Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

change of 7-point SMBG at week 24 showed that LM50 group

reduced post-breakfast and post-dinner glucose concentra-

tions more significantly compared with basal-plus group. The

decrease from baseline in fasting blood glucose was signifi-

cantly greater in the basal-plus group compared with the LM50

group. Body weight increased 0.95 and 1.45 kg in basal-plus

group and LM50 group, respectively. Meanwhile, there was

significant increase in themean daily insulin dose of 20.4 units

in LM50 group and 34.6 units in basal-plus group (P < 0.05). Six

patients intensified their insulin to basal insulin plus two

mealtime glulisine, while seven patients to thrice daily mid-

mixed insulin. Overall, 15%of patients experienced at least one

hypoglycemic event in both groups.

Conclusion:

In a real-world setting, intensification of insulin

therapy from basal failure to basal insulin plus mealtime

glulisine or twice-daily mid-mixed insulin has similar effects

on HbA1c reduction, hypoglycemia events and body weight

change in Taiwan patients with T2D.

PD-10

Kidney function assessment based on eGFR may broaden

metformin eligibility rather than serum creatinine

Uru OSADA

*, Hiroto SASAKI

, Yuya TAKANO

Yuko MUROHASHI

, Takaharu INAZUMI

, Yasuo TERAUCHI

Hiroshi SUNAGAWA

Department of Diabetes and Endocrinology,

Saiseikai Yokohama City Nanbu Hospital,

Department of Diabetes

and Endocrinology, Yokohama City University Graduate School of

Medicine,

Sunagawa Medical Clinic, Japan

Objective:

When considering metformin eligibility, Japanese

Diabetes Society (JDS) and US Food and Drug Administration

recommend serum creatinine (sCr) as a clinical indicator,

whereas Kidney Disease: Improving Global Outomes (KDIGO)

guideline recommends using estimated glomerular filtration

rate (eGFR). We investigated the discrepancy of the two

assessment strategy and also analyzed the frequency and

the clinical factors of metformin prescription.

Research design and methods:

This is a cross-sectional study

of 1364 diabetic patients in our hospitals. The upper threshold

of sCr for metformin eligibility was 1.3 mg/dL for male and

1.2 mg/dL for female according to JDS recommendation. The

lowest threshold of eGFR was 30 mL/min/1.73 m

according to

KDIGO guideline. We first described the patients who was

contraindicated by sCr but was not by eGFR. We next revealed

the clinical background of these patients according to the

presence of metformin prescription. Lastly, the contributing

factors to metformin prescription were searched by multivari-

ate logistic analysis.

Results:

Totally 130 patients showed sCr above JDS threshold.

Among these, 61(47%) patients showed eGFR over 30 mL/min/

1.73 m

, however, only 14 (23%) were prescribed metformin.

The patients with and without metformin prescription were

similar in gender, age and HbA1c (7.7 ± 0.7% vs 8.1 ± 1.6%,

p = 0.35). Also the prevalence of lactic acidosis (LA) risk was

not different between the groups; (1) age, (2) alcohol use, (3)

coronary artery disease, (4) congestive heart failure, (5) liver

disease, (6) ketosis or severe infection, (7) pregnancy and

(8) insulin dependent diabetes. However, the patients

with metformin prescription exceeded in BMI (28.9 ± 4.7 vs

25.6 ± 4.6, p = 0.02) and concomitant use of other oral anti-

diabetic agent (2.5 ± 0.9 vs 1.1 ± 1.0, p = 0.0001). In multivariate

logistic analysis adjusting covariates such as gender, age, BMI,

HbA1c, every 10 mL/min/1.73 m

increase of eGFR, heavy

alcohol use (>5 days/week), coronary artery disease, number

of LA risk factors, number of concomitant oral anti-diabetic

agent and insulin use, only the number of concomitant oral

anti-diabetic agent was significantly associated with metfor-

min prescription (odds ratio 4.3, 95% confidence interval 1.8

–

14.5, P = 0.005).

Conclusion:

The assessment of eGFR rather than sCr may

promote metformin prescription without increasing LA.

PD-11

Improving postprandial blood glucose of type 2 diabetes

patients

Su-Yen LIU

*, Su-Chen LIN

, Jia-Lin CHEN

, Ming-Hui CHEN

Xiu-Wen LUO

Chi Mei Foundation Hopital, Taiwan

This study is a follow-up investigation for type 2 diabetes

patients who have received basic insulin (once a day;

intermediate and long-acting) treatment for more than three

months, who still had fasting plasma glucose of (FPG) less than

150 mg/dL, HbA1c > 7%. These patients were transitioned to

pre-mixed insulin injection twice a day. Since Feb to Aug

2015, there were 47 participants, and 42 of which have

completed the follow-up. Telephone consultation was used

as the health educationmethod in this study, where 163 phone

calls in total were made for the duration of this investigation.

The pre- and post-transition glycated hemoglobin (GH) levels

were 9.7 ± 1.58% and 8.4 ± 1.57%, respectively (overall reduction

of 1.3%). The pre- and post-transition FPG and postprandial

blood glucose (PBG) were 146.2 ± 47.5 mg/dL and 131.6 ± 33.2

mg/dL; and 293.0 ± 74.9 mg/dL and 204.3 ± 54.5 mg/dL, respect-

ively. 26.2%, 31.0%, and 35.7% of the post-transition patients

were determined with GH of <7%, FPG of <110 mg/dL, and FPG

<180 mg/dL, respectively, indicating a significant difference in

the GH, FPG, and PBG levels after the insulin treatment

transition.

Individualized one-on-one interactive consultation can be

used to encourage patient to monitor their blood sugar level

proactively and treat FPG and PBG as equally important. The

timely resolution of questions and assistance, in combination

with health care education group intervention, and promote

patient health and self-reliance.

PD-12

The effectiveness of diabetes care by using multiple

interventions

Ming-Hui CHEN

*, Su-Yen LIU

, Jia-Lin SHEN

, Kai-Jen TIEN

Chwen-Yi YANG

Nursing Department, Chi-Mei Medical Center,

Endocrinology, Chi-Mei Medical Center, Taiwan

Project objective is to improve blood sugar and correct wrong

behaviors by using multiple interventions, including individ-

ual and group health education, which guides the patient self-

reaction, and share the experience of coexistence with

diabetes and correct misconceptions. Recruitment is from

March 1, 2015 until October 31, 2015 at someone of medical

center of south of Taiwan. Recruitment of patients with HbA1c

higher than 7.5 and patients agreed to participate in commu-

nity health education and individual health education of more

than 2 times and telephone interview at least twice. Patients

follow at least three months.

Recruit in a total of 30 people, but only 28 finish final test,

because one death, one person perform bariatric surgery at

other hospital and not return. Weight, BMI have no significant

change, HbA1C,fasting blood sugar and postprandial blood

sugar, blood sugar fluctuations, eating behavior, exercise and

self-monitoring of blood glucose behavior have improvement

of statistical significance (p < 0.05; p < 0.00). An average score of

group health education satisfaction is 4.6 points (out of 5).

PD-13

Metformin suppresses gastric cancer cell growth through

inducing cell cycle arrest at G2/M phases

You-Zuo CHEN

1,2

, Li-Feng LIU

, Kuo-Wang TSAI

1,3

Mei-Chen LIAO

, Chih-Kuang LIANG

4,5

, Ming-Yueh CHOU

Hing-Chung LAM

4,6

Department of Medical Education and

Research, Kaohsiung Veterans General Hospital,

Department of

Biological Science and Technology, I-Shou University, Kaohsiung City,

Department of Chemical Biology, National Pingtung University of

Education, Pingtung County,

Center for Geriatrics and Gerontology,

Kaohsiung Veterans General Hospital,

Division of Neurology,

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

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