Significant Decrease In HbA1c Research Articles

Improving Health and Reducing Chronic Disease Disparities with Latinx Communities: Evaluating the Role of Documented Community-Based Intervention Participation.

Limited evidence exists on the impact of participation in community-based chronic disease self-management and prevention programs on health disparities. The purpose of this research was to determine the effects of participation in the Healthy Here Wellness Referral System on existing disparities in glycated hemoglobin (HbA1c), systolic blood pressure (BP), and diastolic BP among Hispanic/Latinx adults compared with non-Hispanic White adults. We merged administrative clinical and referral data from 2018 through 2022 for adult patients in six focus ZIP codes in New Mexico resulting in a sample of 1331 patients and used regression models to examine predictors of intervention participation as well as propensity-adjusted impacts of participation on HbA1c and BP outcomes. Non-Hispanic White patients who were referred to community-based programming but did not participate saw statistically significant increases in HbA1c. Hispanic/Latinx patients saw statistically significant decreases in HbA1c with referral alone, with no added benefit from program participation. The impact of participation differed statistically significantly (t(683) = 3.55, p < .001) between these two groups for HbA1c levels, as well as for systolic (t(958) = 2.11, p = .04) and diastolic BP outcomes (t(958) = 2.96, p = .003). Results of this study support the promise of using centralized referral systems to co-produce health improvement in community settings. Mixed findings highlight the need for further uptake of theory-informed measurement in evaluations seeking to understand heterogeneous program impacts by race and ethnicity.

The effect of cognitive behavioral therapy for insomnia on sleep and glycemic outcomes in people with type 2 diabetes: A randomized controlled trial

Study objectivesInvestigate whether aiding sleep by online cognitive behavioral therapy for insomnia (CBT-I) can improve glycemic and metabolic control, mood, quality of life (QoL) and insomnia symptoms in people with type 2 diabetes and assess the mediating role of lifestyle factors. MethodsAdults with type 2 diabetes and insomnia symptoms were randomly assigned to CBT-I or care as usual. At baseline, three and six months we assessed HbA1c as primary outcome and glycemic control, metabolic outcomes, sleep, mood and QoL as secondary outcomes. Mixed models were used to determine within-person and between-persons differences in outcomes and mediation analysis for lifestyle factors. ResultsWe randomized 29 participants to CBT-I and 28 to care as usual. Intention-to-treat analysis showed no significant differences in glycemic control, metabolic outcomes, anger, distress or QoL, but showed a significantly larger decrease in insomnia (−1.37(2.65: 0.09)) and depressive symptoms (−0.92(-1.77: 0.06)) and increase in BMI (0.29 kg/m2(0.00:0.57)) in the intervention compared to the control group. Only half of the intervention participants completed the CBT-I. Per protocol analysis showed a not statistically significant decrease in HbA1c (−2.10 mmol/l(-4.83:0.63)) and glucose (−0.39 mmol/l(-1.19:0.42)), metabolic outcomes and increase in QoL. Furthermore, the intervention group showed a significant decrease in insomnia (−2.22(-3.65: 0.78)) and depressive symptoms (−1.18(-2.17: 0.19)) compared to the control group. Lifestyle factors partially mediated the effect of the intervention. ConclusionsCBT-I might improve insomnia symptoms and mood, and perhaps improves glycemic control, albeit not significant, in people with type 2 diabetes and insomnia symptoms, compared to care as usual.

The moderating role of diabetes distress on the effect of a randomized eHealth intervention on glycemic control in Black adolescents with type 1 diabetes.

Due to systemic inequities, Black adolescents with type 1 diabetes are more likely to have suboptimal glycemic control and high rates of diabetes distress, but tailored interventions for this population are lacking. In primary outcomes of a randomized clinical trial, a family-based eHealth intervention improved glycemic control in Black adolescents with type 1 diabetes and elevated depressive symptoms. The present study is a secondary analysis of these clinical trial data examining the moderating effect of diabetes distress on the efficacy of the intervention. Using secondary data from a multicenter randomized clinical trial (Clinicaltrials.gov [NCT03168867]), caregiver-adolescent dyads were randomly assigned to either up to three sessions of an eHealth parenting intervention (n = 75) or a standard medical care control group (n = 74). Black adolescents (10 years, 0 months to 14 years, 11 months old) with type 1 diabetes and a caregiver willing to participate were eligible. Adolescents reported their diabetes distress at baseline, and hemoglobin A1c (HbA1c) data were collected at baseline, 6-, 13-, and 18-month follow-up. No between-group contrasts emerged in a linear mixed-effects regression (p's > .09). Within-group contrasts emerged such that adolescents assigned to the intervention who reported high diabetes distress had lower HbA1c at the 18-month follow-up relative to baseline (p = .004); the 18-month decrease in HbA1c was -1.03%. Black adolescents with type 1 diabetes and high levels of diabetes distress showed significant decreases in HbA1c following a family-based eHealth intervention, suggesting diabetes distress may be a key moderator of intervention efficacy within this population.

THE EFFECTS OF DOWNHILL WALKING ON INSULIN SENSITIVITY, ARTERIAL HEALTH, MUSCLE STRENGTH AND FUNCTIONAL PHYSICAL FITNESS IN PEOPLE WITH TYPE 2 DIABETES MELLITUS

INTRODUCTION &amp; AIMS Exercise is effective in preventing and managing Type 2 Diabetes Mellitus (T2DM). However, a significant number of people do not exercise as they perceive exercise to be physically challenging. Eccentric exercise, a novel aerobic exercise modality is less metabolically demanding and has been shown to have positive effects on blood glucose levels, cardiovascular fitness, and muscle strength in healthy populations. This research was conducted to explore the impact of eccentric exercise, specifically downhill walking, on insulin sensitivity, arterial health, muscle strength, and physical functional fitness in individuals with T2DM. METHODS A 12-week randomised controlled trial was conducted to investigate the effects of downhill, level, and uphill walking on people with T2DM. Sedentary adult participants with T2DM were randomised to perform downhill walking (DW), level walking (LW), or uphill walking (UW) for 30 minutes twice a week for twelve weeks at a standard speed of 2.5km/hr. The primary outcome measure was glycosylated haemoglobin (HbA1c), while secondary measures included arterial stiffness, strength, and physical fitness. RESULTS A significant reduction in HbA1c between baseline and 12 weeks was observed in the UW group However, per-protocol analysis showed a significant decrease in HbA1c in the DW group post-intervention as well. Central Systolic blood pressure significantly decreased between baseline and post-intervention in the DW group. Participants in DW group and UW group showed significant improvements in distance walked in 6MWT post-intervention. A significant increase in knee extensors isometric strength between baseline and 12 weeks was observed for the DW group only. CONCLUSION DW was as effective as UW for improving insulin sensitivity and more effective than LW and UW for improving central systolic blood pressure, muscle strength and functional physical fitness. DW is a viable option for those seeking a less demanding form of exercise.

Impact of a Quality Improvement Initiative on Medical Management of Veterans With Peripheral Artery Disease

Guideline-directed medical therapy (GDMT) for peripheral artery disease (PAD) remains severely underused. Prevention of Amputation in Veterans Everywhere (PAVE) is a screening program designed to prevent or delay major lower extremity amputation. This study aimed to determine whether diagnosis of PAD through the PAVE program improves the prescription of GDMT in veterans with asymptomatic PAD. Patients enrolled into the PAVE program from our institution from 2020 to 2021 were included. Patients with an abnormal ankle-brachial index (ABI), defined as ABI <0.9 or >1.2, were selected for further analysis. Primary outcome was adherence to GDMT, following class I and class IIa recommendations. Secondary outcomes included changes in low-density lipoprotein (LDL), blood pressure, and hemoglobin A1c (HbA1c). A total of 6,313 patients were enrolled into the PAVE program between 2020 and 2021. Of these, 211 had abnormal ABI and were included in our analysis. With enrollment into PAVE, there was significant increase in the prescription of aspirin (74.4% vs 64.9%, p = 0.044) and statins (91.5% vs 82%, p = 0.006). The overall adherence to GDMT significantly increased (56.9% vs 38.9%, p <0.001). The number of patients needed to enroll in PAVE to improve GDMT adherence is 5.6 (95% confidence interval 3.6 to 12.3). Patients enrolled into PAVE program saw significant decreases in HbA1c, with mean decrease of 0.3 (p = 0.012) and a decrease in LDL, with a mean decrease of 6.2 (p = 0.01). In conclusion, enrollment into an amputation prevention program secondarily increased adherence to GDMT, driven by increases in the prescription of statins and aspirin, with resulting decreases in HbA1c and LDL.

Impact of Skills for Change Program on metabolic control, diet and physical activity levels in adults with type 2 diabetes: A cluster randomized trial.

Type 2 diabetes mellitus is highly prevalent in the Arab Gulf countries. Despite this, limited culturally-adapted lifestyle intervention studies have been conducted in this region. In this culturally adapted 12-month cluster randomized trial, 382 patients with type 2 diabetes, aged 20-70 years were recruited from 6 public healthcare centers (3 interventions and 3 controls) in Al Ain, United Arab Emirates. The primary outcome of this study was a change in hemoglobin A1c (HbA1c). The secondary outcomes were Body Mass Index (BMI), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, dietary intake, and physical activity levels. A diet and physical activity intervention, guided by the social cognitive theory, was delivered individually and in group format to the intervention group. The control group continued receiving only their usual diabetes management care. The data were collected at baseline and 1 year after participation. The mean baseline HbA1c levels of the control and the intervention groups were 7.45 ± 0.11% and 7.81 ± 0.11%, respectively. At the end of the 12-month intervention, there was no significant difference in the changes of mean HbA1c between the intervention and the control groups. On the other hand, BMI and daily caloric intake were significantly decreased in the intervention compared to the control group by 1.18 kg/m2 (95% CI: -1.78 - -0.60) and 246 kcal (95% CI: -419.52 - -77.21), respectively, after controlling for age, gender, education, marital status, duration since diabetes diagnosis, diabetes treatment, treatment clinic, and baseline values. Sitting time during the week-end was significantly lower, difference 52.53 minutes (95% CI: 93.93 - -11.14). This community-based lifestyle intervention for patients with baseline HbA1c <8% did not result in a significant decrease of HbA1c but reduced caloric intake, body weight, and weekend inactivity after controlling for the covariates. This trial was registered on February 11, 2020 with Clinicaltrials.gov (NCT04264793).

Effect of Virtual Versus In Person Interpreting on Diabetes Outcomes in Non-English Language Preference Patients: A Pilot Study.

The objective of this pilot study was to explore the impact of interpreter format (virtual vs in person) on clinical outcomes in patients with non-English language preference (NELP) and type 2 diabetes mellitus (T2DM) in a primary care setting. We hypothesized that NELP patients utilizing in person interpreters would have improved HbA1c values, better follow-up rate, and more complex care plans compared to patients utilizing virtual interpreters. We completed a retrospective chart review of 137 NELP patients with T2DM who required a medical interpreter (February to June 2021). We calculated univariate and bivariate statistics to characterize the sample and assess the extent to which measures of continuity (follow-up visit rate and time to follow-up visit), quality (change in HbA1c), and complexity (medication intervention complexity) were associated with interpreter type. There was no statistically significant difference in follow-up rate or average days to follow-up visit for NELP patients with in person as opposed to virtual interpreters. Patients with virtual interpreters demonstrated a non-statistically significant decrease in HbA1c compared to those with in person interpreters. Finally, there was no statistically significant association between interpreter format and intervention complexity. Quality medical interpretation contributes to optimal health outcomes in NELP patients with diabetes. Our study suggests that both in person and virtual interpreters can be effective in providing care for NELP patients, especially for chronic disease management in the context of a primary care relationship. It also highlights the importance of pursuing additional qualitative and mixed method studies to better understand the benefits of various interpreter formats across different visit types.

A comparative study of efficacy and safety of glimepiride versus gliclazide as an add on to metformin in Type 2 diabetes mellitus at a tertiary care hospital

Background: Type 2 diabetes mellitus (T2DM) is a chronic disorder with progressive pancreatic β-cell dysfunction and insulin resistance. Hyperglycemia associated with uncontrolled T2DM leads to various diabetes-related complications. Although metformin is the most preferred first-line drug, 5–10% of patients per year subsequently fail to achieve target HbA1c levels, subsequently requiring combination therapy. While efficacy and cost favor the use of sulfonylureas, hypoglycemic episodes limit its use. Newer generation sulfonylureas such as glimepiride and gliclazide are presumed to have lower incidence of hypoglycemia. Aims and Objectives: The aim of the study was to assess the efficacy and safety of glimepiride versus gliclazide as an add-on to metformin in T2DM. Materials and Methods: A total of 60 patients with T2DM (HbA1c 7.0–10.0%, on metformin monotherapy) were recruited and randomized into two groups of 30 cases each. Group A received glimepiride 2 mg as add-on to metformin 1500 mg and Group B received gliclazide 80 mg as add-on to metformin 1500 mg. HbA1c, lipid profile, body mass index, and total blood count were assessed at baseline and at the end 12 weeks of treatment. Fasting blood sugar (FBS) and post prandial blood sugar (PPBS) were assessed at the end of 4, 8, and 12 weeks and adverse events were assessed throughout the study period. Results: There was a significant decrease in HbA1c, FBS, and PPBS scores from baseline to the end of 12 weeks in both groups (P &lt; 0.001), but the difference was not statistically significant between the two groups (P &gt; 0.05). A significant decrease in lipid levels was observed in both groups except for high-density lipoprotein, low-density lipoprotein in the metformin + gliclazide group. The treatment was well tolerated in both groups, with the most common adverse events being nausea, diarrhea, and epigastric pain. Conclusion: Glimepiride and gliclazide are both equally effective as an add-on to metformin in improving glycaemic indices and are well tolerated in the management of uncontrolled T2DM.

Analysis of Changes in Glucose and Lipid Metabolism in Patients with Clinically Severe Obesity and Type 2 Diabetes Mellitus Undergoing Laparoscopic Sleeve Gastrectomy—Prospective Observational Study

IntroductionWe still lack studies providing analysis of changes in glucose and lipid metabolism after laparoscopic sleeve gastrectomy (LSG) in patients with type 2 diabetes mellitus (DM2). We aimed to investigate postoperative changes in glucose and lipid metabolism after LSG in patients with DM2.Material and MethodsProspective, observational study included patients with BMI ≥ 35 kg/m2 and ≤ 50 kg/m2, DM2 < 10 years of duration, who were qualified for LSG. Perioperative 14-day continuous glucose monitoring (CGM) began after preoperative clinical assessment and OGTT, then reassessment 1 and 12 months after LSG. Thirty-three patients in mean age of 45 ± 10 years were included in study (23 females).ResultsEBMIL before LSG was 17 ± 11.7%, after 1 month—36.3 ± 12.8%, while after 12 months—66.1 ± 21.7%. Fifty-two percent of the patients had DM2 remission after 12 months. None required then insulin therapy. 16/33 patients initially on oral antidiabetics still required them after 12 months. Significant decrease in HbA1C was observed: 5.96 ± 0.73%; 5.71 ± 0.80; 5.54 ± 0.52%. Same with HOMA-IR: 5.34 ± 2.84; 4.62 ± 3.78; 3.20 ± 1.99. In OGTT, lower increase in blood glucose with lesser insulin concentrations needed to recover glucose homeostasis was observed during follow-ups. Overtime perioperative average glucose concentration in CGM of 5.03 ± 1.09 mmol/L significantly differed after 12 months, 4.60 ± 0.53 (p = 0.042). Significantly higher percentage of glucose concentrations above targeted compartment (3.9–6.7 mmol/L) was observed in perioperative period (7% ± 4%), than in follow-up (4 ± 6% and 2 ± 1%). HDL significantly rose, while triglyceride levels significantly decreased.ConclusionsSignificant improvement in glucose and lipid metabolism was observed 12 months after LSG and changes began 1 month after procedure.Graphical

Basic carbohydrate counting and glycemia in young people with type 1 diabetes in India: A randomized controlled trial

ObjectivesThe aim of this study was to evaluate the effect on glycemic control and acceptability of basic carbohydrate counting (BCC) in children and young adults with type 1 diabetes (T1DM). MethodsNinety-two children and young adults (6–25 y of age) with T1DM were randomized to receive either routine nutrition education (RNE), which addressed food groups, glycemic index, and effects of food and exercise on glycemia, or learn BCC with personalized portion size education. A continuous glucose monitoring study and glycosylated hemoglobin (HbA1c) were performed at baseline and after 12 wk. The primary outcome was a change in time-in-range from baseline through 12 wk. A questionnaire on the acceptability of BCC was administered. ResultsAt 12 wk, there was no significant difference in change in time-in-range between the two groups (BCC group: 1.2 ± 12.2; RNE group: 1.9 ± 12.3; P = 0.786). No significant changes were observed in the percentage of time that blood glucose was >180 or >250 mg/dL; <70 or <54 mg/dL; glycemic variability, percentage of nights with hypoglycemia and HbA1c. In subgroup analysis, there was a significant decrease in HbA1c in the BCC group among participants with higher maternal education (–0.5 versus 0.2, P = 0.042). The total score on the acceptability questionnaire was higher in the BCC group (P = 0.022). ConclusionAmong children and young adults in our region with T1DM, BCC provided flexibility in food choices and perception of greater ease of insulin adjustment. Although BCC was equivalent to RNE in terms of glycemic control, larger studies may reveal benefit in outcomes in certain subgroups.

SAT120 Effects Of Long Term Diabetes Education Program On HBA1C In Patients With Type 2 Diabetes Mellitus

Abstract Disclosure: K. Dash: None. N. Kumari: None. M. Harpal: None. T. Surekha: None. B. A. t: None. Introduction: As per IDF 2022, 537 million adults (20-79 years) are living with diabetes &amp; the number is increasing in an alarming way. 1in 10 people are suffering from diabetes and over 3 in 4 adults with diabetes live in low and middle-income countries. Adequate control of the disease is required by educating patients and developing their skills to manage their treatment to prevent complications through continue diabetic education program (DEPs). Aim &amp; Objectives: To measure the change in HBA1C, FBG &amp; PPBG (primary end point) value, who are in continue DEPs [ Sugar 360 (long term, 1 year sugar plan), Sugar 90 (long term-6 months sugar plan) vs. conventional method (SA-1- short term sugar plan, only one visit )with normal follow up] along with standard of care treatment. Secondary end points such as total cholesterol and body weight were also taken into consideration. Methods: Data of 100 type 2 diabetes mellitus patients who had attended diabetes OPD &amp; had at least two follow ups having knowledge about diabetes were included in the study. Visual impairment, psychological impairment and newly diagnosed DM patients were excluded from the study. Data on biochemical parameters of metabolic control such as FBG, PPBG, HBA1c, total cholesterol, TG &amp; BMI were collected. Within subjects design non-parametric and for quantitative data repeated measures ANOVA was used. Results: Mean age is 51.32 years in DEPs patients and mean age is 57.29 years in conventional treatment patients. Significant decrease in HBA1c (9.1% vs. 7.2%), FBG (161.2 mg/dl vs. 119.1 mg/dl), PPBG (244.6 mg/dl vs. 172.2 mg/dl), total cholesterol (175.8mg/dl vs. 159.8mg/dl) &amp; triglyceride (217.5 mg/dl vs. 182.1 mg/dl) were noted in the follow up visit in both groups. However patients on DEPs has better adherence to the follow-up visits and better understanding of disease, blood glucose control measures and lifestyle change. Conclusion: Intensive DEPs was found useful &amp; effective as regards to biochemical than compared with normal conventional treatment in terms of adherence knowledge &amp; control of disease. Presentation: Saturday, June 17, 2023

Switching from Multiple Insulin Injections to a Fixed Combination of Degludec and Liraglutide in Patients with Type 2 Diabetes Mellitus: Results from the Simplify Study After 6Months.

This study aimed to evaluate the effectiveness and safety of switching from basal bolus insulin treatment (BBIT) to a fixed combination of insulin degludec and liraglutide (IDegLira) in patients with type 2 diabetes mellitus (T2DM) who had preserved insulin secretion but inadequate glucose control. The study also aimed to assess the feasibility of implementing this therapeutic approach in common clinical practice settings. This was a non-randomized, open-label, multicenter, prospective, single-arm study involving 234 patients with T2DM who were receiving BBIT. Inclusion criteria were duration of diabetes mellitus > 60months, stable total daily dose of insulin (TDDI) ranging from > 20 to < 70IU/day (approx. > 0.3 to < 0.7IU/kg body weight/day), C-peptide levels > 10% above the lower limit, HbA1c levels > 7% and < 10% (Diabetes Control and Complications Trial), and body mass index > 25kg/m2. The primary endpoints were changes in glycated hemoglobin (HbA1c) and body weight at week 28 after treatment switching. Secondary endpoints included changes in the 7-point glycemic profile, hypoglycemia frequency, blood pressure, blood lipids, liver enzymes, insulin dose, and a patient questionnaire focusing on treatment satisfaction, concerns and impact on daily activities. A subgroup of 55 patients underwent continuous glucose monitoring (CGM) with the evaluation of CGM-derived parameters, such as time in range (TIR), time above range (TAR), time below range (TBR), hypoglycemia, and glucose variability. A significant decrease in HbA1c (8.6% vs. 7.6%; p < 0.0001) and body weight (97.8 vs. 94.0kg; p < 0.0001) was observed at week 28 after treatment switching. Significant improvements were also seen in all measurements of the 7-point glycemic profile (p < 0.0001), reduction in the number of hypoglycemia episodes per patient, and the proportion of patients with at least one hypoglycemia event (p < 0.001). Furthermore, there was a significant decrease in daily insulin dose (55.6 vs. 32.7IU/day; p < 0.0001), as well as improvements in blood pressure, blood lipids, and liver enzymes (gamma glutamyl transferase and alanine aminotransferase). The subgroup of patients who underwent CGM showed a significant increase in TIR (57.9% vs. 69.0%; p < 0.01) and a decrease in TAR (40.1% vs. 28.8%; p < 0.01), while TBR, hypoglycemia (number of episodes per patient and proportion of patients), and glucose variability did not change significantly. The results of this study suggest that switching from BBIT to IDegLira in patients with T2DM and preserved insulin secretion can simplify treatment without compromising glycemic control. The switch to IDegLira was associated with significant improvements in various glucose control parameters, including HbA1c, glycemic profile, hypoglycemia, insulin doses, and CGM-derived parameters TIR and TAR. Additionally, it led to significant reductions in body weight, blood pressure, lipid profile, and liver enzyme levels. Switching to IDegLira may be considered a safe and beneficial approach in clinical practice settings, offering metabolic and individual advantages.

Efficacy of switching from basal-bolus insulin therapy to twice-daily insulin degludec/insulin aspart co-formulation plus insulin aspart in patients with poorly controlled type 2 diabetes.

The aim of this study was to evaluate the efficacy of twice-daily (BID) insulin degludec/insulin aspart (IDegAsp) co-formulation + once-daily (OD) bolus insulin aspart (IAsp) injection (IDegAsp BID-Plus) as simplified intensive insulin therapy in patients with poorly controlled type 2 diabetes mellitus (T2DM) with basal-bolus insulin therapy (BBIT). The retrospective study included 155 patients who switched from BBIT to IDegAsp BID-Plus. After the initiation of the treatment, 73 patients continued regular follow-up and insulin doses, number of injections, hemoglobin A1c (HbA1c) levels, and other parameters were recorded from their files at baseline, 24, and 52 weeks. The mean age of the study population was 54.3±10.2 years, the duration of T2DM was 9.7±5.7 years, fasting plasma glucose (FPG) was 252.7±66.7 mg/dl, and HbA1c levels were 10.5±1.5%. Among the included patients, 15 patients received five injections, 51 patients received four injections, and 7 patients received three injections per day. There was a significant decrease in HbA1c (respectively; 10.46±1.54%, 7.97±1.24%, 7.98±1.23%, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001), FPG (respectively; 251.6±66.5 mg/dl, 136.1±34.7 mg/dl, 125.4±67.0 mg/dl, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001) and daily dose of insulin (respectively; 102.9±29.0 Unit, 73.2±18.2 U, 63.7±20.3 Unit, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001) at the end of week 24 and 52. Based on real-world data, this study demonstrated that IDegAsp BID-Plus treatment provides rapid and sustainable blood glucose control with lower insulin doses and fewer injections than previous intensive insulin therapy.

901-P: Real-World Evidence Supporting the Use of Advanced Hybrid Closed-Loop in Poorly Controlled Type 1 Diabetic Patients

Background: The advanced hybrid closed loop (a-HCL) algorithm of the MiniMed 780G includes automated basal and correction bolus insulin and offers the possibility to choose between three glucose targets. The aim was to evaluate the effectiveness of the a-HCL compared to its predecessors, the predictive low glucose suspension (PLGS, MiniMedTM 640G) and the standard hybrid closed loop (s-HCL, MiniMedTM 670G), and to assess which group of patients benefitted the most from the implementation of the a-HCL. Methods: Type 1 diabetes patients &amp;gt;18 years of age followed at the University Hospital Zurich (USZ), who initially used a PLGS or a s-HCL and were subsequently switched to the a-HCL until December 2021, were included in the study. Glucose metric data regarding HbA1c, time in range (TIR), time above range (TAR), time below range (TBR), average sensor glucose (SG), and variation coefficient (VC) was retrospectively analyzed before and after the conversion to the a-HCL. Results: 88 patients were screened, and 71 patients were included in the analyzes. After the implementation of the a-HCL, there was a significant decrease in HbA1c (pre 7.3±0.7% to post a-HCL 6.8±0.5%, p&amp;lt;0.001), SG (8.8±1.2 mmol/L to 7.9±0.8 mmol/L, p&amp;lt;0.001) and a significant increase in TIR (73.5% to 81%, p&amp;lt;0.001). Additionally, a significant decrease in TAR (23% to 17%, p&amp;lt;0.001) was observed, while TBR (1.5% to 1%, p=0.573) and the VC did not significantly change (33±6.6% to 32.4±5.8%, p=0.313). The changes in glycemic control were most pronounced in patients with a higher baseline HbA1c, a higher baseline SG, a lower baseline TIR, and a higher VC, all measures of poor glycemic control. Furthermore, patients with a body-mass index (BMI) &amp;gt;30kg/m2 achieved the greatest changes in HbA1c and TIR. Conclusion: In conclusion, our data support the use of a-HCL in all patients, but especially in poorly controlled type 1 diabetic patients with a high BMI. Disclosure G.Rathmes: None. S.F.Graf: None. C.Cavelti-weder: None.

87-LB: Real-World Impact of Once-Weekly Injectable Semaglutide on Glycemic Control and Weight Outcomes in Type 2 Diabetes (RELATE-OW Injectable Semaglutide)

Background: Given the scarcity of real-world evidence on long-term effectiveness, this study assessed the effect of a once-weekly injectable formulation of semaglutide type 2 diabetes (sema OW T2D) on HbA1c and weight outcomes in individuals with T2D. Methods: This retrospective database study included adults with T2D and HbA1c ≥7%, initiating sema OW T2D from January 2018 to September 2021, using linked data from IQVIA’s Longitudinal Prescription Claims, Professional Fee Claims, and Ambulatory Electronic Medical Records in the US. Descriptive and bivariate analyses were conducted to evaluate pre- and post-index (12 months) changes in HbA1c and weight-related outcomes. Results: Among the final sample of 1,926 patients, mean HbA1c decreased significantly from 8.9% to 7.6% (p&amp;lt;0.001), with 40.2% of patients achieving HbA1c &amp;lt;7.0% over 12 months post-index. Mean weight decreased from 106.3 to 102.2 kg (p&amp;lt;0.001), with 37.9% and 13.3% of patients experiencing a ≥5% and ≥10% decrease in weight, respectively. Mean BMI decreased from 36.5 to 35.0 kg/m2 (p&amp;lt;0.001), with the proportion of patients with BMI ≥40.0 kg/m2 and BMI ≥30.0 kg/m2 decreasing from 29.2% to 24.4% and 81.1% to 73.6%, respectively. Conclusion: At 12-month follow-up, adults with T2D initiating sema OW T2D had statistically significant decreases in HbA1c, weight, and BMI. Disclosure J. Amamoo: None. R. P. Doshi: Employee; IQVIA Inc. J. Noone: Employee; Novo Nordisk. X. Tan: Employee; Merck &amp; Co., Inc., Novo Nordisk, Stock/Shareholder; Merck &amp; Co., Inc., Novo Nordisk. L. Xie: Employee; Pfizer Inc., Novo Nordisk A/S. C. L. Gamble: Employee; Novo Nordisk. M. Guevarra: Employee; Novo Nordisk. J. Chen: Employee; IQVIA Inc. A. A. King: Advisory Panel; Novo Nordisk, Board Member; JDRF, Speaker's Bureau; Sanofi, Abbott, Dexcom, Inc., Lilly Diabetes.

86-LB: Real-World Impact of Oral Semaglutide on Glycemic Control and Weight Outcomes in Type 2 Diabetes (RELATE–Oral Semaglutide)

Background: The study objective was to evaluate the impact of oral semaglutide type 2 diabetes (oral sema T2D) on changes in HbA1c and weight outcomes in adults with T2D. Methods: This retrospective cohort study from October 2019 to September 2021 analyzed a linked US database from IQVIA’s Longitudinal Prescription Claims, Professional Fee Claims, and Ambulatory Electronic Medical Records. Adults with T2D with HbA1c ≥7% were included. Analyses were conducted to compare pre- and post-index (12 months) HbA1c and weight-related outcomes. Results: The final sample included 398 patients. Over 12 months post-index, mean HbA1c decreased significantly from 8.8% to 7.8% (p&amp;lt;0.001), with 32.4% of patients achieving HbA1c &amp;lt;7.0%. Mean BMI decreased significantly from 35.2 to 34.1 kg/m2 (p&amp;lt;0.001), with the proportion of patients with BMI ≥40.0 kg/m2 decreasing from 25.6% to 20.1%, and the proportion of those with BMI ≥30.0 kg/m2 decreasing from 75.6% to 70.4%. Mean weight decreased significantly from 102.4 to 98.9 kg (p&amp;lt;0.001), with 33.4% and 11.1% of patients experiencing a ≥5% and ≥10% decrease in weight, respectively. Conclusion: At 12-month follow-up, adults initiating oral sema T2D had statistically significant decreases in HbA1c, weight, and BMI from baseline. Further regression analyses will be conducted to control for covariates. Disclosure J. Amamoo: None. R. P. Doshi: Employee; IQVIA Inc. J. Noone: Employee; Novo Nordisk. X. Tan: Employee; Merck &amp; Co., Inc., Novo Nordisk, Stock/Shareholder; Merck &amp; Co., Inc., Novo Nordisk. L. Xie: Employee; Pfizer Inc., Novo Nordisk A/S. C. L. Gamble: Employee; Novo Nordisk. M. Guevarra: Employee; Novo Nordisk. J. Chen: Employee; IQVIA Inc. A. A. King: Advisory Panel; Novo Nordisk, Board Member; JDRF, Speaker's Bureau; Sanofi, Abbott, Dexcom, Inc., Lilly Diabetes.

Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression

Depression and antidepressant medications increase risk for type 2 diabetes. Cambodian-Americans have exceedingly high rates of both depression and diabetes. This paper reports outcomes of a diabetes prevention trial for Cambodian-Americans with depression. Primary outcomes were HbA1c, insulin resistance and depressive symptoms. Participants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either (a) antidepressant medication and/or (b) prolonged elevated depressive symptoms. Participants were randomized to one of three community health worker (CHW) interventions: (1) lifestyle intervention called Eat, Walk, Sleep (EWS), (2) EWS plus medication therapy management sessions with a pharmacist/CHW team to resolve drug therapy problems (EWS + MTM), or, (3) social services (SS; control). Assessments were at baseline, post-treatment (12 months), and follow-up (15 months). The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal educational attainment was 7.0 years. Compared to the other arms, EWS + MTM showed a significant decrease in HbA1c and a trend for reduced inflammation and stress hormones. Depressive symptoms improved for EWS and EWS + MTM relative to SS. There was no change in insulin resistance. Cardiometabolic and mental health can be improved in tandem among immigrant and refugee groups.

The Experience of our Center in Patients Undergoing Insulin Degludec/ Insulin Aspart Co-formulation Therapy.

A co-formulation containing insulin degludec and insulin aspart (IDegAsp) is available for the treatment of diabetes in Turkey. We aimed to evaluate the clinical results of switching to IDegAsp treatment for Type 2 diabetes. A total of 217 patients with type 2 diabetes treated with IDegAsp and having follow-up data were included. The patients were divided into 3 groups. Group 1 switched from basal insulin to IDegAsp, group 2 switched from twice-daily premixed insulin regimen to IDegAsp, and group 3 switched from intensive and thrice-daily premixed insulin regimen to IDegAsp. Groups were evaluated in terms of changes in insulin dose, the number of injections, and changes in HbA1c. The mean follow-up period was 7.5 ± 4.4 months. The mean age was 62.8 ± 12.9 years. The mean duration of diabetes was 15.3 ± 8 years. There was a significant decrease in HbA1c and glucose (p < 0.0001 and p < 0.0001, respectively). HbA1c was significantly reduced in group 1 (p < 0.0001) while insulin dose and the number of injections increased (p < 0.0001 and p < 0.0001, respectively). HbA1c, insulin dose, and the number of injections in group 2 and group 3 (p = 0.001, p = 0.002, p < 0.0001, respectively, and p < 0.0001, p = 0.043, p < 0.0001, respectively) were significantly reduced. This study includes real-life experiences involving a remarkable number of patients in the literature. IDegAsp treatment provided effective blood glucose regulation and caused a significant decrease in the insulin dose and the number of injections, resulting in increased quality of life among those who had to receive twice or more insulin injections.

The effect of date seed powder supplementation on glycaemic markers and lipid profile in women with overweight and obesity: a randomised controlled trial

SummaryThis randomised controlled trial aimed to investigate the effect of date kernel on glycaemic control, lipid profile, and weight in women with overweight and obesity. A total of 124 women with overweight or obesity were randomly assigned to receive the date kernel supplement or placebo for 12 weeks. Haemoglobin A1c (HbA1c) was measured by high‐performance liquid chromatography and fasting plasma glucose and lipid profiles by enzyme‐linked immunosorbent assay kits. In all, 98 subjects aged 40.7 years completed the trial (48 in the date kernel group and 50 in the placebo group). After 12 weeks, date kernel supplementation resulted in a significant decrease in HbA1c [mean (SD): −0.45 (0.36)] and fasting plasma glucose compared to the placebo [−0.16 (0.27)]. No significant change was observed in the lipid profiles of the total participants. However, date kernel decreased cholesterol and triglyceride (TG) in hypercholesterolaemic and hypertriglyceridaemic participants compared to the placebo. Date kernel improved glycaemic markers in overweight or obese women compared with the placebo. Furthermore, a significant reduction in total cholesterol and TG was observed only in hyperlipidaemic subjects. Date seed is a source of valuable components, including dietary fibre and bioactive compounds, that could provide economic, nutritional, and health benefits to the nutraceutical and food industries.

Comparison of the Impact of SGLT2-Inhibitors and Exenatide on Body Fat Composition.

To investigate the effect of SGLT2-iand GLP-1RA as an add-on therapy to metformin on weight loss and body composition, and to compare their effects on glucose and lipid parameters. A descriptive study. Place and Duration of the Study: Goztepe Prof Dr Suleyman Yalcin City Hospital, from January 2016 to May 2021. The study included 50 patients with diabetes on metformin+SGLT2-i(dapagliflozin or empagliflozin, group 1) and 50 patients with diabetes on metformin+GLP-1 receptor agonist (RA, exenatide, group 2). The reduction in weight, BMI, total body, abdominal, leg, and arm fat percentage, and the improvement in body fat-free and muscle mass percentage were significantly higher in Group 2 (p<0.001, p<0.001, p=0.014; p=0.031, p<0.001; p=0.002 and p=0.014, p=0.014, respectively). The decline in abdominal fat mass in the GLP-1 RA group was also significant (p=0.031). There was asignificantdecrease in HbA1c, fasting glucose, and triglyceride levels (p<0.001, p<0.001, and p=0.036) with a significant increase in HDL-C (p=0.015). There was no significant difference between groups for glucose, HbA1c, and lipid parameters (p>0.05). Both SGLT2 inhibitors and exenatide, when added to metformin therapy, were effective in reducing weight and body fat, more by the GLP-agonist. SGLT2-i had no significant impact on decreasing abdominal fat depicting that these agents do not have any benefit in treating visceral adiposity. Type 2 diabetes mellitus, Obesity, GLP-1 receptor, SGLT2 inhibitor, Body fat distribution, Visceral adiposity.