Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

174 ± 29 mg/dL), respectively. The A1c level and A1C target rate

(A1c < 7.0%) decreased by 2.5 ± 1.7%; P < 0.001 (10.2 ± 1.8% to

7.8 ± 0.9%) and increased from 0% to 27.5%, respectively.

Conclusion:

The twice daily premixed insulin therapy, in

combination with a series of diet and health education classes,

regular exercise, and active blood glucose monitoring can be

used to significantly improve the blood glucose levels for Type

II diabetes patients with histories of OAD and basic insulin

therapy.

PD-30

Combination of liraglutide and sitagliptin therapy improves

glycemic control in Japanese patients with type 2 diabetes

mellitus

Yuki MATSUHASHI

, Shinji CHIKAZAWA

*, Hideyuki OTAKA

Kazuhisa TAKAHASHI

, Aya KABMA

, Koki MATSUMURA

Kota MATSUKI

, Eri SATO

, Jutaro TANABE

Miyuki YANAGIMACHI

, Hiroshi MURAKAMI

Makoto DAIMON

Hirosaki University Graduate School of

Medicine, Japan

Aim:

Liraglutide is a glucagon-like peptide-1(GLP-1) analogue

and a GLP-1 mimetic. Sitagliptin is a highly-selective dipepti-

dyl peptide-4(DPP-4) inhibitor. GLP-1 mimetics and DPP-4

inhibitors are widely used in combination with various kinds

of other oral anti-diabetic drugs (OADs) and insulin in Japan.

We evaluated the efficacy of sitagliptin when added to

liraglutide.

Methods:

Japanese type 2 diabetes mellitus (T2DM) patients

with inadequate control of HbA1c (HbA1c>=7.0) who treated

with 0.9 mg of liraglutide subcutaneously once daily

(maximum dosage in Japan) were enrolled in this study

(n = 10). Additional therapy was as follows; OADs (n = 1),

insulin and OADs (n = 9, insulin dosage was 18.0 ± 10.0 units/

day). Means of age, duration of diabetes, body weight (BW) and

body mass index (BMI) were 58.6 ± 12.2 years old, 18.0 ± 7.7

years, 73.4 ± 13.8 kg and 29.3 ± 6.0 kg/m

, respectively. HbA1c,

glycated albumin (GA), fasting plasma glucose (FPG), insulin

(IRI), C-peptide (CPR) and glucagon were measured. Index

of insulin resistance (HOMA-R) and insulin secretion (SUIT

index) were calculated as follows; HOMA-R = IRI*FPG/405,

SUIT index = 1485*CPR/ (FPG-61.8). BW and body compositions

(body fat mass; BFM, lean body mass; LBM, total body water;

TBW, protein and minerals) were analysed using the bioelec-

trical impedance analyser. 50 mg of sitagliptin was added

without altering previous therapy. Each parameter was

compared using repeated-measure ANOVA. Differences of

each parameters between baseline to those in 12 weeks were

calculated. P < 0.05 was defined as statistically significant. Data

was mean ± standard deviation (SD).

Result:

HbA1c and GA were decreased from 8.64 ± 1.43% to

8.19 ± 1.35% and from 21.8 ± 4.6% to 19.6 ± 4.9% (p = 0.003 and

p = 0.005, respectively). FPG was reduced from 181.7 ± 22.8 to

150.5 ± 23.4 mg/dL (p = 0.008). SUIT index was increased from

33.8 ± 25.5 to 40.0 ± 31.0 (p = 0.017); while HOMA-R was not

changed significantly from 7.3 ± 5.1 to 6.3 ± 6.8 (p = 0.243). BW

was not decreased significantly from 73.4 ± 13.8 to 73.1 ± 13.6

kg (p = 0.795). Simple regression analysis showed that

HbA1c

was correlated with AST(r = 0.701, p = 0.024), ALT(r = 0.670,

p = 0.034),

GTP (r = 0.778, p = 0.008), and with or without

diabetic retinopathy(r = 0.555, p = 0.096).

GA was also corre-

lated with AST (r = 0.870, p = 0.001), ALT (r = 0.909, p = 0.001),

GTP (r = 0.930, p < 0.001) and

glucagon (r = 0.652, p = 0.041).

Conclusion:

Combination of liraglutide and sitagliptin therapy

significantly improved glycemic control and insulin secretion.

The present data showed that the improvement of glycemic

control was correlated with liver finction and reduction of

glucagon concentration. The GLP-1 receptor was expressed

vrious organs including the pancreas and GLP-1 mimetic

activate the GLP-1 receptors, whereas the predominant

mechanism of DPP-4 inhibitor was reported to be the local

inhibition of intestinal DPP-4 activity and activation of the

neural axis(gut-to-pancreas). Our data showed that combin-

ation of liraglutide and sitagliptin therapy can be effective in

the treatment of Japanese patients with T2DM.

PD-31

Additional effect of metformin and celecoxib against lipid

dysregulation and adipose tissue inflammation in high-fat fed

rats with insulin resistance

Chieh-Hua LU

1,2

, Yi-Jen HUNG

, Po-Shiuan HSIEH

–

Department of Internal Medicine, Division of Endocrinology and

Metabolism, Tri-Service General Hospital, National Defense Medical

Center (NDMC),

Department of Medical Research, NDMC,

Department of Physiology and Biophysics, NDMC,

Institute of

Preventive Medicine, NDMC, Taipei, Taiwan

Aim:

We determined the potential synergistic effect of

metformin and celecoxib, a selective COX-2 inhibitor, on

obesity-induced adipose tissue (AT) inflammation, insulin

resistance (IR), fatty liver, and high blood pressure in high-fat

fed rats (HFa).

Material and method: Male Sprague-Dawley rats were fed

separately a regular or HF diet for 8 weeks. Then, rats fed the

regular diet were further treated with vehicle for 4 weeks. Rats

fed the HF diet were further divided into 6 groups co-treated

with vehicle, celecoxib (30 mg/kg/day), metformin (300 mg/kg/

day), metformin (150 mg/kg/day), metformin (300 mg/kg/day)

with celecoxib (30 mg/kg/day), andmetformin (150 mg/kg/day)

with celecoxib (15 mg/kg/day) for an additional 4 weeks.

Results:

The HF diet-induced increase in body weight was

significantly suppressed in the metformin alone and metfor-

min combined with celecoxib groups, but not in the celecoxib

alone group. The increases in the HOMA-IR value and the area

under the curve of glucose following an oral glucose tolerance

test, systolic blood pressure, and adipocyte size were signifi-

cantly diminished in treated rats, especially rats undergoing

combined treatment. The augmentation of AT macrophage

infiltration, as well as AT TNF-, MCP-1, and leptin levels in HFa,

were significantly suppressed in the treated groups, especially

in rats treated in combinationwith celecoxib. Furthermore, the

elevated hepatic triglycerides content was significantly

decreased in the combined treatment group when compared

to celecoxib or metformin alone.

Conclusion:

A COX-2 inhibitor exerts a synergistic beneficial

effect with metformin on and obesity-associated metabolic

and cardiovascular disorders in high-fat fed rats.

PD-32

Assessment of Romanian Type 2 Diabetes patients treated

with insulin glargine after failure of non-insulin therapy in

daily clinical practice

Cristian GUJA

*, Gina BOTNARIU

, Anca CERGHIZAN

Mihaela DINCA

, Amorin POPA

, Gina SUCIU

National

Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest,

University of Medicine and Pharmacy

“

Grigore T. Popa

”

, Iaşi,

Clinical Center of Diabetes, Nutrition and Metabolic Diseases, Cluj

Napoca,

Clinical Center of Diabetes, Nutrition and Metabolic

Diseases, Craiova,

Diabetes and Internal Medicine Clinic, Emergency

Clinical County Hospital, Oradea,

Clinical Center of Diabetes,

Nutrition and Metabolic Diseases, Targu Mures, Romania

Background:

Large scale prospective studies showed that tight

metabolic control reduces microvascular complications and, if

implemented soon after diabetes diagnosis, is associated with

long-term reduction in macrovascular disease. In the 2012

EASD/ADA position statement, insulin (usually as basal

insulin) can be recommended already from the second stage,

immediately after metformin monotherapy failure.

Aim:

The aim of our study was to assess in daily clinical

practice in Romania the metabolic control of T2D patients

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

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