Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

amputation, and death. COC and medical expense and

organization of care were counted as independent variables.

Result:

Re-amputation rate is 23.26%, 1/3 amputated diabetes

have been received

≧

3 times amputation. The highest risk of

amputation and re-amputation is high COC, which are 1.26

times (p < 0.001) and 1.62 times (p < 0.001). Amputated dia-

betes patient had 3 times (p < 0.001) risk of specific diabetes

associated death. Different medical organization type was not

related to the risk of amputation. Low COC was related to

poorer vascular and neurological outcome.

Conclusion:

We believed that diabetic foot care was a missing

circle of the chain of multidiscipline diabetes care chain.

PC-08

A patient centred care service model for enhancing Diabetes

Mellitus management in primary care

Jun LIANG

*, M.L. CHAN

, C.W. LO

Department of Family

Medicine and Primary Health Care, New Territories West Cluster,

Hospital Authority, Hong Kong

Background:

Diabetes Mellitus is an important disease

managed in primary care setting. We have more than 40,000

DM patients with regular follow-up and management at 8

General Out-patient Clinics (GOPCs). This review aimed at

assessment of the impact of this service model.

Aims:

1/ To review the clinical outcome of the servicemodel, in

term of key performance indexes [KPI] such as HbA1c,BP and

LDL level

Methodology:

Since March 2011, our clinics has implemented

this structured integrated service model to enhance the

quality care of DM patients, via structural and protocol-

driven approved, provided by multidisciplinary professionals.

The patients would be stratified into various risk categories for

management by their usual doctors, nursing specialists, allied

health professionals or experienced family physician for

advance medical support such as insulin initiation and

titration.

Ongoing quality data in term of various KPIs were retrieved for

clinic peer review for service enhancement and patient care

management.

Results:

The KPIs after the implementation were promising

with currently 50% of patient HbA1c < 7%, 50% of patient

BP < 130/80 mmHg & 65% of patient LDL < 2.6 mmol/L.

Conclusion:

This service model is well-accepted by the

patients with more than 85,000 attendances and over 90% of

diabetic patients have benefited from this over 5 years. With

the structural model provided by the primary care team and

regular KPIs review, the patients

’

chronic disease care

improved and sustained, comparable to many international

standard.

PC-09

Effects of resistance exercise in the deteriorations of cardiac

contractility and mitochondrial uncoupling in cardiac muscle

of diabetic animal model

Tae Hee KO

, Hyoung Kyu KIM

, Tae Nyun KIM

Byoung Doo RHEE

, Kyung Soo KO

, Nari KIM

Jong Chul WON

*, Jin HAN

Department of Physiology, College of

Medicine, Cardiovascular and Metabolic Disease Center, Inje

University, Busan,

Department of Internal Medicine, Haeundae Paik

Hospital, Cardiovascular and Metabolic Disease Center, College of

Medicine, Inje University,

Department of Internal Medicine, Sanggye

Paik Hospital, Cardiovascular and Metabolic Disease Center, College

of Medicine, Inje University, Seoul, Korea

Background:

Cardiomyopathy (CMP) in patients with type 2

diabetes is an important complication of long-standing

hyperglycemia and known to be caused by characterized by

diabetes-induced metabolic and mitochondrial disturbance.

Resistance exercise (RE) has been recommended for measures

of life-style modification in patients with type 2 diabetes. To

date, the beneficial effects of RE in prevention of diabetic CMP

and mitochondrial dysfunction of cardiomyocyte are uncer-

tain. The aimof this study was to determine the effects of RE in

the cardiac contractility and mitochondrial dysfunction in

diabetic animal model.

Design and methods:

Fourteen Otsuka Long Evans Tokushima

Fatty (OLETF) rats were assigned to sedentary control (SC, n = 7)

and resistance exercise (RE, n = 7) groups at 26 weeks of age.

Long-Evans Tokushima Otsuka (LETO, n = 7) rats were used as

non-diabetic control. RE rats were trained by climbing a ladder

5 days per week. Body weight, lipid profiles, and IPGTT were

evaluated at the time of 12 weeks exercise. In addition, cardiac

function and mitochondrial structure of cardiomyocyte were

assessed by echocardiography and electron microscopy.

Mitochondrial respiration and ROS productionweremeasured.

Results:

Weight gain and metabolic alterations characteristic

of OLETF rats (SC) compared to LETO were reduced in RE rats

despite to similar food consumption after 12 weeks of exercise.

Reductions of ejection fraction and fractional shortening in SC

were significantly reversed by RE. Collapsed sarcomeres and

decreased number of mitochondria in SC were not observed in

RE rats. In addition, decreased expression of the peroxisome

proliferator-activated receptor gamma coactivator 1

(PGC-1

)

and mitochondrial transcription factor A (TFAM) in SC were

attenuated in RE. Higher proton leak in cardiomyocytes of SC

represented by different mitochondrial oxygen consumption

rate between oligomycin and antimycin A was attenuated in

those of RE rats. Finally, increased production of ROS with

lower mitochondrial membrane potentials were revered in SC

with higher expression of mitochondrial superoxide dismu-

tase 2 (SOD2).

Conclusion:

These data suggested that RE is effective in

the prevention of diabetic CMP in relation to attenuation of

metabolic disturbances andmitochondrial dysfunction, which

may contribute to decreased contractility of diabetic heart in

animal models.

PC-11

The relationships between fasting plasma glucose and insulin

resistance, first-, second-phase insulin secretion and glucose

effectiveness in adolescents

Te-Lin HSIA

*, Dee PEI

, Chung-Ze WU

, Jun-Dian LIN

Yang-Lin CHEN

Cardinal Tien Hospital,

Shung Ho Hospital,

Tri-

Service General Hospital, Taiwan

It is generally agreed that there are four factors which

contribute to the occurrence of type 2 diabetes, namely,

increased insulin resistance (IR), decreased glucose effective-

ness (GE), first and second phase insulin secretion (FPIS, SPIS,

respectively). Although these factors are studied. However,

most of the literatures are non-Asian and with limited

numbers of subjects. In the same time, there are no reports

for adolescents. In this report, we investigated the relation-

ships between fasting plasma glucose (FPG) and these four

factors in a 18-year-old cohort.

We enrolled 507 subjects; 18-year-old adolescents. The IR, GE,

FPIS and SPIS were calculated by the equations we published.

In short, by using age, body mass index (BMI) and metabolic

components, these for factors could be estimated. The

correlation between FPG and the four factors.

Results:

BMI was 20.11 ± 1.43 kg/m

, systolic and diastolic

blood pressure was 116.46 ± 12.54 and 65.00 ± 8.97 mmHg, FPG

was 93.13 ± 6.50 mg/dL, triglyceride was 70.98 ± 27.30 mg/dL

and HDL-cholesterol was 51.8 ± 10.7 mg/dL. The IR was 3.67 ±

0.014 mmol/L, FPIS was 61.48 ± 26.30

U/min, SPIS was 0.0402

± 0.0095 pmol/mmol and GE was 0.0221 ± 0.0009 min

−

. The

correlation between FPG, IR, FPIS, SPIS and GE are 0.031,

−

0.132,

−

0.217 and

−

0.331 respectively. Other than the FPG and IR, all

other correlations are statistically significant (p < 0.001).

Conclusion:

In this 18-year-old adolescent cohort, elevation of

FPG is mainly due to the decrease in the FPIS, SPIS and GE.

Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65

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