Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

Result:

In our study, lipophilic statin use was associated

with higher risk of cerebrovascular events than hydrophilic

statin use.

Conculsion:

According to our cohort study, hydrophilic statin

usemay be an optimal choice to reduce cerebrovascular events

in diabetic Taiwanese.

PD-55

Effects of intervention by a nutrition support team on serum

albumin level in diabetic patients

Minoru KUSAMA

*, Yu KOUCHI

, Mayumi SEKIGUCHI

Eitaro NAKASHIMA

, Rui IMAMINE

, Asako MIZOGUCHI

Hazime MASE

, Ai SATO

, Atsuko WATARAI

Takahiko KAWAMURA

, Nigishi HOTTA

Department of

Diabetes and Endocrinology, Chubu Rosai Hospital,

Division of

Nutrition Management, Chubu Rosai Hospital,

Division of Health

Examination, Chubu Rosai Hospital, Japan

Objective:

Both glycemic control and improvement of under-

nutrition are important in the management of underlying

disease in diabetic patients. The effects of intervention by a

nutrition support team (NST) on nutritional parameters

including serum albumin (Alb) level in diabetic inpatients

were investigated and compared with nondiabetic controls.

Methods:

This study included 42 diabetic (D group) and 98

nondiabetic (N group) inpatients who received NST inter-

vention during hospitalization. Retrospective investigation

was conducted based on the clinical record data. Pre- and

postintervention values for clinical parameters (body weight,

blood pressure, lipid levels, serum Alb, renal function) were

statistically examined. A p value less than 0.05 was considered

statistically significant.

Results:

Baseline data (D group/N group): age, 73.9/70.5 years;

body mass index (BMI), 21.4/19.9 kg/m

; date of initial NST

intervention, day 25/24; duration of NST intervention, 33/36

days; number of NST interventions, 5.5/5.0. The baseline

HbA1c in the D group was 7.6%. Underlying diseases included

respiratory (36 patients), gastrointestinal (22 patients), ortho-

pedic (20 patients), cerebrovascular (14 patients), and other

diseases (48 patients). Nutritional intervention involved

enteral (27 patients), intravenous (27 patients), and oral

feeding (86 patients). No significant difference in baseline

clinical parameters was observed between the two groups.

Final results: In the D group, 39 patients were discharged alive

and 3 died, while 82 were discharged alive and 16 died in the N

group. In both groups, a significant decrease in BMI (D group,

21.2 to 20.1 kg/m

; N group, 19.7 to 18.8 kg/m

) and a significant

improvement in serum Alb level (D group, 2.6 to 2.8 mg/dL; N

group, 2.7 to 2.9 mg/dL) were observed. In the D group, a

significant positive correlation was observed between change

in serum Alb level and number of NST interventions (r = 0.32),

while a significant negative correlation was observed between

change in serum Alb and baseline serum Alb levels (r =

−

0.40).

Multiple regression analysis of factors influencing differences

between pre- and postintervention serum Alb levels in the

total patient population (dependent variables: sex, age, status

of diabetes, BMI, serum Alb, number of NST interventions)

identified age and baseline serum Alb level as significant

independent factors.

Conclusion:

In clinical practice, more frequent NST interven-

tions in diabetic patients resulted in improved nutritional

status. Results also suggested that NST intervention in

younger patients or for undernutrition might result in

improved nutrition regardless of diabetic status.

PD-56

Titration when switching from insulin degludec to insulin

glargine U300 among Japanese diabetes patients

Takuya ISHIKAWA

1,2

*, Tomotaka KATO

, Yasuhiro IIJIMA

Mamoru SAKURAI

, Jumpei SHIKUMA

, Rokuro ITO

Hiroyuki SAKAI

, Kazuo HARA

, Takashi MIWA

Akira KANAZAWA

, Masato ODAWARA

Division of Diabetes,

Endocrinology and Metabolism, Department of Diabetes,

Endocrinology, Metabolism and Rheumatology, Tokyo Medical

University, Tokyo

Department of Internal Medicine, Toda Chuo

General Hospital, Saitama, Japan

Background:

In recent years, there has been a focus on using

basal insulin to treat diabetes patients due to its core

characteristics regarding stability and persistence. Two of the

long-acting and stable types of insulin available in Japan are

insulin degludec (IDeg) and insulin glargine U300 (G300). To

date, there is no definite evidence regarding how to adjust the

dosage of insulin when switching from IDeg to G300 as well as

G300 to IDeg in Japanese diabetes patients. Our research

compared the efficacy of IDeg and G300 by way of using a

continuous glucose monitoring system (CGM) on Japanese

diabetes patients in order to evaluate the suitable amount for

titration when switching from IDeg to G300.

Method:

Four Japanese diabetes patients treated with IDeg

under diabetes educational hospitalization between Oct. 2015

and Jan. 2016[type 1 diabetes (T1DM): n = 1, type 2 diabetes

(T2DM): n = 3, mean age: 67.5 ± 17.3 years, mean BMI: 28.9 ± 4.6,

mean HbA1c: 11.2 ± 1.6%, mean CPR index: 0.95 ± 0.7, mean U-

CPR: 28.5 ± 24.4 μg/day] were recruited. The patients were

subsequently switched to G300 with the same dosage of

IDeg. The patients were under regular examination through

the use of CGMs for two days prior to the switch and three days

following the switch.

Result:

There was no statistical difference between the periods

before and after the switch in regards to average blood glucose

level and the standard deviation (SD) of the blood glucose level.

In T1DM, following the switch, there seemed to be a tendency

that the blood glucose level during the early morning (00:00

–

7:00) was higher compared to the same time period prior to the

switch.

Conclusion:

In Japanese diabetes patients who have hypose-

cretion of insulin, there is a possibility that the effect of G300 is

shorter than that of IDeg during the titration. According to our

results, we think that the dosage of insulin should be the same

when titrating from IDeg to G300, so as to avoid hypoglycemia.

To further expand and solidify our conclusion, it is necessary

to reviewmore cases. By the day of meeting, there will be more

cases to present.

PD-57

Study of patients who presented to the emergency outpatient

department with the chief complaint of hypoglycemia

Yu KOUCH

*, Minoru KUSAMA

, Rui IMAGINE

, Ai SATO

Hajime MASE

, Asako MIZOGUCHI

, Atuko WATARAI

Takahiko KAWAMURA

, Eitaro NAKASHIMA

, Nigishi HOTTA

Dept. of Metabolic and Endocrinology & Diabetic Center, Chu-bu

Rousai Hospital, Japan

Aim:

To investigate the characteristics of patients who

presented to the emergency outpatient department of our

hospital with the chief complaint of hypoglycemia.

Methods:

One hundred twenty patients (68 men, 52 women)

with hypoglycemia who were treated at our emergency

outpatient department from November 2012 to October 2015

were included in this study.

Results:

Among the 120 patients, 32 had type 1 diabetes

mellitus, 74 had type 2 diabetes mellitus, and 14 had

conditions other than diabetes mellitus. Of the 106 diabetic

patients, 61 were men and 45 were women. A high proportion

of patients presented to the hospital in March and October

(11.7% for both months). The patient characteristics were

as follows: mean age, 68 ± 14 years; mean disease duration,

18 ± 10 years; mean body mass index, 21.9 ± 3.9; mean hemo-

globin A1c (HbA1c), 7.5% ± 1.6%; mean blood sugar level

at presentation, 54 ± 42 mg/dL; mean estimated glomerular

filtration rate, 57 ± 37 min-11.73 m

−

; and mean C-reactive

protein, 0.43 ± 1.00 mg/dL. The most common cause of hypo-

glycemia, accounting for 42.5% of all causes, was receiving

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

–

S211

S108