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2015 ADA Posters 1474-1929.Indd EPIDEMIOLOGY—AGINGCATEGORY 1470-P time is indeed benefi cial for metabolism of overweight and obese pregnant Correlation of Serum Folate Levels with Glucose Levels in Gesta- women needs to be assessed in further studies. tional Diabetes Mellitus (GDM) in Relation to Vitamin B12 Levels MAY O.O. KHIN, SIMON GATES, PONNUSAMY SARAVANAN, Coventry, United Kingdom EPIDEMIOLOGY—AGING In non-pregnant type 2 diabetes, high serum folate levels have adverse effects on metabolic markers in vitamin B12 defi cient setting, whereas folic acid supplementation can improve glycaemic control in some patients. Guided Audio Tour: Diabetes and Aging—It’s All the Rage! (Posters: 1472-P This study aims to examine the association between serum folate levels to 1479-P), see page 15. and plasma glucose levels in normal and insuffi cient B12 (<150pmol/l) GDM. This retrospective study included GDM identifi ed between 2009-2012 in a & 1472-P district general hospital, UK. All GDM received folic acid (40ug/day) as rou- Disability-Free Life-Years Lost due to Diabetes Mellitus among tine antenatal care. Serum folate, B12 and homocysteine were measured at Older U.S. Adults 24-28 weeks and compared with glucose levels at diagnostic and postpar- BARBARA BARDENHEIER, JI LIN, XIAOHUI ZHUO, MOHAMMED K. ALI, TED tum OGTT. THOMPSON, EDWARD W. GREGG, Atlanta, GA, North Wales, PA Total of 188 pregnancy included, 60 GDM (31.9%) were B12 defi cient and 31 Increases in diabetes incidence and life expectancy among the diabetes GDM (17%) had high folate levels (>16ug/l). In both normal and B12 defi cient population have led to an increase in the number of years spent with diabe- GDM, plasma homocysteine had signifi cant negative correlation with folate tes. However, the effect of diabetes on the quality of those extra years is (r=-0.38 vs. r=-0.44), and not B12 levels. There was a signifi cant inverse as- unknown. sociation between serum folate and fasting glucose levels at both diagnostic We analyzed longitudinal data from the Health and Retirement Study and postpartum OGTT. The association was signifi cant in normal B12 GDM and modeled disability-free life-years lost due to diabetes over a lifetime and not B12 defi ciency, and was independent of age, BMI and parity. in the United States. We estimated incidence of disability, remission from Our fi ndings suggest that the effects of serum folate levels on fasting disability, and mortality by self-reported diabetes status among 11,141 glucose levels may differ by vitamin B12 status and highlight the importance adults aged > 50 years with baseline years of 1998 and 2004, followed to of normal vitamin B12 levels for folate to act on glycaemic levels. 2010. Three measures of disability were examined: severe functional de- Table. Pearson’s Correlation-Plasma Glucose Correlates with Serum Folate cline (mobility), some diffi culty with >1 instrumental activities of daily liv- Levels. ing (IADL), and some diffi culty with >1 activities of daily living (ADL). Using All GDM Normal B12GDM B12 insuffi cient GDM these estimates, we developed a discrete-time fi ve state Markov model to estimate the numbers of years with and without disability by baseline age mid-pregnancy Postpartum mid-pregnancy Postpartum mid-pregnancy Postpartum and diabetes status. From ages 50 and 60 for all 3 disability defi nitions, (n=188) (n=67) (n=128) (n=45) (n=60) (n=22) diabetes was signifi cantly associated (p<0.05) with earlier average age of fasting -0.17(<0.05) -0.26(<0.05) -0.19(<0.05) -0.36(<0.01) -0.08 (NS) -0.02(NS) disability onset, reduced total years of life and reduced disability-free life 2hr postprandial -0.14(<0.05) -0.14(NS) -0.18(<0.05) -0.20 (NS) -0.02(NS) -0.08(NS) years. Compared to those without diabetics, from age 50 men have 1.5 to BMI -0.23(<0.01) -0.29(<0.01) -0.04(NS) 2.2 more disabled years for all 3 disability measures and women have 3.5 Genetics POSTERS more mobility loss disabled years and 2.6 more ADL disabled years. From Epidemiology/ Multiple regression for fasting glucose age 50, men with diabetes have 6-7 years earlier onset of disability (mobil- All GDM Normal B12GDM B12 insuffi cient GDM ity, IADL, ADL) than non-diabetic men, 2-4 fewer total years of remaining folate mid-pregnancy Postpartum mid-pregnancy Postpartum mid-pregnancy Postpartum life, and have 6-7 fewer disability-free total years of life. From age 50, (n=188) (n=67) (n=128) (n=45) (n=60) (n=22) women with diabetes have a 7-8 year earlier onset of disability (mobility, β -0.04(<0.05) -0.04(<0.05) -0.04(<0.05) -0.06(<0.05) -0.01(NS) -0.003(NS) IADL, ADL) than non-diabetic women, 2-4.5 fewer total years of remain- ing life, and have 6-7 fewer disability-free total years of life. This study Adjusted β -0.03(<0.05) -0.05(<0.05) -0.04(<0.05) -0.07(<0.01) -0.01(NS) -0.007(NS) (Age,BMI,Parity) suggests diabetes reduces the quality of life of adults by exposing them to disability at earlier ages and reducing disability-free years remaining NS=Not Signifi cant. compared to adults without diabetes. 1471-P & 1473-P Sedentary Behavior Is Associated with Improved Cytokine Pro- Incidence of Mobility Loss and Subsequent Recovery by Diabetes fi le but Not with Glucose or Lipid Metabolism in Obese Pregnant Status, 1998-2010 Women BARBARA BARDENHEIER, JI LIN, XIAOHUI ZHUO, MOHAMMED K. ALI, TED MIREILLE VAN POPPEL, MINAKSHI NAYAK, AKOS HEINEMANN, MIRIAM PEIN- THOMPSON, EDWARD W. GREGG, Atlanta, GA, North Wales, PA HAUPT, GERNOT DESOYE, Graz, Austria, Amsterdam, Netherlands Few studies have quantifi ed the incidence of mobility loss or subsequent Sedentary behavior is an independent risk factor for the metabolic syn- recovery associated with diabetes. We used generalized estimating equa- drome, but the role of sedentary behavior in the development of gestational tions to analyze prospective data from the Health and Retirement study, a diabetes is unclear. U.S. population-based sample of 11,141 adults aged > 50 years with biennial This longitudinal cohort study tested the hypothesis that less sedentary visits from 1998 through 2010. Compared to non-diabetic persons, incidence behavior is related to better insulin sensitivity, lipid and cytokine profi le in of mobility loss was 75% higher (p<0.05) for diabetic men (24.1 vs. 13.8 per obese pregnant women. 1000 PY) and 83% for diabetic women (34.6 vs. 18.9 per 1000 PY). [Figure Among 46 overweight and obese pregnant women, fasting blood was 1] Recovery from incident mobility loss was lower for those with diabetes taken at 15, 24 and 32 weeks of gestation, and a 100 g oral glucose tolerance than without, but was similar by sex (226.4 for non-diabetic women, 244.5 test was performed at 24 and 32 weeks. Fasting levels of glucose, insulin, to- for non-diabetic men, 220.0 for diabetic women, 210.8 for diabetic men per tal cholesterol, HDL, LDL, triglycerides were measured, as well as cytokines. 1,000 PY). [Figure 2] Incident mobility loss was higher among diabetic women Insulin sensitivity, fi rst and second phase insulin response were calculated. than men, with little difference in recovery. Sedentary behavior was measured objectively using accelerometers. The relationship between sedentary behavior and metabolic outcomes were as- sessed using linear regression analysis. Women spent about 60% of their time sitting throughout pregnancy. In cross sectional analyses, an association of sedentary time at 15 and 24 weeks with increased total cholesterol and HDL was found. Changes in sedentary time were not associated with glucose metabolic or other lipid outcomes, but increased sedentary time was associated with lower CRP and leptin levels, and with higher adiponectin levels at 32 weeks of pregnancy. In conclusion, no consistent longitudinal relationship between sedentary habits of obese and overweight pregnant women with glucose or lipid me- tabolism was found. Increases in time spent sedentary in pregnancy were associated with improved cytokine profi le. Whether increasing sedentary For author disclosure information, see page A810. & Guided Audio Tour poster ADA-Funded Research A382 EPIDEMIOLOGY—AGINGCATEGORY & 1475-P Inconsistency in Self-Report of Diabetes in Panel Surveys: The Health and Retirement Study CHRISTINE CIGOLLE, COREY NAGEL, ANA QUINONES, Ann Arbor, MI, Portland, OR Chronic disease data from longitudinal health interview surveys are used often in epidemiologic studies. Yet, these data may be limited by discrep- ancies in self-report across multiple interview waves. We examined incon- sistencies in the self-report of diabetes across 12 years of the Health and Retirement Study (HRS), a nationally representative, longitudinal survey (funded by the National Institute on Aging). We investigated a multistep method of adjudicating discrepancies across waves. We analyzed HRS waves 1998-2010. The sample included adults ≥51 years (n=24,156) who participated in ≥1 wave. We assessed the extent of problemat- ic responses in the self-report of diabetes, in comparison to 6 other diseases. We examined sociodemographic and geriatric determinants as predictors of problematic response patterns. We then used questions about the diseases (e.g., treatment with oral medication/insulin) and respondent hemoglobin A1c data to devise a multistep adjudication method to resolve discrepancies in respondents’ self-report of diseases across successive waves. 28.5% of respondents had inconsistency in their self-report of chronic diseases across waves, with variation by disease, ethnicity, and education. 704 respondents had inconsistency in diabetes self-report (1.2% of all respon- dents; 11.4% of respondents with diabetes).
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