Diabetes Research and Clinical Practice - Volume 120 - Supplement 1 - October 2016

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PC-16
Ratio of insulin cessation in patients with new onset insulin
usage
Mustafa KULAKSIZOGLU1*, Ahmet KAYA1, Fatma OZDAMAR2.
1 Division of Endocrinology and Metabolism, Necmettin Erbakan
University, Meram Medical Faculty, 2Endocrinology and Metabolism
Division Diabetes Nurse, Necmettin Erbakan University, Meram
Medical Faculty, Turkey
A total of 138 patients whom insulin treatment was started for
glycemic regulation were enrolled into the study. Patients were
hospitalised for insulin education. After 6 months, patients
were evaluated again. Mean ages were 54.3 ± 11.09 years (30–
78), there were 66 males (47.82%), and 72 females (52.17%).
Diabetes duration was 6.7 ± 5.7 (0 –20) years, initial HbA1c was
% 10.9 ± 2.06 (7.9 –17.7). All patients were taking 2 gr/day
metformin and insulin treatment was started after cessation
of other oral antidiabetics. 82 patients (59.42%) were started
premix analog insulin, 16 patients (11.59%) were started long
acting analog insulin and 40 patients (28.98%) were taking
basal-bolus treatment. After glycemic control and education,
patients were discharged from the hospital.
After 6 months, control visit was done. 93 (67.39%) patients
were taking the same insulin treatment. In 17 patients (12.31%)
insulin treatment regimen was changed by other doctors, 28
(20.28%) patients reported that they stopped insulin treatment
after discharge. Reasons for cessation were; fear of hypogly-
cemia, fear of injection and fear of addiction.
As a result majority of patients who were hospitalised
and started insulin treatment stopped insulin injections
right after the discharge. Some patients’ s treatment strategies
were changed by other doctors. These are factors that lead to
glycemic dysregulation and chronic complications. Only
continuing education can get over these barriers.
PC-17
The impact of seasonal lifestyle changes on glycemic control in
T2DM – Based on Diabetes Case Management Program 2001,
Taiwan
Kuei-Mei YEH 1*, Martin M-T FUH1, Chia-Ing LI2. 1China Medical
University Hospital, Department of Metabolism, 2China Medical
University Hospital, Department of Medical Research, Taiwan
Background and aims: In order to evaluate the impact of sea-
sonal lifestyle changes on the glycemic control of diabetes for
the ensuing development of personalized prevention program.
Materials and methods: From Jan. 2006 to Dec. 2012, 131
patients with T2DMparticipating randomly in DCMP 2001 with
lifestyle intervention only without having any medication
were under study. Accordingly, anthropometric and biochem-
ical data were measured at least at 3-month interval and the
lifestyle measurements (lifestyle I: no smoking, no alcoholic
and regular exercise; lifestyle II: smoking and/or alcoholic
and/or no exercise), total daily caloric intakes, macronutrient
consumptions and dietary recommendations were also tri-
monthly recorded in each diabetes patient after seeing
physician. Participants were divided into 2 groups based on
the age recruited, <65 and 65 years in the DCMP 2001. The
fasting blood glucose (FBS mg/dL) and A1c (%) levels were
presented by Mean ± SD. Data comparison between the initial
FBG and A1c level and the chronologically sequential season
changes of FBG and A1c level within each group were
consecutively performed in the continuous 5 years. Student-t
test was used for data analysis.
Results: The general characteristics of 131 study participants
with their FBG and A1c levels in 2 groups were demonstrated in
Poster Table 1. The statistically significant differences of FBG
and A1c level between the first recruited and sequential
season changes for continuous 5 years were shown (p < 0.05)
in Poster Tables 2 and 3.
Conclusion: The results clearly suggested that the impact of
lifestyle in different seasons on the glycemic control was
significantly different that was also demonstrated in different
age groups. The stability of lifestyle attributed to glycemic
changes was more stable in patients with age more than 65.
Further study would be required.
PC-18
Geographic difference of barriers to insulin initiation in
primary care physicians in Taiwan
Yin-Huei CHEN1,2, Yi-Chih HUNG1,2, Chia-Ing LI3,
Man-Ping CHANG4, Ching-Chu CHEN1,5 *. 1Division of
Endocrinology and Metabolism, Department of Medicine, China
Medical University Hospital,2Department of Medicine, ChinaMedical
University, 3Department of Medical Research, China Medical
University Hospital, 4Department of Nursing, School of Health,
National Taichung University of Science and Technology, 5School of
Chinese Medicine, China Medical University, Taichung, Taiwan
Aims: Insulin initiation is often delayed among type 2 diabetes
patients with suboptimal glycemic control. Previous studies
showed that difference in patient characteristics across
countries along with physician and healthcare environment
difference may contribute to the likelihood of insulin intensi-
fication. However, the geographic difference of barriers to
insulin initiation in one country is not well understood. In
this study, we examined the geographic difference of barriers
to initiate insulin treatment among Taiwan primary care
physicians.
Methods: We conducted a cross-sectional, questionnaire-
based survey. The participants were categorized as follows
based on their clinical practice place: Northern Taiwan, Central
Taiwan and Southern Taiwan. We used a 24-item question-
naire to explore barriers for primary care physicians timely to
initiate insulin. Physicians who didn’t have insulin-treated
patients were excluded.
Results: 240 participating physicians whose clinical setting
were in Northern Taiwan (n = 85), Central Taiwan (n = 80) and
Southern Taiwan (n = 75) met eligibility criteria and completed
the questionnaire. After adjusting for clinical setting before
private practice, specialty, participating pay for performance
and number of insulin-treated patients per month, physicians
in Northern Taiwan have more concerns about insulin
initiation than physicians in Southern Taiwan. The difference
was observed with regard to the “physician and personnel
issue”, “time consuming” and “concerns regarding insulin
therapy” (Northern Taiwan vs. Southern Taiwan, P = 0.002;
0.003; 0.002, respectively).
Conclusions: Compared with primary care physicians in
Southern Taiwan, physicians in Northern Taiwan have
higher barriers to insulin initiation. Their concerns about
insulin use may lead to delay of insulin treatment.
Optimizing Diabetes Therapy
PD-01
The association of glycated albumin and hemoglobin A1c with
glycemic excursions in Chinese type 2 diabetic patients
Qing LI1–3*, Yuqian BAO1–3, Weiping JIA1–3, Jieming PAN 1–3,
Lei ZHANG1– 3, Junling TANG1–3. 1Shanghai Jiaotong University
affiliated Sixth People’s Hospital, 2Department of Endocrinology and
Metabolism, 3Shanghai Clinical Center for Diabetes, China
Background: Hemoglobin A1c (HbA1c) is mostly used to
evaluate the long-term glycemic control and the risk for the
development of complications in diabetes. Serum glycated
albumin(GA) has been reported to be a useful and rapid
indicator of glycemic control for diabetic patients. Postprandial
glucose excursion is known to be a risk factor for diabetic
micro- and macro-angiopathy in diabetic patients recently
studies indicated that glycation excursion could influence
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S91