Experiences of a severe hypoglycemic event (SHE) , although infrequent occurrences, may interfere with engaging in social activities and increase distress. Previous work in parents suggests having nasal glucagon (NG) - a ready-to-use rescue agent for SHE - alleviates some of these psychosocial concerns. To examine whether young adults also perceived psychosocial benefits from NG, we recruited individuals aged 18-26 with T1D for an online survey. Participants rated the perceived impact of possible SHEs on fully engaging in social activities and distress (‘strongly disagree’ to ‘strongly agree’) and perceived changes since starting NG (‘worsened a great deal’ to ‘improved a great deal’) . Participants then answered questions about preparedness and protection using a validated measure to compare perceptions of NG to a glucagon kit requiring reconstitution. The final sample included 364 young adults (Meanage = 21.6 years; 73.6% female; MeanHbA1c = 7.1%) . Roughly one third of participants (35.4%) agreed/strongly agreed that possible SHEs limited their engagement in social activities. Most participants (63.7%) agreed/strongly agreed that treating a SHE was distressing. Since having NG, 30.9% of participants reported their freedom to engage in social activities improved/greatly improved and 67.4% reported no change. Of those who reported some amount of distress about SHEs (n = 326) , 49.7% reported their distress improved/greatly improved (i.e., reduced) and 48.8% of participants reported no change. Participants reported greater positive perceptions of Preparedness/Protection with NG (Median = 5.9, IQR = 5.1-6.3) compared to the glucagon kit requiring reconstitution (Median = 4, IQR = 3-4.9) as analyzed with a Wilcoxon signed rank test (p < .001) . Our results suggest that NG may provide meaningful psychosocial benefits for young adults, which could be especially important as they navigate this transitional age for diabetes management. Disclosure C. S. Kelly: None. H. Nguyen: None. W. Luo: Other Relationship; Lilly, Sanofi. K. S. M. Chapman: None. J. Poon: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. L. A. Baker: None. W. Wolf: None. M. Perez-Nieves: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. B. Mitchell: Employee; Eli Lilly and Company. Stock/Shareholder; Eli Lilly and Company. Funding Eli Lilly and Company

Background: T1D autoantibodies can be detected months to years before disease onset, but few people undergo screening. We explored attitudes toward autoantibody screening in people with T1D and caregivers and relatives of people with T1D. Methods: Participants were recruited from the T1D Exchange Registry or referred by an Online Registry participant. Guided by the Health Belief Model, we conducted 4 focus groups with 26 participants (11 adults with T1D with a child without T1D; 8 caregivers to a child with T1D and a child without T1D; 7 biological siblings to a person with T1D). Transcripts were analyzed using NVivo. Results: Responses are summarized in Table 1. Most participants held positive attitudes toward screening. The most common perceived benefit was to obtain knowledge; the anticipated emotional burden of a positive screen was the most frequently reported barrier. Anxiety and relief were emotions associated with a positive and negative screen, respectively. Participants desired information about antibody screening and its interpretation and accuracy. A healthcare providers’ recommendation might prompt the decision to screen. Conclusions: Participants expressed positive attitudes and perceived benefits of autoantibody screening but also reported barriers to screening, particularly the emotional burden of a positive result. Disclosure M.Peter: None. K.S.M.Chapman: None. J.L.Dunne: Employee; Janssen Research & Development, LLC. C.S.Kelly: None. W.Wolf: None.

Research on diabetes distress in continuous glucose monitor (CGM) users with T1D is divided. Some studies suggest CGM users experience less distress compared to non-users, whereas other studies find no differences in distress. While research shows higher distress is related to higher HbA1c, more work is needed to understand how distress is related to CGM metrics. Thus, we recruited adult CGM users with T1D (n = 199) from the T1D Exchange Registry to complete an online survey about diabetes characteristics and a screener of diabetes distress (DDS-2). CGM metrics (defined in Table 1) were computed from CGM data within 12 months prior to survey completion. Participants were grouped into lower (DDS-2 < 3, n = 120) or higher (DDS-2 ≥ 3, n = 79) diabetes distress. We used Welch’s t-tests to compare mean differences in blood glucose (BG) experiences and CGM metrics between participants with lower and higher diabetes distress. As shown in Table 1, participants with higher diabetes distress reported higher HbA1c, and - via CGM metrics - experienced more time in higher BG ranges and less time within standard target ranges, had higher blood glucose variability, and had higher GMI compared to those with lower distress. Associations between distress and CGM metrics replicated in a MANCOVA after adjusting for duration of T1D. Our results suggest, in CGM users, higher perceived diabetes distress is associated with more time in hyperglycemia. Disclosure C. S. Kelly: None. H. Nguyen: None. K. S. M. Chapman: None. E. M. Cornelius: None. M. Peter: None. W. Wolf: None.