Diabetes Research and Clinical Practice - Volume 120 - Supplement 1 - October 2016

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the usual doses of drugs after consuming less than the normal
amount of food (except during sick days). No cases of death
were directly caused by hypoglycemia. Hospitalization was
necessitated in 52.4% of all cases.
Conclusions: We conclude that avoiding the onset of hypogly-
cemia and selecting target HbA1c levels and drugs according to
the patient’s age and disease status should be prioritized.
PD-58
The acute efficacy and safety of dulaglutide in Japanese adults
with type 2 Diabetes Mellitus
Asako MIZOGUCHI1*, Rui IMAMINE 1, Minoru KUSAMA1,
Hajime MASE 1, Ai SATO1, Makiko MINATOGUCHI1,
Atsuko WATARAI 2, Takahiko KAWAMURA2, Nigishi HOTTA1,
Eitaro NAKASHIMA 1. 1Department of Diabetes and Endocrinology,
Chubu Rosai Hospital, 2Research Center for the Promotion of Health
and Employment Support, Chubu Rosai Hospital, Japan
Background: Recently, many kinds of GLP-1 receptor agonist
are widely used in clinical practices for improving glycemic
control in patients with type 2 diabetes mellitus (DM).
Dulaglutide is a novel weekly GLP-1 receptor agonist which
came to Japanese market in October 2015 and is expected to
have greater glucose and body weight (BW) lowering effect on
patients with type 2 DM. In this study, we retrospectively
investigated the efficacy and safety of dulaglutide in clinical
practice.
Method: Thirty-five patients with type 2 DM in our hospital
who were administrated dulaglutide were enrolled from
October 2015 to March 2016 consecutively. We observed up to
12 weeks in this study. We collected the clinical data of HbA1c
and body weight every month through the study period.
Also we investigated adverse side effects, i.e. hypoglycemia.
Moreover, we conducted a questionnaire study about dulaglu-
tide and its injection device after its administration.
Results: Baseline characteristics are indicated thus; Male 22
patients (62.9%) Female 13 patients (37.1%). Age: male 64 years
old, female 65 years old. HbA1c: 8.0%, BW: 68.9 kg. Before
replacement or initiating dulaglutide, the 9 patients used
other GLP-1 receptor agonist, the 13 patients used insulin.
After 8 weeks, HbA1c in all the patients has decreased − 0.45%
(p < 0.05, vs baseline). In only male after 4 weeks HbA1c
has decreased −0.31% (p < 0.05, vs baseline) After 8 weeks
patients who added dulaglutide on insulin significantly
improved HbA1c ( −0.35% p < 0.05, vs baseline). BW signifi-
cantly decreased in all patients after 4 weeks treatments
( −0.52 kg p < 0.05, vs baseline) but not in 8 weeks. There were
no reports of any severe hypoglycemia attack during study
period. In the questionnaire in this study, 40% of the patients
felt that they had better glycemic control and 40% of them felt
they had lower frequency of hypoglycemia using dulaglutide
than their previous therapy. All patients prefer weekly GLP-1
receptor agonist to daily one.
Conclusion: In this study, dulaglutide improved glycemic
control in Japanese type 2 DM patients in clinical practice.
Furthermore, continuing to add the diabetes patients and
extend the period of observation we are going to report this
study.
PD-59
Inhibition of central GSK3 regulates body weight and glucose
metabolism
Rie TAKAHASHI1, Licht MIYAMOTO1*, Keisuke FUKUTA1,
Koichiro TSUCHIYA 1. 1Dept. of Medical Pharmacology, Inst. of
Biomedical Sciences, Tokushima University, Japan
Overweight and obesity lead tometabolic disorders like insulin
resistance and hypertension, which related to development of
type 2 diabetes, coronary heart disease and cancer with the
increase of body mass index (BMI).
The WHO statistics in 2014 shows that more than 2 billion
people are overweight (BMI from 25 to 29.9), and more than
half a billion are obese (BMI 30 or greater). This survey indicates
that about one-third of the world’s population tends to be
obese.
GSK3 (glycogen synthase kinase 3) is a ubiquitous kinase
and a downstreammolecule of insulin signal pathway. Insulin
regulates glucose homeostasis with increasing glucose uptake
and storage. When it binds to the insulin receptor, glucose
uptake is accelerated to promote the glycogen synthesis in
the liver and skeletal muscle by GSK3 inactivation. In this
mechanism, GSK3 can be a target for the development of
treatment for type 2 diabetes, but its central action has not
been understood yet.
It has been demonstrated that central administration of insu-
lin causes anorexigenic effect and leads to reduction of body
weight. Therefore, we used GSK3 inhibitor to reveal signifi-
cance of central GSK3 on metabolism and feeding behavior.
All experiments were performed using 8- to 10-week-old
male ddY mice. We administered vehicle (PBS) or a GSK3
inhibitor to the mice by ICV injection. The mice were housed
individually under 12-hour day and night cycle. In a single
dose, ICV administration was performed after 16 hours fast
and then we measured the change in body weight, food intake
and water consumption. Otherwise, as another experiment,
repetitive administration was also performed for 10 days and
we conducted ipGTT after 7days treatment.
The single dose of GSK3 inhibitor led to reduction of body
weight, food intake and water consumption. The continual
administration of GSK3 inhibitor showed more striking
effects. An ipGTT revealed that glucose tolerance tended to
be improved in the mice administrated with GSK3 inhibitor in
comparison to the control mice. The maximum glucose
concentration in the GSK3 inhibited mice was lower than the
other group.
Recently, GSK3 inhibitors have been developed for medication
of Alzheimer’s disease. Our results suggested that central
GSK3 should be a new target to treat metabolic diseases, and
GSK3 inhibitors would be novel anti-obesity agents having
antidiabetic effect.
PD-60
Factors related to diabetes’ ABC control in a Taipei community
hospital – A prospective follow-up study
Tong-Yuan TAI1*, Yu-Kang CHANG2 , Jiun-Yian LIN1 ,
Pi-Yuan WONG1, I-Chuan LIN1, I-Ju LIEN1,
Chung-Hsueh CHUNG1, Chih-Cheng HSU2. 1 Taipei Jen-Chi
Hospital, Taipei 2Institute of Population Health Sciences, National
Health Research Institutes, Taiwan
Background: The majority of diabetes patients in Taiwan have
been cared in either community clinics or local hospitals;
however, quality of diabetes control in community settings
remains unclear. This study aimed at demonstrating per-
formance of diabetes care and investigating factors that
influenced ABC (HbA1c, blood pressure, and low-density
lipoprotein cholesterol [LDL-C]) control in a community
hospital in Taipei.
Methods: We adopted the current status of ABC control in
National Diabetes Health Promotion Centers in Taiwan, which
have been regularly supervised and accredited by the Health
Promotion Administration, as the performance indicators to
evaluate quality of diabetes care in the investigated commu-
nity hospital. Logistic regressions were used to identify
significant factors related to diabetes’ ABC control.
Results: Since 2006, the investigated community hospital
has implemented a diabetes management program, strength-
ening dietetic consultation, health education, and case
management. The data surveillance center has currently
recorded 300 enrollees to this program. The percentage of
good ABC control, including HbA1c < 7%, blood pressure <130/
80 mmHg, and LDL-C < 100 mg/dL, one year after participating
in the program was 40.7%, 33.7%, and 32.8%, respectively.
Compared to the corresponding indicators in National
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S109