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PD-49
Effects of teneligliptin in elderly patients with type 2 diabetes
mellitus
Mariko ABE
1
*, Suzuko MATSUMOTO
1
, Takashi OMOTO
1
,
Masahiro SHINOZAKI
1
, Shinya NISHIO
1
, Shinichi ANTOKU
1
,
Mizuo MIFUNE
1
, Michiko TOGANE
1
, Hiroyuki ITO
1
.
1
Department
of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital,
Japan
Objectives:
The aim of this study was to examine the effects of
teneligliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, in
elderly patients with type 2 diabetes.
Methods:
One hundred and seventy-five patients with type 2
diabetes treated with 20 mg once daily teneligliptin were
studied as the treated set (TS) in order to analyze the safety
of teneligliptin. One hundred and thirty-seven subjects whose
medications remained unchanged during the observation
period were retrospectively investigated as the full analysis
set (FAS) to assess the effectiveness of teneligliptin for 6
months. The subjects were divided into two groups: the elderly
group (
≥
70 years of age, n = 66) and the non-elderly group (<70
years of age, n = 71). The parameters were analyzed separately
in the subjects receiving monotherapy, additional therapy
(i.e. teneligliptin added to the other antidiabetic agents), and
switching therapy (i.e. teneligliptin was switched from the
other DPP-4 inhibitor).
Results:
In the TS, adverse events were recorded in 39 subjects
(22%). In the FAS, the HbA1c levels were significantly improved
in subjects receiving monotherapy (n = 56) or additional
therapy (n = 29) in the elderly group (7.2 ± 0.6% to 6.6 ± 0.4%
and 7.5 ± 0.9% to 6.6 ± 0.9%, respectively), similar to the non-
elderly group (7.5 ± 1.3% to 6.8 ± 0.8% and 7.4 ± 1.2% to
6.6 ± 1.1%, respectively). The change in the HbA1c levels at 6
months after the initiation of teneligliptin therapy was not
significantly different between the elderly and non-elderly
groups (
−
0.6 ± 0.5 and
−
0.8 ± 1.1, respectively in the subjects
receiving monotherapy, and
−
0.8 ± 0.8 and
−
0.8 ± 0.5, respect-
ively in those receiving additional therapy). The HbA1c levels
were not significantly changed both in the elderly and non-
elderly subjects receiving switching therapy (n = 52).
Conclusions:
Teneligliptin is equally effective for elderly
patients with type 2 diabetes and non-elderly patients.
PD-50
The effectiveness and safety of sulfonylureas in type 2
diabetes with chronic kidney disease in center Taiwan
Yi-Shan WANG
1
*, Yuan-Ting YANG
1
, Shih-Pan YANG
1
,
Su-Yu CHIEN
1
.
1
Department of Pharmacy, Changhua Christian
Hospital, Changhua, Taiwan
Background:
The administration of sulfonylureas in Chronic
kidney disease (CKD) requires careful attention to dosing and
routes of elimination, especially include long-acting sulfony-
lureas (e.g., glimepiride, glibenclamide). There are not recom-
mended for nondialysis CKD patients with GFR <30 mL/min.
But the physicians also prescribe them in some cases in real
world. Therefore, we perform a medication evaluation to
assess the effectiveness and safety of sulfonylureas.
Objective:
The aimof this study was to assess the effectiveness
and safety of sulfonylureas in type 2 diabetes with CKD.
Method:
We retrospectively review patients with diagnosis of
gout (ICD-9 580) concomitant with sulfonylureas (including
glimepiride, glimepiride/metformin and glibenclamide) dur-
ing Jun to Dec 2015 in Changhua Christian Hospital. Patients
with prescription of sulfonylureas less than 7 days were
excluded. We collect the data of patient age, sex and analyzed
the progression of renal function (eGFR, serum creatinine) and
preprandial blood sugar. Prescribed Daily Dose (PDD) of
sulfonylureas was calculated. Hospital-based spontaneous
reporting systems databases were survey for the sulfonylureas
adverse reaction reporting.
Results:
A total of 131 patients were included with mean age
69 ± 12.3 years. There were 64 female and 67 male. The average
duration of prescription was 168.6 ± 128.4 days. Prescribed
Daily Dose (PDD) of glimepiride, glimepiride/metformin and
glibenclamide was 3.4 mg, 4.3/1065 mg, 5 mg. The serum
creatinine was increased from 2.9 ± 2.3 to 3.2 ± 2.6 mg/dL. The
eGFR was decreased from 31.8 ± 19.7 to 29.7 ± 19.3 mL/min/
1.73 m
2
. 48.9% (64) of patients with eGFR < 30 mL/min/1.73 m
2
at the baseline. In subgroup analysis, 79 patients with
glimepiride (the duration of prescription average 170.4 ± 134.7
days), 32 patients with glimepiride/metformin (average 172.2 ±
105.5 days), 2 patients with glibenclamide (average 21 ± 14
days), the preprandial blood sugar derement was 16.8 ± 61.2
mg/dL, 2.1 ± 40.9 mg/dL and 0 mg/dL respectively and eGFR
derement was 1.2 ± 3.3, 5.6 ± 17.2, 0.6 ± 0.6 mL/min/1.73 m
2
.
There are no ADR report in three arm, but we found nine
cases with glimepiride occurred hypoglycemia. The incidence
of hypoglycemia was 6.9% (9/131).
Conclusion:
Sulfonylureas is an effective sugar-lowering
agent. We found a trend that glimepiride/metformin use, the
more eGFR decline. The safety of sulfonylureas was well
tolerated from the adverse reaction reported. But the total 9
cases occurred hypoglycemia were glimepiride group.
Therefore, we need to closely monitor blood sugar in in type
2 diabetes with CKD patients.
PD-51
Baseline characteristics of patients initiating insulin treatment
for type 2 diabetes in the Western Pacific: Evidence from the
VISION Study
Wayne SHEU
1
*, Chaicharn DEEROCHANAWONG
2
,
Roberto MIRASOL
3
, Risa OZAKI
4
,
Wan Mohd Izani WAN MOHAMED
5
, Steven BABINEAUX
6
,
Thomas LEW
7
, Abdul JABBAR
8
.
1
Taichung Veterans General
Hospital, Taichung, Taiwan;
2
Rajavithi Hospital, Rangsit Medical
School, Bangkok, Thailand;
3
St. Luke
’
s Medical Center, Quezon City,
Philippines;
4
The Chinese University of Hong Kong, Hong Kong;
5
Hospital Universiti Sains Malaysia, Kelantan, Malaysia;
6
Eli Lilly
and Company, Indianapolis, IN, United States of America;
7
Eli Lilly
and Company (Taiwan), Taipei, Taiwan;
8
Eli Lilly S.A., Dubai, United
Arab Emirates
Background/objective:
The Verifying Insulin Strategy and
Initial Health Outcome ANalysis (VISION) is an 18-month,
9-country, prospective observational study of patients with
type 2 diabetes initiating insulin therapy as part of routine
practice in the Middle East and North Africa and Western
Pacific regions. This (ongoing) study is designed to assess
treatment approaches and decisions, clinical effectiveness of
insulin therapy, cost/resource use, treatment patterns, and
the demographic and clinical characteristics of patients.
The objective of this analysis was to describe the baseline
characteristics, including several patient reported outcomes,
of patients from the Western Pacific region enrolled in VISION.
Methods:
Patients provided consent to participate in the study
after the decision to initiate insulin therapy was made. The
Western Pacific region included 1025 patients from Thailand
(n = 315), Malaysia (n = 230), Philippines (n = 178), Taiwan (n =
161), and Hong Kong (n = 141). Baseline variables assessed as
part of this analysis included glycated hemoglobin (HbA1c),
patient questionnaires (satisfaction with diabetes medication
and Expectations about Insulin Therapy Questionnaire [EITQ]),
and initial insulin regimen prescribed. EITQ total scores range
from 0 to 70, with higher scores indicating more positive
expectations.
Results:
Mean HbA1c at insulin initiation was 9.08% in
Hong Kong, 9.87% in Taiwan, 9.93% in Thailand, 10.24% in
Malaysia, and 10.57% in Philippines. The proportion of patients
dissatisfied with their diabetes medication varied between
countries: 7.5% inThailand; 16.2% inMalaysia; 25.6% inTaiwan;
27.5% in Hong Kong; 43.9% in Philippines. Mean EITQ total
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S106