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

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PD-07
Self-perceived low-carbohydrate dieters in diabetes clinic in
Japan and their actual behavior
Yomogi FUKAZAWA1*, Kaoru SASAKI1, Fumie OKAZAKI1,
Asako MURAI 2, Mayumi HAKOGI2, Masayu KUNISADA2,
Reiko TOKUNAGA 1, Miyuki NOGAWA1, Yuko WATANABE2,
Hitomi FUJII 2, Takaichi MIYAKAWA1. 1Kunitachi Mirai Clinic,
2 Tama-center Mirai Clinic, Japan
We have eaten rice as staple food in Japan. Even the Japan
Diabetes Society has recommended getting 60% of all calories
from carbohydrates.
However, the “Low-carbohydrate diet ” to reduce body weight
has been popular in developed countries and also cessation or
decreasing carbohydrates has been recognized as being
effective and an easy way to implement fair glycemic control
in the relatively short-term. We investigated the influence of
media and patients understanding about low-carbohydrate
diets using questionnaires and face to face discussions with
diabetes patients.
We administered a questionnaire of 12 questions and asked to
diabetes patients to fill them in. The answers and consent
were obtained from 150 patients (96 male and 54 female),
average age was 68.5 (SD: 12.3) y/o, BMI was 25.6 (5.0), HbA1c
7.17 (1.05) %.
88 patients (61 male and 54 female: chi-squire test: n.s.)
answered that they practiced low-carb diet. The “low-carb”
group had lower HbA1c (p < 0.04), and BMI (p < 0.01). Had a
longer duration of illness (p < 0.05), and less diet consultation
with a dietitian (p < 0.05). The most chosen reason to practice
this diet was “to improve HbA1c (93%)”, however their HbA1c
was not significantly better. Other reasons were “to loseweight
(29%) ” and “ recommended on TV (11%)”. People who reduced
or cut staple food in “all three meals” tended to be older than
those who did only “1–2 meals” (p < 0.001). On the other hand,
people who answered “to eat fruit three times a day ” were
older (p < 0.01). Patients who did not go on a “low-carb” diet
tended to choose the correct answer of carbohydrate –rich food
(such as grains, fruit, and sweets) ” more than those who said
that they did the “low-carb” diet. 79% of all the patients
answered that they did not drink vegetable juice and this is
thought to be because of our educational exhibition about the
amount of sugar contained in drinks ”. 64% of the “low-carb”
dieters answered that a “low-carb” diet was effective for
diabetic kidney disease.
“ Low-carb” dieters had relatively good control in glucose and
body weight. They were interested in diabetes control.
However they received less diet consultation from dietitian.
Even when they said they eat “low-carb” food, not all of them
correctly answered about “carb- rich food”. They were “self-
perceived ” low-carb dieters. Some people misunderstood
“ low-carb” food as good for diabetic kidney disease. They
need appropriate information about diet.
PD-08
Effect of the therapy of weekly-GLP1 analog given monthly to
eldery type 2 diabetes patients
Rui IMAMINE 1*, Ai SATOU1, Hajime MASE1,
Asako MIZOGUCHI1, Makiko MINATOGUCHI1,
Minoru KUSAMA1, Atsuko WATARAI2, Takahiko KAWAMURA2,
Eitaro NAKASHIMA 1. 1Chubu Rosai Hospital Diabetes and
Endocrinology, 2Chubu Rosai Hospital Preventive Medical Center,
Japan
Objective: Japan is one of the world’s leading nations in terms
of longevity. In addition, the Japanese people are prone to
diabetes. For dementia patients and for elderly patients living
alone, compliance with drug therapy can be seen in many
cases as risky. So, GLP1 analog formulations administered
once a week has been shown as an effective treatment against
type 2 diabetes mellitus in the elderly. In this study, it was
evaluated when administered once a month.
Research and methods: To target type 2 diabetes mellitus
patients, 13 outpatients at our hospital (5 male/8 female) over
the age of 67 were administered weekly-exenatide once a
month. HbA1c, 1, 5-anhydroglucitol [1, 5-AG], urine albumin-
to-creatinine ratio [U-Alb/Cr], as well as a treatment satisfac-
tion survey were also carried out. The effects of monthly
administration were compared with those administered once
a week with patients with type 2 diabetes in 17 people (11
male/6 female) over the age of 35.
Results:
1. Background for monthly dose group: Age 77.2 ± 6.9 (mean
± SD) years, type2 diabetes duration 20.4 ± 7.4 years, HbA1c
7.7 ± 0.4%, BMI 24.7 ± 3.7
2. After 3 months HbA1c; 7.1 ± 0.5% (p < 0.01)
3. After 2 months BMI; 24.3 ± 4.1 (p < 0.05)
4. Compared with weekly dose group (Age 64.6 ± 14.0 years,
type 2 diabetes duration 17.4 ± 8.0 years, HbA1c 8.7 ± 1.2%,
BMI 27.6 ± 5.5): Change of HbA1c after 3 months;
−0.68 ± 0.2% vs. −1.19 ± 1.4% (n.s.). A significant difference
in 1,5AG and U-Alb/Cr, in both groups, before and after
administration was not observed. In the treatment
satisfaction survey after the administration, no significant
difference in the two groups was observed. In elderly
patients with type 2 diabetes who were given a weekly
GLP1 analog administered once a month, compared to the
previous administration, a promising improvement in
HbA1c and BMI was seen. When compared to the weekly
administration group, no significant difference in the
amount of change in HbA1c was observed.
Conclusions: For aged patients with type 2 diabetes, the
usefulness of the method of treatment of administering
a GLP1 analog monthly as opposed to weekly could be
confirmed.
We will continue to follow up as part of the treatment of the
elderly with type 2 diabetes.
PD-09
Insulin intensification with basal plus mealtime insulin or
mid-mixture premixed insulin in type 2 diabetes in real-world
clinical practice
Yi-Sun YANG1,4, Chien-Ning HUANG1,4*, Edy KORNELIUS1,4,
Shih-Chang LO1, Yueh-Chu WU 2, Ching-Lu LI2, Yu-Tze LIN2,
Hui-Wen HSIAO2, Tin-Wen CHIA3. 1CHUNG-Shan Medical
University Hospital, Endocrinology and Metabolism, 2Department of
Nursing, Chung-Shan Medical University Hospital, 3Department of
Nutrition, Chung-Shan Medical University Hospital, 4Chung-Shan
Medical University, Institute of Medicine, Taiwan
Insulin Intensification with Basal plus Mealtime Insulin or
Mid-mixture Premixed Insulin in Taiwanese Type 2 Diabetic
Patients Inadequately Controlled on Basal Insulin with or
without Oral Antidiabetic Drugs in Real-World Practice.
Background: This study was performed to compare the
efficacy of basal once-daily glargine plus mealtime glulisine
(basal-plus group) with twice-daily mid-mixed insulin (LM50
group) in Taiwan patients with type 2 diabetes (T2D) inad-
equately controlled by basal insulin with or without oral anti-
diabetic drugs (OADs) in real-world practice.
Methods: This single-center, non-interventional, prospective,
observational study enrolled T2D patients with inadequate
glycemic control (glycosylated hemoglobin [HbA1c] ≥7.5%)
who had been on basal with or without OADs for ≥3 months
and were already decided to intensify insulin therapy by their
physician prior to the start of the study. All treatment decisions
were at the physician’s discretion to reflect real-world practice.
Results: A total of 71 patients were included in the analysis
(mean duration of diabetes, 12.8 ± 5.8 years; mean HbA1c,
9.02 ± 1.2%). After 24 weeks of insulin intensification therapy,
HbA1c decreased −0.68% and −0.62% in basal-plus group and
LM50 group, respectively, which was not significant. The
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S94