Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

Djulis hull supplements on the three hour postprandial

plasma glucose (PPG) of Type II diabetes patients. A total of

10 outpatient participants were enrolled in this study. The

participants were asked to take or not to take a Djulis hull (5 or

10 g), prior to their standard meal consisting of 75 g of glucose

water. The patient PPG levels at 30, 60, 90, 120, and 180minutes

after meal were compared to two measurements of their

fasting plasma glucose (FPG) levels. The study results indi-

cated: four of the participants exhibited decrease of area under

the PPG curve over 180 mins; four of the participants exhibited

delayed glycemic response, yet, with no reduction in the area

under the PPG curve; and the other two patients showed no

PPG effect with the intake of Djulis hull. It was determined that

the dietary fiber rich Djulis hull can have PPG effects that are

high individual specific. Therefore, it is suggested that when

eating high-fiber diet, Type II diabetes patients should

consider their individual glycemic response for adjusting

their medication dosage or timing strategies.

PD-46

The effect of transglucosidase for improving postprandial

blood glucose of Type II diabetes patients

Wen-hui CHEN

*, Tzu-Ying WU

Nutrition Division of Lukang

branch of Changhua Christian Hospital (CCH), Taiwan

Transglucosidase (TGD) can be obtained from the fermenta-

tion of Aspergillus Niger. This enzyme can catalyze carbohy-

drate in the digestive tract into unabsorbable oligosaccharides.

Therefore, it is suspected that TGD can be used for lowering

postprandial blood glucose (PBG) of diabetes patients. A total of

nine Type II diabetes outpatient volunteers were enrolled in

this study. Each of the participants were asked to take a TGD

capsule or not, prior to eating their standard breakfast that

contained 60 g of carbohydrates. The patient fingertip PBG

levels at 30, 60, 90, 120, and 180 minutes after meal were

compared to two measurements of their fasting blood glucose

(FBG) levels. The TGD capsules contain 100mg of TGD that was

manufactured by Amano Enzyme Inc. The study results

indicated that the intake of pre-meal TGD can decrease the

time that it takes for PBG to return to that of a FBG level (from

150 mins without TGD to 120 mins with TGD). The regression

analysis also determined that the use of TGD can significantly

reduce PBG (P = 0.028) and the area under the curve of the PBG

plot over the 180 post-meal period (P = 0.02). Therefore, the use

of pre-meal TGD can be used to lower the PBG for Type II

diabetes patient. However, the long term use of TGD and its

effect may warrant further investigations.

PD-47

Efficacy and safety of once-weekly GLP-1 RA in patients with

type 2 diabetes treated with DPP-4 inhibitor

Masako MURAKAMI

*, Naoko HIRAHARA

, Hiroshi MORITA

Shigekazu SASAKI

Dept of Diabetes and Endocrinology &

Metabolism,

Dept of Medicine, Hamamatsu University School of

Medicine, Japan

Objective:

The efficacy and safety of once-weekly glucagon

–

like peptide-1 (GLP-1) receptor agonist were assessed in

Japanese patients with type 2 diabetes who were treated

with dipeptidyl peptidase-4 (DPP-4) inhibitor therapy in

advance.

Study design andmethod:

We started the treatment of 0.75 mg

of dulaglutide or 2 mg of long-acting exenatide once-weekly

subcutaneous injection in 36 patients who were already DPP-4

inhibitor therapy at least for 6 months duration with inad-

equate glycemic control, 32 subjects on dulaglutide and 4 on

exenatide respectively. 15 patients were on insulin and 11

out 36 subjects were on Sodium Glucose co Transporters 2

Inhibitor (SGLT2i) together with DPP-4 inhibitor treatment.

Insulin was titrated based on glycemic control to avoid

hypoglycemia. After 16 weeks, the change in glycated

haemoglobin (HbA1c) level, daily dose of insulin, body

weight, urinary albumine excretion and the incidence of

adverse events were accessed in retrospective way.

Results:

The patients were 66.8 ± 14 years of mean age, and 26.0

of BMI with average duration of 11.6 years in Diabetes. The

mean level of HbA1c in baseline was 9.0% and decreased to

8.29% at 16 weeks however the mean BMI stayed at 25.9 at 16

weeks later. The mean daily dose of insulin in baseline was

34.2 Units and 18.7 Units daily at 16 weeks. The rates of urinary

albumin excretion was decreased, 185 in baseline and

102.4 mg/gCr at 16 weeks. The adverse events were gastro-

intestinal-related events, 2 out of 36 patients each on dulaglu-

tide and on exenatide were failed to continue within a week

after administration.

Conclusions:

Once-weekly GLP-1 receptor agonist on insulin-

based or oral antidiabetes drugs treatment were effective, for

the subjects with inadequate glycemic control on DPP-4

inhibitor treatment, at lowering HbA1c with a remarkable

reduction of 45.3% in daily insulin dose and urinary albumin

excretion and associated with few adverse event and no

weight gain over 16 week.

PD-48

Liraglutide add-on to insulin improved glycaemia but

exhibited short durability after cessation in type 1 diabetes

with residual insulin secretion

Yoshiyuki HAMAMOTO

1,2

*, Sachiko HONJO

Yoshiharu WADA

Kansai Electric Power Hospital,

The Tazuke

Kofukai Medical Research Institute, Kitano Hospital, Japan

Background and aims:

GLP-1 receptor agonists are expected to

be protective against

-cell destruction. Therefore, long-period

treatment with liraglutide (Lira) in patients with type 1

diabetes (T1D) who have residual insulin secretion may not

only improve glycaemic control but also result in sustained

effects through recovery of beta-cell mass. In this study, we

investigated the durability of the effect of Lira treatment on

glycemic control after its cessation.

Methods:

Six T1D patients with residual insulin secretion

[fasting C-peptide (CPR) level >0.3 ng/mL] received Lira add-on

to insulin therapy for 1

–

2 years, and changes in HbA1c, body

weight and daily insulin doses were investigated during the

Lira treatment period and 6 months after its cessation.

Results:

The characteristics of the subjects were as follows;

male/female 4/2, age 51.3 ± 10.0 yrs (mean ± SD), BMI 21.7 ± 3.2

kg/m

, fasting C-peptide level 0.18

–

1.25 ng/mL (median

0.35 ng/mL), anti-GAD antibody 1.5

–

250 U/mL (median 27 U/

mL), and duration of diabetes 1.5

–

28 yrs (median 7 yrs). HbA1c

before Lira was 8.1 ± 1.3%, and was tended to decrease to

7.6 ± 1.0% (p = 0.11) at the end of Lira treatment. Total daily

insulin dose was reduced from 44.5 ± 20.3 to 40.3 ± 15.5 U/day

although it did not reach statistical significance (p = 0.19).

Immediately after the cessation of Lira, HbA1c level was

significantly increased to 7.9 ± 1.2% at 1 month (p = 0.02) and

finally reached to the similar level to the baseline level before

Lira (8.3 ± 1.5%, p = 0.38 vs. before Lira). Daily insulin dose was

also increased to the identical amount before Lira (44.5 ± 22.1

U/day, p = 0.50 vs. before Lira and p = 0.05 vs. end of Lira). Body

weight showed a slight reduction at the end of Lira treatment,

but regained after the stop of Lira (61.9 ± 4.6 kg, 60.4 ± 5.5 kg

[p = 0.04 vs. before Lira], and 62.2 ± 5.3 kg [p = 0.07 vs. before

Lira and p = 0.38 vs. end of Lira] at baseline, end of Lira and 6

months after Lira cessation, respectively).

Conclusion:

In conclusion, adding Lira on insulin therapy in

T1D may have a therapeutic potential to improve glycemic

control with decreased insulin doses, but the benefit cannot be

maintained without continuation of Lira suggesting that the

effects were unlikely to be demonstrated though the recovery

of beta-cell mass.

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

–

S211

S105