135 / 244
Background:
High advanced glycation end products (AGEs)
diets promote inflammation and oxidative stress and insulin
resistance; AGEs levels increase during cooking because of the
processing or heat treatment used.
In our previous study reported that the changes in vitamin D
were negatively correlated with those of blood AGEs, inde-
pendent of the changes of weight loss, during a weight loss
period among obese women. However, the effect of a vitamin
D-rich diet on AGEs is still unclear.
Objective:
The primary objective is to determine whether
intake of a vitamin D-rich diet on AGEs diet can lower blood
AGEs levels of overweight adult women. The secondary
objective is to compare changes in inflammation and oxidative
stress markers with vitamin D concentration and other health
indicators.
Vitamin D-rich diet on Advanced Glycation End products trial
(VINTAGE trial).
Methods:
Overweight non-diabetic Japanese women (n = 20)
will be included. A randomized crossover intervention design
alternating normal and Vitamin D-rich diet (4-week duration)
with a 4-week washout period will be used. The inclusion
criteria will be as follows: female; age, 20
–
50 years; overweight
and obese. The exclusion criteria will include the following:
smoking; high alcohol consumption; known allergies; medi-
cation use; diseases/disorders (cancer; cardiovascular, hema-
tological, respiratory, gastrointestinal, endocrine, central
nervous system, or psychiatric disorders); menopause or
pregnancy and/or lactation; judged unsuitable for the study
by the medical doctor.
We will measure the following parameters at baseline, after 4-
week intervention (first intervention period), and before and
after the second intervention period: Height, body weight,
body fat content, circumference, and blood pressure will be
measured, and urine analysis will be conducted. Skin AGEs
will be evaluated by skin autofluorescence. SerumAGEs levels,
vitamin levels, and chronic disease risk markers will be
evaluated using blood samples. Participants will complete
the International Physical Activity Questionnaire for assess-
ment of habitual physical activity. Dietary habits will be
evaluated by food recording for 1 week. After baseline mea-
surements, subjects will be divided into two groups based on
AGE and diet habit data. During the intervention period,
participants will record self-checked data (body weight, blood
pressure, and number of steps) and will receive a weekly
telephone phone call to ensuring compliance of dietary intake.
Result:
The study will be completed in early 2017.
PD-81
Effects of resistance exercise training in type 2 diabetes
Hui Min HSIEH
1
, Chiu Mi CHANG
1
, Yu Lien LIU
1
, Yu Jen LAI
1
,
Cheng Hsiu LIN
1
, YU Ling LIN
1
*.
1
Ministry of Health and Welfare
Feng Yuan Hospital, Taiwan
Objective:
According to the Standards of Medical Care in
Diabetes 2016, adults with diabetes should be advised to
perform aerobic physical activity and resistance training.
Compare to aerobic exercise, the benefit of resistance training
is less emphasized. According to the results of our question-
naires in T2DM patients, the top two problems about
resistance training are 1. Have no equipments (44%) 2. Don
’
t
know how to do the exercise (12%). Clinical Trials has shown
the benefit of resistance training including improve blood
glucose control, reduce cardiovascular risk factors and reduce
insulin resistance. To promote the clinical use of resistance
training, we start the program.
Methods:
This program was executed between Jan. 2015 and
Dec. 2015 at Fengyuan Hospital. We use the Balanced Score
Card concept. The three major strategic perspectives include
(1) customer, (2) internal process, (3) learning & innovation. In
the aspect of learning &Innovation: Lectures to the diabetes
association and community to educate the benefit of
resistance training in diabetes. We also trained our case
manager and volunteer to promote the program. In the
aspect of internal processes: the Endocrinology and
Metabolism department cooperate with the Rehabilitation
department to design the teaching video for resistance bands.
Application of the exercise plans to the diabetes association,
out-patient department, Ward, and community. We also put
the video on the famous online broadcasting platform-
YouTube for sharing and hope to facilitate the use of the
video. We incorporate the program to the self-management
education in the Diabetes Shared Care Network in Taiwan. In
the aspect of Customer: we use the colorful rubber bands-
rainbow loom, for hand-made resistance bands-cost about 0.3
dollars. It made the resistance training became easy, interest-
ing and cheap.
Results:
After the resistance training program, 89% patients in
our diabetes association could perform resistance training
constantly and incorporate the program into their regular
exercise plan. 34% patients achieved the recommended target
of ADA: perform resistance training at least twice per week.
The number of patients involved in the training program over
200 persons till the end of 2015.
Conclusion:
Resistance training as an adjunct to standard of
diabetes care is simple and effective in improving glycemic
control. Through interdisciplinary team works and the
Diabetes Shared Care Network in Taiwan, resistance band
training is potentially less expensive and more accessible.
PD-82
Real-World (RW) treatment patterns in patients with T2DM
newly initiated with antihyperglycemic (AHA) medications in
the US
Jennifer CAI
1
, Chakkarin BURUDPAKDEE
2
, Victoria DIVINO
2
,
Mayuresh FEGADE
3
*.
1
Janssen,
2
IMS Health, United States of
America;
3
Janssen Medical Affairs, India
Objectives:
Randomized controlled trials have established
the efficacy of canagliflozin (CANA) in T2DM; whereas RW
studiesmeasuring effectiveness are limited. This retrospective
study evaluated treatment patterns with CANA, dapagliflozin
(DAPA), GLP-1 agonists (GLP-1s) and DPP-4 inhibitors (DPP-4s)
among patients with T2DM over a 12-month follow up from a
US managed care perspective.
Methods:
Patients newly initiating CANA, DAPA, GLP-1s, or
DPP-4s from 2/1/2014
–
6/30/2014 were identified from the IMS
PharMetrics Plus Database (empagliflozin, approved in 8/2014,
was excluded). The first fill defined the index date/drug.
Patients were required to have a T2DM diagnosis (ICD-9-CM
250.x [0,2]) and
≥
360 days of continuous enrollment pre-
(baseline) and post-index (follow-up). Up-titration of CANA
and DAPA, adherence (proportion of days covered, PDC;
medication possession ratio, MPR) and persistence on index
therapy were assessed. A gap
≥
90 days between two prescrip-
tions defined discontinuation.
Results:
The final sample was 23,702 patients (6,546 CANA,
3,087 DAPA, 6,273 GLP-1s and 7,796 DPP-4s; 56% male and
mean [SD] age 55 (9.1) years). More than half of CANA patients
(57%) initiated 100 mg and 20% up-titrated to 300 mg in a mean
(SD) of 138 (93) days, while the majority of DAPA patients (66%)
initiated 5 mg and 21% up-titrated to 10 mg in 157 (90) days.
The mean PDC for CANA was 0.71 compared to 0.64 for DAPA,
0.56 for GLP-1s, and 0.62 for DPP-4s, respectively; MPR results
were similar. More CANA patients were persistent (68%)
compared to DAPA (57%), GLP-1s (52%) or DPP-4s (54%)
patients, with mean (SD) persistence days of 279 (126), 260
(128), 236 (139) and 242 (138) respectively.
Conclusions:
Adherence and persistence were better with
CANA compared to DAPA, GLP-1s and DPP-4s. These findings
may reflect CANA
’
s better effectiveness and/or tolerability,
which may lead to improved diabetes management in the RW
setting.
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S117