Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

scores were 44.0 in Taiwan, 45.5 in Hong Kong, 48.6 in

Philippines, 48.7 in Thailand, and 49.2 in Malaysia. The initial

insulin regimen varied considerably between counties; pre-

mixed insulin was more commonly prescribed in Malaysia

(40%), Philippines (34%), and Thailand (32%), whereas basal

insulin was more commonly prescribed in Taiwan (87%) and

Hong Kong (99%). No patients were prescribed basal-bolus

insulin at initiation and only a small proportion of patients in

Malaysia and Philippines were prescribed basal plus prandial

insulin at initiation.

Conclusions:

There were several differences by country in

baseline characteristics among patients from the Western

Pacific region enrolled in VISION. These differences may affect

subsequent treatment requirements and clinical outcomes.

PD-52

Long-term efficacy and safety of add-on therapy of vildagliptin

in type 2 diabetes mellitus with insulin treatment

Ippei KANAZAWA

*, Ken-ichiro TANAKA

, Masakazu NOTSU

Sayuri TANAKA

, Nobuaki KIYOHARA

, Sayo KOIKE

Yuko YAMANE

, Yuko TADA

, Motofumi SASAKI

Mika YAMAUCHI

, Toshitsugu SUGIMOTO

Shimane

University Faculty of Medicine,

Yamane Hospital,

Matsue City

Hospital, Japan

Background and aims:

Dipeptidyl peptidase (DPP)-4 inhibitors

are often used worldwide because they improve glycemic

control without increasing the risk of hypoglycemia. Previous

studies have shown that intensive treatments with insulin

administration increase the risk of hypoglycemia, resulting in

the deterioration of quality of life and mortality. Although the

usefulness of DPP-4 inhibitors for patients with type 2 diabetes

treated with insulin is suggested, the long-term efficacy and

safety of add-on therapy of vildagliptin in the patients is still

unclear.

Subjects and methods:

Patients with type 2 diabetes treated

with insulin were enrolled, who had no history of taking DPP-4

inhibitors, if informed consent was obtained after a detailed

explanation of the study purpose and methods. The partici-

pants in this open labeled trial were divided randomly into two

groups as follows, their mean age and HbA1c levels as well as

the ratio of men to women were not significantly different

between these groups. Vildagliptin was orally administered

one or two times after meal (50

–

100 mg/day) in the vildagliptin

group (n = 37), and patients had conventional treatments

without any DPP-4 inhibitors in the control group (n = 36).

HbA1c levels, dose and times of insulin injection, the number

of hypoglycemia episode, as well as liver and renal functions

were monitored for 2 years.

Results:

The baseline characteristics of the subjects including

age, dose of insulin, or HbA1c levels were not different between

two groups. In the vildagliptin group, HbA1c levels were

significantly decreased, and the significance of HbA1c reduc-

tion was maintained for 2 years (form 8.0 ± 1.2% to 7.4 ± 1.0,

p < 0.05, at the end of observational period). In addition, the

dose and times of insulin injection were significantly reduced

(

−

5.6 units, p < 0.01, and from

−

0.9 times, p < 0.001). On the

other hand, these parameters were not changed in the control

group. The number of patients who experienced hypoglycemia

three times and more per year was significantly fewer in the

vildagliptin group (n = 4) compared to the control group (n = 11)

(odds ratio 0.28, 95% CI 0.08

–

0.97, p < 0.05). The serum levels of

ALT and estimated glomerular filtration rate were not changed

between two groups.

Conclusion:

Vildagliptin as add-on to insulin treatment for 2

years was well tolerated and led to sustained reductions in

HbA1c, the dose and times of insulin injection, and the risk of

hypoglycemia.

PD-53

Comparison of eGFR before and after the administration of

ipragliflozin using creatinine and cystatin C as indicators

Tomotaka KATO

1,2

*, Yuichi IKEUCHI

1,2

, Yasuhiro IIJIMA

1,2

Yusuke KAKIZAKI

, Junko SASAKI

, Shinichi TAMARU

Kenshi KAN

, Junpei SHIKUMA

, Rokuro ITO

, Kazuo HARA

Takashi MIWA

, Masato ODAWARA

Tokyo Medical University

Hospital,

Todachuo General Hospital, Japan

Background:

Whilst serum creatinine concentration is gener-

ally used in the evaluation of kidney function, the production

of creatinine is influenced by muscle mass, and thus, it could

vary greatly depending on factors, such as gender, age,

nutritional condition and muscle mass. Since Cystatin C is

not influenced by factors, such as muscle mass, eGFR using

Cystatin C is considered to be useful as renal functionmarkers.

In this study, comparative assessment was carried out on eGFR

before and after the administration of ipragliflozin using

cystatin C as an indicator.

Methodology:

Subjects of the study were sixteen outpatients

with type II diabetes (11 males and 5 females aged 51.7 ± 6.7

and disease duration of 7.5 ± 4.4 years). 50 mg Ipragliflozin/day

was administered in combination as pre-treatment. The

transition of renal function were compared and examined in

eGFR using serum creatinine and cystatin C before the

administration and also three, six, nine and twelve months

after the commencement of medication. Comparative assess-

ment was also carried out on the transition of HbA1c, body

weight and liver function, etc.

Results:

Blood glucose level significantly decreased from

HbA1c8.4 ± 0.9% before the administration to 7.3 ± 0.9% (p <

0.05) after twelve months. Whilst the increase in eGFRcr

was marginal from 87.1 ± 16.4 mL/min before the administra-

tion to 91.3 ± 18.4 mL/min (p = 0.16) after twelve month,

eGFRcyc showed significant increase from 94.8 ± 13.7 mL/min

to 102.2 ± 15.6 mL/min (p < 0.05) during the same period. A

significant reduction in body weight was observed which

was 81.7 ± 15.8 kg (p < 0.05) after twelve months compared to

84.2 ± 16.3 kg before the administration. Liver function also

significantly improved from AST: 33.6 ± 16.7 IU/L, ALT: 47.1 ±

26.7 IU/before the administration to AST:26.0 ± 17.7 IU/L (p <

0.05), ALT: 32.5 ± 28.1 IU/L (p < 0.05) after twelve months.

Conclusion:

For Japanese patients with type II diabetes,

Ipragliflozin not only had sustained hypoglycemic effects but

also showed weight reduction and liver function improving

effects. The study also suggested a potential renal protection

effect of Ipragliflozin in long-term, and the assessment of eGFR

using Cystatin C was considered to be useful in such renal

function evaluation.

PD-54

Long-termefficacy of hydrophilic or lipophilic statin therapy in

diabetic Taiwanese

Chihung CHOU

–

*, Hsin Hung CHEN

–

Institute of Medicine,

Chung Shan Medical University, Taichung,

Division of Cardiology,

Changhua Christian Hospital,

Division of Cardiology, Yuanlin

Christian Hospital, Changhua,

Institute of Public Health and

Medicine, Chung Shan Medical University, Taichung,

Division of

Metabolism & Endocrinology, Changhua Christian Hospital,

Changhua,

Division of Metabolism & Endocrinology, Nantou

Christian Hospital, Nantou, Taiwan

Aim:

To evaluate the long-term efficacy of hydrophilic and

lipophilic statin therapy for cardiovascular outcomes in

diabetic Taiwanese

Method:

Newly diagnosed patients with type 2 diabetes were

divided into 2 cohorts, namely hydrophilic statin and lipo-

philic statin cohorts. Cox proportional hazard regression

models was used to analyze the risks of cardiovascular

outcomes.

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

–

S211

S107