Background/Objectives: The global increase in metabolic dysfunction-associated steatotic liver disease underscores the need for accessible and reliable markers to assess hepatic steatosis. The triglyceride-glucose (TyG) index, derived from fasting plasma glucose and triglyceride levels, has emerged as a practical surrogate marker of insulin resistance and has been increasingly associated with metabolic liver involvement. This study aimed to evaluate the relationship between the TyG index and the severity of hepatic steatosis assessed by ultrasonography. Methods: This retrospective cross-sectional study included 480 adult patients without a prior diagnosis of diabetes mellitus or hypertension who underwent fasting laboratory testing and abdominal ultrasonography between January 2024 and May 2025. Fasting plasma glucose and triglyceride levels were obtained on the same day as ultrasonographic evaluation. Hepatic steatosis was assessed by a single experienced radiologist using standardized ultrasonographic criteria, and patients were categorized into three groups according to steatosis grade (grade 0, grade 1, and grade 2-3; n = 160 for each group). Demographic data and laboratory parameters, including glucose, triglycerides, HbA1c, platelet count, neutrophils, lymphocytes, monocytes, ALT, AST, and total cholesterol levels, were recorded. The TyG index was calculated using the formula: TyG = ln[(fasting triglycerides × fasting glucose)/2]. Results: A total of 480 patients (30.6% male) were included in the analysis. Mean fasting glucose, triglyceride, and TyG index values were 94.20 ± 11.15 mg/dL, 146.91 ± 83.94 mg/dL, and 8.70 ± 0.55, respectively. Metabolic and inflammatory parameters increased significantly with advancing steatosis grades (all p < 0.05). The TyG index demonstrated a clear stepwise increase from grade 0 (8.29 ± 0.42) to grade 1 (8.74 ± 0.42) and grade 2-3 steatosis (9.07 ± 0.49) (p < 0.001), with all pairwise comparisons remaining statistically significant. Receiver operating characteristic (ROC) analysis showed good discriminative performance of the TyG index for hepatic steatosis (AUC = 0.829), and an optimal cutoff value of 7.90 was identified using the Youden index, yielding high sensitivity for detection. In multivariable logistic regression analysis, the TyG index remained the strongest independent predictor of hepatic steatosis (adjusted OR 11.41, 95% CI 6.10-21.34; p < 0.001). Conclusions: The TyG index increased progressively with the severity of hepatic steatosis and showed strong associations with metabolic and inflammatory parameters. These findings support the TyG index as a simple and accessible marker reflecting metabolic dysfunction and hepatic steatosis, with potential value for early risk stratification in clinical practice.

Abstract A 9‐year‐old, spayed, female, domestic shorthair cat was presented with an acute onset of lethargy, vomiting and anorexia. The cat had a prior diagnosis of diabetes mellitus and was being managed with bexagliflozin, a sodium‐glucose cotransporter‐2 inhibitor. On presentation, the cat was diagnosed with euglycaemic diabetic ketoacidosis. Treatment included intravenous dextrose supplementation and a constant rate infusion of regular insulin. The cat responded well to therapy and was discharged 9 days after admission on subcutaneous glargine insulin.

Diabetic ketoacidosis (DKA) is the presence of metabolic acidosis with an elevated anion gap, ketonemia or ketonuria, with or without hyperglycemia, in the context of a prior diagnosis of diabetes mellitus (DM) or a new diagnosis of DM. In this case, it is caused by a relative or absolute insulin deficiency, leading to ketogenesis, lipolysis, lipotoxicity, and metabolic acidosis. There is a vast amount of literature—articles, reports, books, journals, and many other sources—focused on advances in the treatment and pathophysiology of DM and its decompensated states, primarily diabetic ketoacidosis. However, no ideal study has yet been established to fully explain the pathophysiology, triggers, and, of course, optimal treatment without generating controversy. Therefore, the objective of this review is to analyze, describe, and discuss updates on the pathophysiology and treatment of DKA in a precise and concise manner, in order to support healthcare personnel in managing patients with this complication. Decompensated DM can have a broad pathophysiology, so ideal treatments must be considered to avoid short- and long-term complications, including ketoacidosis, as well as certain variations in clinical presentation, such as in the case of euglycemic ketoacidosis

To determine the prevalence of nonadherence to breast cancer and colorectal cancer screening, associated risk factors, and screening preference among hospitalized women with and without diabetes aged 50-75 years who were cancer-free at baseline. A prospective study compared women with and without diabetes who were cancer-free (except for skin cancer) at baseline and between 50 and 75 years of age, admitted to the general medical service at an academic center were approached for study participation from December 1, 2014, to May 31, 2017. The study evaluated breast and colorectal cancer screening nonadherence prevalence, preference for screening locale, sociodemographic and clinical variables associated with nonadherence using multivariable logistic regression model. Of 510 women, 39% had a prior diagnosis of diabetes mellitus, and 36% were African American. Women with diabetes were more likely to have obesity, reliance on assistive devices for ambulation, inability to work (have a disability), and a greater average number of comorbidities compared to women without diabetes. Women with or without diabetes were equally nonadherent with BRC (28% vs 36%, p = 0.6) and CRC (25% vs 28%, p = 0.51) screening guidelines. After adjustment for sociodemographic and clinical risk factors, only high risk for CRC (OR = 3.20, 95%CI; 1.03-9.91) was an independent risk factor associated with nonadherence to BRC among hospitalized women with diabetes. Whereas after similar adjustment, age younger than 60 years (OR = 2.91, 95%CI; 1.15-7.35) and current or prior smoking (OR = 2.80, 95%CI; 1.14-6.86) were associated with nonadherence to CRC among women with diabetes. 46% of women with diabetes expressed a preference for in-hospital screening for BRC, while 45% expressed a similar preference for CRC. Hospitalizations may offer additional screening opportunities as almost half of the women with diabetes preferred undergoing breast and colorectal cancer screening during a hospital stay.

Background and Objectives: We conducted a retrospective observational study to evaluate the impact of elevated blood glucose levels in patients with SARS-CoV-2 infection and a prior diagnosis of diabetes mellitus (DM) or newly diagnosed hyperglycemia. Materials and Methods: This study analyzed 6065 patients admitted to the COVID-19 departments of the "Marius Nasta" National Institute of Pulmonology in Bucharest, Romania, between 26 October 2020 and 5 January 2023. Of these, 813 patients (13.40%) were selected for analysis due to either a pre-existing diagnosis of DM or hyperglycemia at the time of hospital admission. Results: The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were elevated in patients with blood glucose levels exceeding 300 mg/dL. These elevations correlated with the presence of respiratory failure and increased mortality rates. Additionally, oxygen requirements were significantly higher at elevated blood glucose levels (p < 0.001), with a direct relationship between glycemia and oxygen demand. This was accompanied by lower oxygen saturation levels (p < 0.001). Maximum blood glucose levels were associated with the severity of respiratory failure (AUC 0.6, 95% CI: 0.56-0.63, p < 0.001). We identified cut-off values for blood glucose at admission (217.5 mg/dL) and maximum blood glucose during hospitalization (257.5 mg/dL), both of which were associated with disease severity and identified as risk factors for increased mortality. Conclusions: High blood glucose levels, both at admission and during hospitalization, were identified as risk factors for poor prognosis and increased mortality in patients with SARS-CoV-2 infection, regardless of whether the hyperglycemia was due to a prior diagnosis of DM or was newly developed during the hospital stay. These findings underscore the importance of glycemic control in the management of hospitalized COVID-19 patients.

Although immune checkpoint inhibitor-related type 1 diabetes mellitus (ICI-T1DM) is a rare condition, it is of significant concern globally. We aimed to elucidate the precise incidence, risk factors, and impact of ICI-T1DM on survival outcomes. The study is a large retrospective cohort study, performed using the DeSC Japanese administrative claims database comprising 11 million patients. The database population is reportedly similar to the entire population of Japan. Patients administered ICI between 2014 and 2022 were enrolled in the study, including 21,121 patients. The risk factors for ICI-T1DM development and their characteristics were evaluated by logistic regression analysis. Development of a new irAE after the day following the first administration of ICI was set as the study outcome. ICI-T1DM was observed in 102 (0.48%) of the 21,121 patients after ICI initiation. PD-(L)1 and CTLA-4 combination therapy was associated with an increased risk of ICI-T1DM compared with PD-1 monotherapy (odds ratio [OR], 2.36; 95% confidence interval [CI], 1.21-4.58; P = 0.01). Patients with a prior diagnosis of diabetes mellitus (OR, 1.59; 95% CI, 1.03-2.46; P = 0.04) or hypothyroidism (OR, 2.48; 95% CI, 1.39-4.43; P < 0.01) also exhibited an increased risk of ICI-T1DM. The Kaplan-Meier analysis revealed that patients with ICI-T1DM showed higher survival rates than those without (log-lank test, P < 0.01). Multivariable Cox regression analysis demonstrated that ICI-T1DM development was associated with lower mortality (hazard ratio, 0.60; 95% CI, 0.37-0.99; P = 0.04). Collectively, the results of this study demonstrate the precise incidence and risk factors of ICI-T1DM. The development of ICI-T1DM, like other irAEs, is associated with higher survival rates.

To evaluate glycated hemoglobin (HbA1c) levels in patients who have not been diagnosed with diabetes mellitus (DM) but exhibit oral DM symptoms prior to dental implant surgery. This study was designed as a retrospective cohort. It was conducted on patients who previously presented to the Department of Oral and Maxillofacial Surgery for dental implant surgery and had not been diagnosed with DM. The inclusion criteria were as follows: patients with the need for dental implants and augmentation, presence of oral DM symptoms, and access to blood test results that included HbA1c. Patients with a prior diagnosis of DM were excluded from the study. A retrospective analysis was conducted on data from 253 patients who applied for dental implant surgery. Among them, 72 patients underwent HbA1c level assessments via blood tests. Patients with previously uncontrolled DM (n = 21) and those whose blood tests were performed at different institutions (n = 8) were excluded from the study. Consequently, the study encompassed a cohort of 43 patients. Among the participants, 55% of them were female and 45% of them were male. The HbA1c values of the patients ranged from 5.1 to 10.9, with an average value of 6.57 ± 1.44. Of the patients, 41.8% were diagnosed with DM, 30.2% were prediabetic (preDM), and 27.9% did not receive any diagnosis. There was no statistically significant relationship between the combinations of xerostomia, delayed wound healing, oral infection, burning sensation in the mouth, periodontitis, and dental caries with HbA1c levels (P > .05). In this study, patients presenting to the clinic for dental implant surgery were directed based on oral symptom findings, and the rates of diagnosed DM and preDM were determined to be 7.11% and 5.14%, respectively. Considering the negative effects and prevalence of uncontrolled DM, it may be recommended to assess the HbA1c levels in patients with oral symptoms before dental implant surgery.

Abstract Introduction Male Fertility is a marker of overall health. The relationship between cardiovascular risk factors (CVR) and male infertility is an emerging area of interest with prior data showing the incidence of developing cardiac disease over time being greater in men with male factor infertility versus the general population. Objective Our study sought to determine the prevalence of CVR factors among young men presenting for infertility evaluation at an Andrology Clinic. Methods A retrospective review was conducted on all patients (pts) under the age of 45 years who presented to an infertility clinic between March 2023 and May 2024. Patient demographics, smoking status, comorbidities, Lipid panel ([triglycerides (TG), cholesterol (Chol), low-density lipoproteins (LDL), high-density lipoproteins (HDL)]), Body Mass Index (BMI), blood pressure (BP), and a complete hormone panel were collected. The hormone panel included free testosterone (fT), total testosterone (TT), estradiol (E2), sex hormone binding globulin (SHBG), prolactin (P), follicle-stimulating hormone (FSH), luteinizing hormone (LH), Hemoglobin A1c (HgA1c), and hematocrit (Hct). The hormonal panel was collected before 11 AM using LCMS. Individuals with any missing values were not included in the analyses. Results 442 men with a mean age of 28.03 years [sd 7.02] were included. The mean BMI was 28.04 kg/m2 [sd 7.02]. In this cohort, only 4.4% of patients had a prior diagnosis of Diabetes Mellitus (DM), 9.4% with Hypertension (HTN), and 5.5% with dyslipidemia (DLP). However, among new pts presenting for infertility evaluation without any known comorbidities 22.0% of pts had elevated HbA1c ≥5.7%, 61.78% had HTN (&amp;gt;120/80 mmHg) on two consecutive reads, 31.5% had elevated TG levels (≥150 mg/dL), 35.0% had low HDL levels (&amp;lt;40 mg/dL), and 38.23% of pts had two or more of these risk factors. 36.6% percent of pts were overweight (BMI ≥25 and &amp;lt; 30 kg/m2), 17.6% were obese (BMI ≥30 and &amp;lt; 35 kg/m2), and 11.2% were morbidly obese (BMI ≥35 kg/m2). 26.0% of pts were smokers, and 21.9% had hypogonadism (TT &amp;lt;300 ng/dL). There was no statistically significant difference in the prevalence of these risk factors among different ethnic groups or ages. Conclusions Our study revealed a high prevalence of undiagnosed CVR factors in young men presenting for primary infertility evaluation. Our study underscores urologists' pivotal role in evaluating overall men’s health. Assessing BMI, BP measurements, HgA1c, lipid, and hormone panels in this patient population may be useful parameters to identify young infertile men at risk for cardiac disease and lead to earlier detection of undiagnosed CVR factors and early preventative interventions. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific; Coloplast; BK Ultrasound.

The consequences of discontinuing metformin in patients with heart failure have not been determined. Knowing that acute exacerbation of chronic heart failure contributes to substantial increases in major adverse cardiovascular events (MACE), we proposed a retrospective study to examine whether discontinuing metformin in patients hospitalized with heart failure impacts mortality and readmission rates. We conducted a retrospective analysis of patients admitted with a diagnosis of acute heart failure to hospitals in the HCA Healthcare System from 2020 to 2022. Included patients had a prior diagnosis of diabetes mellitus, acute heart failure, and were taking metformin prior to admission. After applying our exclusion criteria, a total of 7740 patients remained. The primary outcomes were 30-, 60-, and 90-day readmission rates and secondary outcomes were mortality and length of stay. Patients who were discharged without a prescription for metformin (NONDIS-MET) were 4.489 (95% CI 3.673-5.488, p < 0.0001) times more likely to have a MACE outcome in 30 days compared to patients who received a discharge order for metformin (DIS-MET). The findings were similar for 60-day and 90-day readmission rates, with NONDIS-MET patients 3.457 (95% CI 2.893-4.131, p < 0.0001) and 2.992 (95% CI 2.534-3.533 p < 0.0001) times more likely to have a MACE outcome than MET patients, respectively. However, when metformin was continued during the patients' hospital stay (CONT-MET) there was no significant association with MACE outcomes, readmission, or mortality rates. We found that diabetic patients admitted with acute heart failure exacerbations had a higher incidence of major adverse cardiac events and were more likely to be readmitted when they were not prescribed metformin after discharge. Our findings agree with prior work showing the cardioprotective effects of metformin; however, continuing metformin during hospital admission did not affect our patients adverse outcomes.

Abstract Background and introduction Diabetes mellitus (DM) represents a global public health issue and is increasing worldwide. DM is associated with a significant loss of quality of life, a pronounced increase in the risk for cardiovascular diseases (CVD) and involves a high financial burden for society. Importantly, CVD and DM share many common risk factors. In Germany, all patients discharged after an acute coronary syndrome (ACS) or coronary bypass surgery are offered a comprehensive inpatient rehabilitation. Risk stratification of this patient population might therefore inform selection and targeting of preventive means to prevent the risk for subsequent DM. Purpose To estimate the incidence of DM and the prognostic value of various established and new cardiovascular risk factors in two cohorts of patients with chronic coronary syndrome (CCS) undergoing rehabilitation. Methods The two prospective cohorts included patients with CCS participating in an inpatient cardiac rehabilitation programme in Germany (KAROLA-I: years 1999/2000, KAROLA-II: 2009-2011) (details in ref. 1). Participation rate was 58% in both cohorts. Blood samples and information on sociodemographic factors, lifestyle, and medical treatment were collected at baseline. During follow-up (KAROLA-I median 12.1 years, KAROLA-II median 9.9 years), each patient and their primary care physicians were contacted regularly by post to complete a standardized questionnaire. Development of incident DM was based on information from primary care physicians. Vital status was assessed via the residents’ registration office. Incident rates for DM were calculated. Cox regression analysis was used to estimate the risk for DM for potential risk factors during follow- after adjustment for covariates (including cohort). Results We included 1601 patients with no prior diagnosis of DM (n=835 from KAROLA-I and n=766 from KAROLA-II) in this study (mean age 60.9 years, 85.0% men). 15.4% of patients were obese at baseline and 60.5% were former and 5.4% were current smokers, respectively. At baseline, mean LDL-cholesterol and HDL-cholesterol levels were 161.3 mg/dl and 41.9 mg/dL, respectively. Mean hs-CRP was 7.3 mg/L, hs-cTnT was 17.6 ng/L, hs-cTnI 22.4 ng/L, and NT-proBNP 894.9 ng/L. During a median follow-up of 9.9 years, n=277 incident DM cases were diagnosed (rate per 1000 person-years 19.1 (95% CI 17.0-21.5)). After adjustment for sex, age, and school education the following mutually adjusted risk factors were associated with the risk of DM: obesity HR 2.18 (95% CI 1.63-2.92); smoking (former HR 1.58 (95% CI 1.19-2.09), current HR 1.77 (95% CI 1.01-3.08)), hs-CRP &amp;gt; 2 mg/L HR 1.32 (95% CI 1.03-1.71), hs-TnI ≥ 6 ng/L HR 1.88 (95% CI 1.13-3.12) when compared to respective reference categories. Conclusions Several modifiable risk factors were associated with the increased risk of DM in patients with CCS who participated in an inpatient rehabilitation program and offer targets for prevention.

Multiple sclerosis (MS) is an inflammatory disease characterized by the demyelination of primarily the central nervous system. Diffuse esophageal spasm (DES) and achalasia are both disorders of esophageal peristalsis which cause clinical symptoms of dysphagia. Mechanisms involving dysfunction of the pre- and post-ganglionic nerve fibers of the myenteric plexus have been proposed. We sought to determine whether MS confers an increased risk of developing achalasia or DES. Cohort analysis was done using the Explorys database. Univariate logistic regression was performed to determine the odds MS confers to each motility disorder studied. Comparison of proportions of dysautonomia comorbidities was performed among the cohorts. Patients with a prior diagnosis of diabetes mellitus, chronic Chagas' disease, opioid use, or CREST syndrome were excluded from the study. Odds of MS patients developing achalasia or DES were (OR, 2.09; 95% CI, 1.73-2.52; P < 0.001) and (OR, 3.15; 95% CI, 2.89-3.42; P < 0.001), respectively. In the MS/achalasia cohort, 27.27%, 18.18%, 9.09%, and 45.45% patients had urinary incontinence, gastroparesis, impotence, and insomnia, respectively. In the MS/DES cohort, 35.19%, 11.11%, 3.70%, and 55.56% had these symptoms. In MS patients without motility disorders, 12.64%, 0.79%, 2.21%, and 21.85% had these symptoms. Patients with MS have higher odds of developing achalasia or DES compared to patients without MS. MS patients with achalasia or DES have higher rates of dysautonomia comorbidities. This suggests that these patients have a more severe disease phenotype in regards to the extent of neuronal degradation and demyelination causing the autonomic dysfunction.

A-8 | Modes of Failure of Guide Catheters Extensions: Insights from the Manufacturer and User Facility Device Experience (MAUDE) database

Objective: To determine the relationship between pre-existent hyperglycemia among patients with COVID-19 pneumonia requiring oxygen supplementation.&#x0D; Study Design: Cross-sectional study&#x0D; Place and Duration of Study: COVID-19 isolation wards, High Dependency Units, and Intensive Care Units of Mayo Hospital Lahore Pakistan, from Apr to May 2021.&#x0D; Methodology: Eighty-one patients with hyperglycemia but without a prior diagnosis of diabetes mellitus were selected for this study. The data was collected from COVID PCR positive patients admitted to the isolation ward and intensive care unit at Mayo Hospital, Lahore. All the patients admitted during a 2-month duration from April to May 2021.&#x0D; Results: A Total of 81 patients were included, of which 54(66.7%) were males. On the basis of HbA1c, 68(84%), 12(14.8%) and 1 (1.2%) patient(s) were diagnosed diabetic, pre-diabetic and non-diabetic respectively. Of the four patients requiring mechanical ventilation, 3(75%) were diabetic, and 1(25%) was pre-diabetic. Of patients who required non-invasive ventilation, 68(84.4%), 12(14.2%) and 1(1.3%) were diabetic, pre-diabetic and non-diabetic, respectively.&#x0D; Conclusion: There is a significant burden of undiagnosed diabetes mellitus and pre-diabetes among patients with severe COVID-19 who require oxygen supplementation or admission to high-dependency units. Therefore, all patients should undergo thorough testing to exclude underlying diabetes mellitus.

Diabetic foot infections (DFIs) can lead to limb loss and mortality. To improve patient care at a safety-net teaching hospital, we created a multidisciplinary limb salvage service (LSS). We recruited a cohort prospectively and compared it to a historical control group. Adults admitted to the newly established LSS for DFI during a 6-month period from 2016 to 2017 were included prospectively. Patients admitted to the LSS had routine endocrine and infectious diseases consultations according to a standardized protocol. A retrospective analysis of patients admitted to the acute care surgical service for DFI before creation of the LSS during an 8-month period from 2014 to 2015 was performed. A total of 250 patients were divided into two groups: the pre-LSS (n = 92) and the LSS (n = 158) groups. There were no significant differences in baseline characteristics. Although all patients were ultimately diagnosed with diabetes, more patients in the LSS group had hypertension (71% versus 56%; P = .01) and a prior diagnosis of diabetes mellitus (92% versus 63%; P < .001) compared to the pre-LSS group. Significantly, with the LSS, fewer patients underwent a below-the-knee amputation (3.6% versus 13%; P = .001). There was no difference in the length of hospital stay or 30-day readmission rate between the groups. Further broken down into Hispanic versus non-Hispanic, we noted that Hispanics had significantly lower rates of below-the-knee amputations (3.6% versus 13.0%; P = .02) in the LSS cohort. The initiation of a multidisciplinary LSS decreased the below-the-knee amputation rate in patients with DFIs. Length of stay was not increased, nor was the 30-day readmission rate affected. These results suggest that a robust multidisciplinary LSS dedicated to the management of DFIs is both feasible and effective, even in safety-net hospitals.

Gestational Diabetes mellitus (GDM) is fast becoming an important cause of maternal and perinatal morbidity and mortality. The objective of this study is to assess the prevalence and the perinatal outcome of gestational diabetes in an antenatal population. This was a cross-sectional study. The patients were pregnant women between 24-28 weeks of gestation without a prior diagnosis of diabetes mellitus. The consenting women were evaluated using fasting plasma glucose and oral glucose tolerance testing using 75 grams of glucose in 300ml of water orally. Two hundred and fifteen women participated in the study and the prevalence of GDM was 9%. The mean fasting plasma glucose was 4.04mmol/l at the time of the Oral glucose tolerance test (OGTT) and 5.78mmol/l after the oral glucose load. When compared with pregnant normoglycaemic patients, GDM patients had significantly fewer vaginal deliveries (p=0.05), higher birth weight (3.71kg), and more neonatal admissions (50%). Gestational diabetes mellitus is an important disease entity, and it is a cause of maternal and perinatal morbidities.

Abstract This case series explores Covid-19 associated Mucormycosis (CAM), its risk factors, clinical features and outcomes from a tertiary centre in Maharashtra, India, during the second wave of COVID-19. Methods: A retrospective, observational case series of 104 consecutive patients admitted to the hospital at various stages of complications of CAM, during the second wave of the COVID-19 pandemic (Jan’21-Apr’21). The diagnosis was confirmed using Potassium hydroxide wet mount (KOH), histopathology, fungal culture, and Cone-Beam Computed Tomography(CBCT). Results: There were 81% men, mean age of 49 ± 12.4 years, and all patients had a history of corticosteroids usage, 82% had a prior diagnosis of diabetes mellitus (DM) and the rest were newly diagnosed. Diagnosis of mucormycosis was confirmed on 2 modalities in 71%; KOH and histopathology in 31 (30%), and fungal culture with KOH and histopathology together detected 25 (24%). 9% were diagnosed exclusively with CBCT. Patients with prior DM had higher morbidity OR 8.30 [95% CI: 2.12, 32.5; p=0.002] and mortality OR 13.23 [95% CI: 1.67, 104.7; p=0.014] than non-DM patients. Mortality was higher in patients with rhino + orbital involvement than patients with rhino + maxillary involvement [OR 8.37 [95% CI: 1.52, 46.09; p=0.014]. Conclusion: Diabetes remained the highest risk factor for the development of CAM in patients with COVID-19 on corticosteroids, with high mortality and morbidity. Timely medical and surgical interventions and multi-disciplinary approaches could potentially reduce mucormycosis-associated mortality. Among the diagnostic modalities, detection using CBCT may increase the diagnostic yield in patients not detected in other modalities.

Association between SLGT2 Inhibitor Use and the Progression of Monoclonal Gammopathy of Undetermined Significance to Multiple Myeloma

Introduction: Elevated glycosylated hemoglobin (HbA1c) levels have been associated with adverse outcomes in heart failure (HF). However, the relationship between hemodynamics and glycemia has not been established. Hypothesis: Elevated HbA1c levels are associated with abnormal right heart catheterization (RHC) hemodynamic parameters in patients with HF with reduced ejection fraction and no prior diagnosis of diabetes mellitus (DM). Methods: We performed a retrospective study of adults patients (&gt;21 years) with a left ventricular ejection fraction &lt;40% who underwent a RHC between June 1, 2015 and June 1, 2021 and had HbA1c levels measured 30 days before or after the RHC. We excluded patients who had received blood transfusions within 90 days prior to HbA1c measurement and patients with known DM. We conducted univariate and multivariate regression analysis adjusted for age, gender, and body mass index (BMI) to test for an association between RHC hemodynamic parameters and HbA1c. Results: A total of 136 patients were included with a mean age of 55 ± 15 years; 75% were males. The mean BMI was 29.88 ± 8.08 kg/m2, and meanHbA1c was 5.99 ± 0.64%. Unadjusted univariate models showed that HbA1c is significantly associated with cardiac index (CI) by Fick and thermodilution, right atrial pressure (RAP), and mean pulmonary arterial pressure (mPAP). After multivariateanalysis, for every one unit increase in HbA1c, there was a 0.19 and 0.26 L/min/m2decrease in expected CI by thermodilution and by Fick, respectively ( P = 0.03 and P &lt;0.01). For every one unit increase in HbA1c, there was a 2.39 mmHg increase in expected RAP ( P = 0.01). There was no association between MPAP and HbA1c after adjustment (Table 1). Conclusions: Changes in HbA1c levels measured within 30 days before or after the index RHC in patients with a left ventricular ejection fraction &lt;40% were associated withchanges in hemodynamic parameters that correlate with congestive hemodynamics(reduced CI and elevated RAP).

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Abstract Background Cryptogenic stroke represents about 25–30% of all ischemic strokes. Continuous electrocardiographic monitoring using implantable loop recorder (ILR) can detect asymptomatic and undiagnosed atrial fibrillation (AF). Purpose To assess patient-specific factors in ILR implantation and AF detection in patients with cryptogenic strokes. Methods We retrospectively reviewed 379 patients with cryptogenic stroke indicated for ILR implantation, from January 2017 to June 2021 at our university hospital. We evaluated patient demographic and clinical characteristics to assess the risk factors associated with higher incidence of AF detection, using logistic regression models. Results Of the 379 ILRs implanted, 60.4% were males with 71.2% Caucasian, mean age 67.6 years, and mean BMI 28.5. The mean CHADSVASC score of 3.9 at the time of ischemic stroke. These patients had prior diagnosis of diabetes mellitus (27.4%), hypertension (65.7%), chronic kidney disease (19.5%), coronary artery disease (20%) and congestive heart failure (2%). Of the entire cohort, AF was diagnosed in 16% of patients with 14 months mean follow up. There were more females diagnosed with AF on ILR (20% v. 18.7%, p&amp;gt;0.05). Caucasians were more likely to have AF detected compared to non-Caucasians (OR 2.3, 95% CI, p&amp;lt;0.02). There were 52 patients with mobile cardiac outpatient telemetry (MCOT) before having ILR implantation. AF was not detected on MCOT, but 15% were diagnosed with AF with ILR monitoring. In univariate analysis, increasing age is strongly associated with the detection of AF (p=0.03). Conclusions There continues to exist race disparities in ILR implantation and eventual AF detection, leading to further socioeconomic health disparities. ILR should be considered especially in elderly with cryptogenic stroke given the higher incidence of AF detection. Funding Acknowledgement Type of funding sources: None.