To evaluate the contemporary prevalence of diabetic peripheral neuropathy (DPN) in participants with type 1 diabetes in the T1D Exchange Clinic Registry throughout the U.S. RESEARCH DESIGN AND METHODSDPN was assessed with the Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ) in adults with ‡5 years of type 1 diabetes duration. A score of ‡4 defined DPN. Associations of demographic, clinical, and laboratory factors with DPN were assessed. RESULTSAmong 5,936 T1D Exchange participants (mean 6 SD age 39 6 18 years, median type 1 diabetes duration 18 years [interquartile range 11, 31], 55% female, 88% non-Hispanic white, mean glycated hemoglobin [HbA 1c ] 8.1 6 1.6% [65.3 6 17.5 mmol/mol]), DPN prevalence was 11%. Compared with those without DPN, DPN participants were older, had higher HbA 1c , had longer duration of diabetes, were more likely to be female, and were less likely to have a college education and private insurance (all P < 0.001). DPN participants also were more likely to have cardiovascular disease (CVD) (P < 0.001), worse CVD risk factors of smoking (P 5 0.008), hypertriglyceridemia (P 5 0.002), higher BMI (P 5 0.009), retinopathy (P 5 0.004), reduced estimated glomerular filtration rate (P 5 0.02), and Charcot neuroarthropathy (P 5 0.002). There were no differences in insulin pump or continuous glucose monitor use, although DPN participants were more likely to have had severe hypoglycemia (P 5 0.04) and/or diabetic ketoacidosis (P < 0.001) in the past 3 months. CONCLUSIONSThe prevalence of DPN in this national cohort with type 1 diabetes is lower than in prior published reports but is reflective of current clinical care practices. These data also highlight that nonglycemic risk factors, such as CVD risk factors, severe hypoglycemia, diabetic ketoacidosis, and lower socioeconomic status, may also play a role in DPN development.Diabetic neuropathy is a prevalent complication in patients with diabetes and a major cause of morbidity and mortality (1). Among the various forms of diabetic neuropathy, distal symmetric polyneuropathy (DPN) and diabetic autonomic neuropathies are by far the most studied (1).

Breakfasts higher in protein lead to a greater reduction in hunger compared to breakfasts higher in carbohydrate. However, few studies have examined the impact of higher protein breakfasts with differing protein sources. Our objective was to determine if protein source (animal protein (AP) versus plant protein (PP)) influences postprandial metabolic response in participants consuming a high protein breakfast (~30% energy from protein). Normal weight (NW; n = 12) and overweight women (OW; n = 8) aging 18–36 were recruited to participate. Participants completed two visits in a randomized, cross-over design with one week between visits. Subjects had 15 minutes to consume each breakfast. Blood glucose and appetite were assessed at baseline, 15, 30, 45, 60, and 120 minutes postprandial. Participants kept a 24-hour dietary record for the duration of each test day. No difference was found between NW and OW participants or breakfasts for postprandial appetite responses. AP had a significantly lower glucose response at 30 minutes compared with PP (−11.6%; 127 ± 4 versus 112 ± 4 mg/dL; P < 0.05) and a slower return to baseline. There was no difference in daily energy intake between breakfasts. These data suggest that protein source may influence postprandial glucose response without significantly impacting appetite response in breakfast consumers.

While standard of care medical nutrition therapy for type 1 diabetes (T1D) centers on matching carbohydrate to insulin at meals, recent literature has shown superior glycemic control and cardiovascular measures with lower carbohydrate dietary patterns (&lt;130g/day) compared to the standard MyPlate (50% total calories as carbohydrate) approach. Aims: To determine if a 60-80 g CHO (LC) per day diet leads to improved glycemic control, cardiovascular, and inflammatory markers compared to the standard of care (SOC) (&gt; 150 g CHO per day). Methods: Participants (age 18-30) with T1D on insulin pump therapy were recruited from an endocrinology practice from May through December, 2018. Glycemic variability (continuous glucose monitor derived time in range (TIR), 70-180 mg/dL and hemoglobin A1c), total cholesterol, HDL, LDL, triglycerides (TRIG), and LDL particle number, and nutrient intake were assessed using a randomized cross over design with 12 week interventions of LC and SOC. An 8-week washout period was employed between interventions. Preliminary Results: Expressed Mean(SD). 11 subjects started the study and 5 withdrew due to noncompliance. Of the first 4 patients to finish the LC arm, mean TIR increased from 62.2 (16 .2) to 65.7 (16.2) %, + 3.5 (13.4)%; A1c decreased from 7.1 (0.6) to 6.7 (0.6), -0.5% (0.2); Total Cholesterol decreased from 186.3 (7.2) to 172.0 (25.7) mg/dL; LDL decreased from 104.8 (25.7) to 85.0 (9.2) mg/dL; HDL increased from 63.5 (21.9) to 69.8 (25.5) mg/dL; TRIG decreased from 89.5 (14.9) to 75.8 (21.4) mg/dL; LDL Particle number decreased from 1233.7 (286.6) to 1008.3 (61.5) nmol/L. Of the first 3 patients to finish SOC, no significant differences were seen. Conclusion: These preliminary results are encouraging, demonstrating that LC is associated with trends towards improvements in glycemic control (TIR and A1c) without deleterious effects on lipids. Larger more robust studies are needed for further exploration. Disclosure C.M. Crowder: None. D. Jelley: Research Support; Self; AbbVie Inc., AstraZeneca, Novo Nordisk Inc. M. Condren: None. L. Chalmers: None. J.L. Graef: None. Funding University of Oklahoma Health Sciences Center; Harold Hamm Diabetes Center; OU-TU School of Community Medicine; Dexcom, Inc.

Every day consumers vote which products line the shelves of grocery stores, coops , and niche markets by use of their dollars. Public unrest with regard to the environment, animal welfare, food purity, and human health impacts of agricultural production practices have led to the rise of alternatively produced food products. While the sales of alternatively produced foods are increasing, studies regarding the qualities of such products impact consumer purchases have yielded inconsistent results. This study examined students' perceptions of sensory aspects of conventionally produced and alternatively produced foods to better understand how sensory aspects impact decisions to purchase. Students reported consistent perceptions regarding the favorability of each sensory aspect of chicken and apples; the alternatively produced versions of the products yielded higher mean scores on every sensory aspect. However, students' perceptions of the sensory qualities of chocolate, milk, and beef were not consistent; for example, they reported more favorable perceptions of the appearance and smell of conventionally produced milk, but perceived a more favorable texture and flavor from the alternatively produced milk. The results of this study imply when making purchasing decisions, consumers may value specific sensory attributes over others. An alternative approach to marketing alternatively produced products is to focus on valued extrinsic aspects designed to attract consumers to purchase products in spite of their perhaps less valued perceptions of sensory aspects.

Currently, there is debate as to what the macronutrient composition of breakfast should be for optimal health. Studies have shown that subjects who eat a breakfast high in protein (PRO) stay fuller throughout day compared to subjects who consumed a carbohydrate (CHO)‐based breakfast. The objective of this study was to determine if protein quality (animal v plant) at breakfast makes a difference in postprandial (pp) satiety and glucose response when compared to a standard CHO‐based breakfast. Normal weight women (n=7) ages 18‐36 were provided 3 isocaloric breakfasts: animal PRO (30% PRO, 40% CHO, 30% fat), plant PRO (30% PRO, 45% CHO, 30% fat), and CHO‐based (20% PRO, 50% CHO, 30% fat). Breakfasts were consumed in a randomized, crossover design with at least a 1‐week washout period between each breakfast. Satiety and glucose measurements were taken at 0, 15, 30, 45, 60, 90, 120‐min postprandial. Subjects preferred (P < 0.05) the taste and appearance of the animal PRO over the plant PRO and CHO‐based breakfasts and the plant PRO was preferred (P < 0.05) to the CHO‐based breakfast. There was no significant difference in satiety response to the 3 breakfasts over the 2‐hour pp period. In addition, there was no significant difference in glucose response over the 2‐hour pp period. However, subjects had a lower peak in pp glucose at 30 min after consuming animal PRO (36.2%) compared to plant PRO (44%) and CHO‐based (47.8%). Although there is no difference in satiety response, these data suggest that consumption of an animal PRO breakfast results in a lower pp glucose response. Funded by University of Arkansas Honors Grant.