups, whereas villitis of unknown etiology was significantly more common among the IVF group (16.2% versus 8.3%; P = 0.007). Neonatal outcome is relatively favourable in IVF patients with placental-related diseases. Placental chronic villitis is more common in IVF patients, pointing to an additive immunological cause.