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

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by gavage for 12 weeks. BMD was determined using the
Piximus instrument and software version 1.46 (GE Lunar,
Madison, WI). Micewere anesthetized and scanned prior to the
onset of treatment and at sarcrifice. Total body BMD (g/cm 2)
excluding the head region and femur BMD was obtained from
each scan, and the percent change in BMD was calculated.
Rosiglitazone-treated group showed significant greater BMD
decrease compared to control group at the end of study at both
total body and femur BMD ( −4.2% ± 2.75 in Rosiglitazone group
vs. − 1.9% ± 2.7 in Placebo group in total body BMD, −7.7% ± 3.5
in Rosiglitazone group vs. −1.6% ± 2.1 in Placebo group in femur
BMD, p < 0.05, respectively). However, pioglitazone- and lobe-
glitazone-treated groups showed similar decrease in both total
body and femur BMD at the end of study compared to the
control group. In conclusion, lobeglitzaone, a new PPARγ
agonist, exerts neutral effects on bone in mice compared to
the effects from rosiglitazone.
PD-73
Risk stratification of diabetic foot disease among new patients
in a community based Haemodialysis Programme
Hua YAN1*, Kim Hwa CHUA1, Li Zhi WONG1, Jon Choon LEE 1.
1 Clinical Services Division, National Kidney Foundation, Singapore
Introduction: Diabetic foot complications are common in
diabetic patients undergoing chronic dialysis. Among patients
newly admitted In National Kidney Foundation (NKF)
Haemodialysis (HD) Programme annually, more than 70%
were diabetic (DM). Early identification of risk of developing
foot problems may be useful in preventing such complications
from arising and/or deteriorating. We therefore explored the
risk stratification for foot problems of DM patients upon
admission to the NKF HD programme.
Patients and methods:
• All new patients starting on chronic HD in NKF HD program
from1 Jan 2012 to 31 Dec 2013 and who were diabetic were
included in the study.
• Patients’ data captured included demographics (age,
gender, ethnicity and marital status), admission date to
NKF, and risk category for DM foot disease.
• A total of 366 patients were included in the study
• Patient characteristics were as follows: Median age 58 years
(range 24–91), 4.6% was aged 20–40 years, 14.2% was aged
41– 50 years, 40.2% aged 51– 60 years, 29.5% was aged 61–70
years: and 11.5% aged above 70 years. 58.7% were males
and 41.3% were female. 67.5% were married, 11.8% were
single, 10.9%were divorced and 9.8%werewidowed. Ethnic
distribution showed 55.2% Chinese, 36.9% Malay, 7.7%
Indian, and 0.3% Others.
• A risk assessment for diabetic foot disease was carried out
upon entry to the program. Information was then entered
into a structured checklist form. These were collated,
transcribed and retrospectively analysed at the end of the
study period.
• The risk assessment for diabetic foot problems was carried
out using a DM foot screen tool adopted from NICE
guideline (NICE, 2004) with exclusion of renal replacement
therapy as a risk factor.
• Correlations between the risk assessment and demograph-
ics factors were carried out using Χ² analysis
Results: Among the 366 newly joined DM patients, 59.8% were
classified as having low risk for DM foot problems, 14.5% had
moderate risk, 22.4% had high risk and 3.3% had active foot
ulcers. There was no significant relationship between demo-
graphic factors and the risk category for DM foot disease.
Conclusions: Over 40% of DM patients starting HD have a
significant risk (moderate risk and above) of developing
significant diabetic foot disease. 3.3% already have active
ulcers. Knowing the risk category may enable a more focused
approach for foot care in DM patients.
PD-74
The effect of risk stratification on 1st year lower limb
amputation in diabetic patient starting haemodialysis in
community setting
Hua YAN1*, Kim Hwa CHUA1, Li Zhi WONG1, Jon Choon LEE 1.
1Clinical Services Division, National Kidney Foundation, Singapore
Introduction: Diabetic (DM) foot complications are common in
diabetic patients undergoing chronic dialysis. The rate of lower
limb amputation among DM patients with ESRD was10 times
as great as among the diabetic population at large (PAUL
W. Eggers, et al 1999).
In National Kidney Foundation (NKF) Singapore, more than
70% of newly admitted ESRD patients were diabetic. We
therefore explored the first year risk of lower limb amputation
among NKF diabetic patients based on their risk stratification
for foot problem. It aimed to strengthen clinical pathway on
DM foot care to achieve reduction in lower limb amputation
rate among NKF DM patients.
Patients and Methods:
• All newpatients starting on chronic HD in NKF HD program
from1 Jan 2012 to 31 Dec 2013 and who were diabetic were
included in the study.
• Patients’ data captured included demographics (age,
gender, ethnicity and marital status), admission date to
NKF, and initial risk category for DM foot disease,
subsequent follow up for amputation event until 31 Dec
2014. The amputation rate was calculated for the first year
after assessment.
• A total of 366 patients were included in the study.
• Patient characteristics were as follows: Median age 58 years
(range 24–91), majority were in the 50th-70th. 58.7% were
males and 41.3% were female. 55.2% were Chinese and
44.8% were Malay and other races.
• Initial risk assessment for diabetic foot disease was
carried out upon entry to the program. Information was
then entered into a structured checklist form. These were
collated, transcribed and retrospectively analysed at the
end of the study period.
• The risk assessment for diabetic foot problems was carried
out using a DM foot screen tool adopted from NICE
guideline (NICE, 2004) with exclusion of renal replacement
therapy as a risk factor.
Results: Among the 366 newly joined DM patients, first
year lower limb amputation rate was strongly correlated
with initial foot disease risk (p < 0.05). The rates were 1.4%
(Low risk), 7.6% (Moderate), 9.8% (High) and 33.4% (Active foot
ulcer).
Conclusions: Results of this study suggest that active foot
ulcers are significantly associated with first year lower limb
amputation. Prompt foot screen and intervention to prevent
ulcer formation is paramount. Adopting a multidisciplinary
approach in the management of DM foot starts from patient
admission would largely improve patient outcome on
amputation.
PD-75
Comparison of glycemic control in Asian and non-Asian T2D
patients initiating insulin glargine 100 U/mL as add-on
therapy to OADs
Shih-Tzer TSAI1*, Juliana CHAN2, Pongamorn BUNNAG3 ,
Siew Pheng CHAN4, Iris Thiele Isip TAN5, Ling GAO6 ,
Wolfgang LANDGRAF7. 1Taipei Veterans General Hospital, Taipei,
Taiwan; 2The Chinese University of Hong Kong, Hong Kong;
3Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;
4University of Malaya Medical Centre, Kuala Lumpur, Malaysia;
5University of the Philippines, Manila, Philippines; 6Analysta Inc.,
Somerset, New Jersey, United States of America; 7Sanofi,
Frankfurt, Germany
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S114