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

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Results: In type 1 diabetic patients, the mean values of BG
before and 1– 6 days after replacing Gla with Deg were 151.2 ±
29.1, 162.5 ± 51.5, 182.4 ± 53.3, 166.2 ± 39.5, 173.3 ± 55.9, 157.4 ±
45.1, and 156.2 ± 44.3 mg/dl, respectively; and those of BG at
night were 132.0 ± 44.4, 147.2 ± 63.2, 180.0 ± 81.7, 166.8 ± 83.1,
167.4 ± 76.7, 162.2 ± 58.6, and 152.4 ± 89.0 mg/dL, respectively.
Thus, the mean values of BG both for a day and at night were
temporarily elevated significantly 2 days after the drug
replacement but thereafter improved. The SD values and
frequencies of hypoglycemia both for a day and at night did not
significantly change by the drug replacement. In addition,
there was no significant difference in the insulin dose between
before and after the drug replacement.
In type 2 diabetic patients, the mean and SD values of BG, and
frequencies of hyperglycemic both for a day and at night did
not significantly change by the drug replacement. There was
no significant difference in the insulin dose between before
and after the drug replacement.
Conclusion: In both type 1 and type 2 diabetic patients,
replacement of Gla with Deg could be accomplished by using
nearly the same units of the drugs. Sequential changes in BG
by the drug replacement both for a day and at night in type1
and type 2 diabetic patients differed from each other.
PD-78
Efficacy and safety of mitiglinide versus acarbose for treatment
of Chinese patients with type 2 diabetes: Open, multi-center,
randomized study
Zilin SUN 1*, Yang YUAN1, Yanmei LIU2, Chenguang WU3,
Jun LIANG 4, Shaogang MA5, Fei HUA6. 1Department of
Endocrinology, Zhongda Hospital, Southeast University, Nanjing,
2 Department of Endocrinology, The First People’s Hospital of
Yancheng, Yancheng, 3Department of Endocrinology, The First
People’s Hospital of Zhenjiang, Zhenjiang, 4Department of
Endocrinology, The Central Hospital of Xuzhou, Xuzhou,
5 Department of Endocrinology, The Second People’ s Hospital of
Huaian, Huaian, 6Department of Endocrinology, The First People’s
Hospital of Changzhou, Changzhou, Jiangsu, China
Background: Acarbose was a kind of commonly used oral anti-
diabetic drug special for post-prandial blood glucose and had
been widely used in China, but its common gastrointestinal
adverse reactions could not be tolerated in some patients.
Mitiglinide was a rapid- and short-acting insulinotropic
sulfonylurea receptor ligand that was known to improve
postprandial hyperglycemia in patients with type 2 diabetes
mellitus. The aimof this study was to evaluate the efficacy and
safety of mitiglinide versus acarbose in patients with type 2
diabetes mellitus.
Methods: In this open, multi-center, randomized controlled
trial, patients with type 2 diabetesmellitus within 5 years were
divided randomly into mitiglinide or acarbose treatment
group, treated with mitiglinide 10 mg or acarbose 50 mg
three times a day for 12 weeks, respectively. The primary
outcome measure was change from baseline in glycosylated
hemoglobin (HbA1c) at 12 week, secondary outcome measure
included change from baseline to the end of treatment in
fasting blood glucose (FBG), postprandial blood glucose(PBG)
and safety. This study was registered with Clinical Trial.gov,
Clinical Trials.gov Identifier was NCT02143765.
Results: A total of 248 patients were enrolled and 237 patients
could be incorporate to the evaluation analysis (118 in the
mitiglinide group and 119 in the acarbose group). After
treatment, HbA1c, FBG, PBG were all decreased significantly
in the two groups (all, P < 0.0001). HbA1c reduction at week 12
was – (0.95 ± 1.11) % in the mitiglinide group and –(0.80 ± 1.27)%
in the acarbose group with difference (0.15 ± 1.19) %, but there
was no significant difference between two groups (P > 0.05). At
week 8, the FBG reduction was –(1.31 ± 1.29) mmol/L (mitigli-
nide) and –(0.86 ± 1.68) mmol/L (acarbose) with difference
(0.45 ± 1.51) mmol/L, there was significant difference between
two groups (P < 0.05). At week 12, the differences in reduction
of FBG and PBG from baseline between the two groups were no
statistic significance (P > 0.05). The incidence of adverse event
was14.66% in the mitiglinide group and 6.54% in the acarbose
group (P = 0.0508). The incidence of abdominal distension in
acarbose group was significantly higher than in mitiglinide
group (P = 0.0055).
Conclusion: HbA1c, FBG and PBG could all be decreased
significantly by either mitiglinide or acarbose, and both
groups showed similar efficacy. Mitiglinide group had fewer
gastrointestinal reaction and better safety
PD-79
Mechanisms of postprandial suppression of hepatic AMPK
activity through insulin-PI 3-kinase pathway
Kana UMEMOTO1*, Licht MIYAMOTO1, Sayaka UESHIMA1,
Mayu HOSOI1, Gouki TOMOKAWA1, Koichiro TSUCHIYA 1.
1Dept. of Medical Pharmacology, Inst. of Biomedical Sciences,
Tokushima University Graduate School, Japan
The number of diabetic and prediabetic patients has been
increasing all over the world. Diabetes increases the risk of
cardiovascular diseases such as arteriosclerosis, myocardial
infarction and stroke, which gives ill effects on the quality of
life by concurrent complications like retinopathy, nephropa-
thy and neuropathy.
AMPK is known as a serine/threonine kinase protein complex
with three subunits. The subunit has a catalytic functionwhile
and subunit have a modulating effect. AMPK is considered to
be one of the desirable therapeutic targets in the treatment of
obesity and diabetes, because activated AMPK inhibits anab-
olism whereas promotes catabolism.
We have recently revealed that leptin activates hepatic AMPK
predominantly through central action via hypothalamus
although direct action suppresses the activity, meanwhile,
both direct and indirect action of leptin can increase AMPK
activity in skeletal muscles. However, the detailed mechanism
has not been clarified. Therefore, we searched for another
post-translational modulation of AMPK to further reveal
the mechanism regulating hepatic AMPK activity in vitro and
in vivo.
When mice (ddY, 7 wks, male) were divided into control and
12 h fasted groups, we found ameal-sensitive phosphorylation
site of liver AMPK, and the phosphorylation was reduced in the
fasting group. Furthermore, insulin injection increased the
liver AMPK phosphorylation and lowered the activity of it.
Because insulin varies its concentration with meal, this had
led us to hypothesize that AMPK phosphorylation is controlled
by insulin.
Thus we further studied the possible mechanisms of insulin
for AMPK phosphorylation using cultured hepatic cells (FaO).
Insulin stimulation increased the phosphorylation of AMPK,
and it was unaffected by pretreatment with rapamycin,
whereas wortmannin, a PI 3-kinase inhibitor, reduced the
phosphorylation by insulin.
In conclusion, our findings may suggest that food intake
controls AMPK activity through insulin-PI3K pathway, which
enhance development of insulin resistance. Because impaired
glucose tolerance will develop diabetes with insulin resistance
at a high frequency, this mechanism might be a novel
therapeutic target for metabolic diseases including diabetes.
PD-80
The effect of vitamin D-rich diet on advanced glycation end
products in overweight and obese women: VINTAGE trial
Shin SUKINO1*, Kazuhiko KOTANI1,2, Shinsuke NIRENGI1,
Kokoro TSUZAKI1, Yaeko KAWAGUCHI1, Fumi YOSHIOKA1,
Hiroshi OKADA1, Akiko SUGANUMA1, Kaoru TAKAHASHI3,
Naoki SAKANE1. 1Division of Preventive Medicine, National
Hospital Organization Kyoto Medical Center, 2Division of Community
and Family Medicine, Jichi Medical University 3Hyogo Health Service
Association, Japan
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S116