Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

oxidation with subsequent chronic inflammation play an

important role in diabetic macroangiopathy. Astaxanthin

(AX) is one of the carotenoids with excellent anti-inflamma-

tory and antioxidative capacity.

Purpose:

The purpose of this study was to investigate the effect

of astaxanthin and astaxanthin formula (AXF) on metabolic

and thrombogenic risks in type 2 diabetic patients.

Material and method: One hundred and three type 2 diabetic

patients were recruited from department of metabolism

and endocrinology of Cheng Ching Hospital in Taichung

city. After exclusion of unqualified patients, all subjects were

randomly assigned into three groups including placebo

group (P), AXF (AX 6 mg + vitamin E 150 mg + Tocotrienol

45 mg/day) group and AX (AX: 14 mg/day) group, respectively.

After two month

’

s supplementation, plasm concentration of

AX, fasting blood glucose (FBG), HbA1c, lipid profiles, markers

of hepatic and renal function, oxidative and inflammatory

markers, coagulation and anti-coagulation factors were

measured.

Results:

The results showed the plasma levels of AX increased

by supplementation in a dose-dependent manner. Plasma

concentration of HbA1c, CRP and vWF was significantly

decreased in AXF group. Plasma concentration of HbA1c,

Triglyceride and Total Cholesterol, GPT, TNF-

, CRP and vWF

was significantly decreased in AX group. In addition, plasma

concentration of coagulation factor VII and PAI-1 was signifi-

cantly decreased, and AT-III level was significantly increased

in AX group.

Conclusion:

In conclusion, AX supplementation for two

months may have beneficial effects on type 2 diabetic patients

in ameliorating hyperglycemia and hyperlipidemia. AX sup-

plementation also decreases oxidative stress and restrains

chronic inflammations, therefore mends endothelial damage

and thrombogenic risk in type 2 diabetic patients.

PD-64

The usefulness of newly long acting insulin as Degludec

for 2 years in Japanese Type 1 Diabetes

Takaichi MIYAKAWA

*, Noriaki KAWAGOE

Yuko WATANABE

, Miyuki NOGAWA

, Hiroko YOSHIMURA

Makoto HASEGAWA

, Hitomi FUJII

Tama-center Mirai Clinic,

Kunitachi Mirai Clinic, Japan

Objective:

We have used the newly long acting insulin as

Degludec for 69 Type 1 diabetes outpatients for 2 years. And 29

outpatients of themwe performed CGMS (Continuous Glucose

Monitering System; Medtronic iProTM2). To assess the useful-

ness of Degludec (1) for 2 years and (2) for daily profile used

CGMS.

Subjects and methods:

To analyze (1) the time course of

HbA1c, body weight, insulin dose for 2 years in type 1

outpatients, who switch from insulin glargine (n = 36;

GroupA) or insulin detemir (n = 28;GroupB) to insulin degludec.

n = 69, 53.0 ± 16.8 y/o, BMI 21.6 ± 2.9. C-peptide 0.24 ± 0.41 ng/

dL, (2) the time course of blood glucose profilewho switch from

insulin glargine or insulin detemir to insulin degludec, by

CGMS) at the time of switching (n = 19) and 1

–

3 months after

switching (n = 10). We investigated indicators of the dawn

phenomenon (DP);

⊿

BG (pre-breakfast BGminusminimumBG

at 2

–

6 AM).

Results:

(1) The mean HbA1c was significantly improved

from 7.94 ± 1.03 to 7.59 ± 1.03 (p < 0.0001). Body weight was

slightly increased from 56.1 to 57.0 kg (P < 0.01). 31 cases were

improved >0.5% of HbA1c level without severe hypoglycemia.

28 cases were not changed HbA1c level. Only 7 cases were

worsened >0.5%. 3 cases were dropout or changed insulin.

Group A; The mean HbA1c was improved slightly from 8.00 to

7.80 (p < 0.01). Body weight was slightly increased. Insulin

doses were not changed.

Group B: The mean HbA1c was from 7.86 to 7.58 (p < 0.01). Body

weight was not changed. Insulin doses was decreased from

16.8 to 11.7

(2) Frequency of nocturnal hypoglycemia was decreased than

former insulins (P < 0.01). Nighttime and daytime hypogly-

cemia was correlated with

⊿

BG (P < 0.01).

⊿

BG and CPR were

correlated (P < 0.03).

Conclusion:

(1) For 2 years Degludec is useful to improve HbA1c

level switching from Glargine and Detemir in Japanese Type1

diabetes patients.

(2) Frequency of nocturnal hypoglycemia was decreased

However, Dawn phenomenon during use is dependent on

residual intrinsic insulin secretions, and the patients with

more marked Dawn phenomenon tended to experience

hypoglycemia during the day or night. Careful titration of the

stable insulin degludec is required in response to fasting blood

glucose levels in type 1 diabetes.

(3) As a result 45% of patients have continued improvement

>0.5% of HbA1c level without severe hypoglycemia for 2 years.

PD-65

Evaluation of the CGMs in type-2 diabetic patients switched

from Liraglutide and Insulin Degludec to Liraglutide and

Insulin Degludec/Aspart

Yusuke KAKIZAKI

*, Tomoko FUJITA

, Tomono TAKAHASHI

Takashi MIWA

, Masato ODAWARA

Division of Diabetes,

Endocrinology and Metabolism and Rheumatology, Tokyo medical

University, Japan

Background:

The combination of Liraglutide (Lira) and Insulin

Degludec (IDeg) is often used. However, there are also some

cases therapeutic goals cannot be achieved. Insulin Degludec/

Aspart (IDeg/Asp) was newly released. Switching fromLira and

IDeg to Lira and IDeg/Aspmight possibly improve the glycemic

control, without changing the number of injections. However,

there are no reports on the effects of the therapy.

Aim:

We switched Lira and IDeg to Lira and IDeg/Asp in type-2

diabetic patients, and evaluated CGMs.

Purpose:

A patient with type-2 diabetes had been adminis-

tered Lira and IDeg before breakfast, and we switched the

medication to Lira and IDeg/Asp, with same amount of IDeg,

during hospitalization. We measured the CGMs over 72 hours,

and evaluated average blood glucose levels and the MAGE.

Results:

Average blood glucose level for a day decreased from

195 ± 47 mg/dL before the switch to 177 ± 32 mg/dL after the

switch. The MAGE decreased from 66 before the switch to 41

after the switch. In the time period from before breakfast to

before lunch, the average blood glucose level decreased from

237 ± 49 mg/dL before the switch to 162 ± 22 mg/dL after the

switch, and the MAGE decreased from 58 before the switch to

28 after the switch. In the time period from before lunch to

before dinner, the average blood glucose level decreased from

230 ± 27 mg/dL before the switch to 180 ± 31 mg/dL after the

switch, and theMAGE was 34 before the switch and 37 after the

switch. In the time period from before dinner to before sleep,

the average blood glucose level was 196 ± 12 mg/dL before the

switch and 196 ± 18 mg/dL after the switch, and the MAGE

increased from 17 before the switch to 43 after the switch. In

the time period from before sleep to before breakfast on the

following day, the average blood glucose level was 150 ± 17 mg/

dL before the switch and 153 ± 17 mg/dL after the switch, and

the MAGE was 26 before the switch and 30 after the switch.

Hypoglycemia was not observed during the observation

period.

Conclusion:

It was shown switching IDeg to IDeg/Asp

might make it possible to improve glycemic control during

the time after breakfast and before dinner, without increasing

the number of injections and burden on the patient. We

will investigate more cases and report on them at the

conference.

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

–

S211

S111