Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

empaglifozin at baseline. 53.0% of 149 patients used basal

insulin regimen once daily. After adding SGLT2i for 6 months,

A1C has been reduced in 122 patients, and reduced by equal

and more than 1% in 42.3% of 122 patients. Overall A1C has

been significantly reduced by 0.9 ± 1.2%. For different A1C

groups (<8%, 8

–

9%, 9

–

10%, and

≧

10% at baseline), the reduction

of A1C was 0.4, 0.4, 1.3, and 1.9%, respectively (p < 0.001). BW

has been reduced in 121 of patients, and reduced by equal and

more than 3 kg in 28.9% of 121 patients. Systolic BP and

diastolic BP were both significantly reduced by 5.4, and

3.1 mmHg, respectively. Regarding insulin dose adjustment,

basal and bolus insulin dose was reduced by 9.4 (n = 87) and

10.3 (n = 53) units, respectively. Before using SGLT2i, hypogly-

cemia from SMBG readings has been found in 41 patients

(33.9%, N = 121), and the incidence of hypoglycemia was 0.36

per patient per month. After using SGLT2i for 3 months,

hypoglycemia has been found in 58 patients (45.7%, N = 127),

and the incidence has been increased to 0.67 per patient per

month. Meanwhile, vaginitis, micturition, and urinary tract

infection (UTI) were self-reported in 9.1, 4.2, and 0.7% of

patients, respectively.

Conclusions:

Adding SGLT2i into insulin regimen significantly

improved T2DM patients

’

A1C, BW, and BP. For those patients

with worse A1C control, the improvement in A1C was

more significant. However, adding SGLT2i may result in

hypoglycemia. Vaginitis, micturition, and UTI were commonly

seen adverse events with SGLT2i therapy.

PD-101

Outcomes of holistic care for patients with type 1 diabetes

(T1D) by multidisciplinary teams in Thailand

Supawadee LIKITMASKUL

*, Taninee SAHAKITRUNGRUANG

Nawaporn NUMBENJAPON

, Pornsri SRIUSSADAPORN

Wannee NITIYANANT

Diabetes Association of Thailand,

Bangkok, Thailand

Objectives:

In Thailand, the optimal treatment and experi-

enced care teams for caring of T1D are not available

countrywide. This three-year project aims to improve the

care and establish multidisciplinary teams for caring patients

with T1D.

Subjects:

85 T1D and 31 multidisciplinary teams from 25

participating hospitals were enrolled. T1Dwere 54 females and

31 males with mean age of 20 ± 11 years. Insulin injection

patterns were twice, three times and

≥

4 times daily in 13, 22

and 65%, respectively. For those who received insulin

≥

4 times

a day, 22% used NPH and 43% used long acting insulin analog

as basal insulin.

Methods:

All care teams were trained for diabetes self-

management education (DSME) and skills before the start. All

patients were switched to basal-bolus insulin analog regimen

with self-monitoring of blood glucose (SMBG) at least four

times a day free of charge. The first year, two 3-day diabetes

camps were set up to accommodate all patients, parents and

teams for learning all essential tasks of diabetes self-manage-

ment. In the second and third year four 2-day diabetes camps

were organized in the 4 regional areas of Thailand to refresh

the knowledge and add essential tasks to live happily with

diabetes.

Results:

The mean ± SD of A1C of the group at enter, the end of

first, second and third year were 9.09 ± 2.98, 8.49 ± 1.69 (p =

0.001), 8.72 ± 1.99% and 8.91 ± 2.04%, respectively. In patients

aged 5

–

10 years, A1C at enter, the end of first, second and third

year were 8.43%, 8.0%, 8.21% and 8.09% (p = 0.26), in patients

aged 10

–

18 years were 9.8%, 8.28%, 9.47% and 9.43% (p = 0.83),

and in those >18 years were 7.9%, 7.85%, 7.7% and 7.73%

(p = 0.03), respectively. At the end of program, the proportion of

patients who achieved A1C < 7.5% increased from 18.3% to

24.5%, while patients with A1C 7.5

–

8.5% rose from 23.9% to

30.6%. Episodes of severe hypoglycemia declined, SMBG

frequency increased from at entry 2.87

–

3.48 times/day. The

carbohydrate counting problems, eating disorders decreased

from 35%, 20% at baseline to 11%, 5%, respectively. The care

teams had better self-confidence in giving care and commu-

nication with patients and families.

Conclusion:

The 3-year process of this program has improved

DSME skills of the patients and families. The optimal supply of

insulin analogs and glucose strips contributed to improve

overall glycemic control, although not sustained. This program

encourages ongoing communication and interaction among

the patients, families and healthcare professionals facilitating

better management outcomes.

PD-102

Effect of dapagliflozin in Japanese type 2 diabetes patients who

have inadequate glycemic control

Yasuhiro IIJIMA

1,2

*, Tomotaka KATO

, Humiyoshi YAKOU

Masahumi NAKAYAMA

, Rokurou ITOU

, Akihiko TANAKA

Kazuo HARA

, Takashi MIWA

, Masato ODAWARA

Tokyo

Medical University,

Todachuo General Hospital, Japan

Objective:

To evaluate the efficacy and safety of dapagliflozin

in the clinical practice.

Method:

Subjects were 35 patients with type 2 diabetes who

had been treated at our hospital. Dapagliflozin (5 mg/day) was

administered to the patients (study subjects) for 12 months.

Blood and urine samples were collected at baseline, 6 and 12

months, and physical examination was performed at each

time point. Efficacy was evaluated by measuring HbA1c levels,

body composition, blood pressure, and liver and renal

function.

Results:

At 6 month, dapagliflozin significantly reduced HbA1c

and glycoalbumin from baseline, and the changes were

maintained over 12 months. (HbA1c 6.95 ± 0.66% (12M) vs

7.49 ± 1.06% (baseline) [P < 0.0001]; glycoalbumin; 18.5 ± 4.2%

(12M) vs 17.3 ± 2.9% (baseline) [P = 0.005]). Compared to the

baseline value, BMI and waist circumference (WC) were also

significantly reduced at 6month, whichweremaintained up to

12 months. (BMI 26.6 ± 3.6 (12M) vs 28.6 ± 3.8% (baseline)

[P < 0.0001], WC 93.7 ± 9.4%(12M) vs 99.6 ± 8.9% (baseline)

[P < 0.0001]).

Blood pressure, uric acid, and parameters for hepatic function

significantly decreased, while hematocrit value and eGFR

significantly increased from baseline. In addition, 12 patients

who had dapagliflozin with reduced dose glimepiride showed

improved blood glucose levels, BMI, and WC.

Conclusions:

Dapagliflozin significantly improved blood

glucose levels, BMI, and waist circumference in patients with

type 2 diabetes. Similarly, dapagliflozin administered to poorly

controlled type 2 diabetes patients with glimepiride improved

blood glucose levels, BMI, and waist circumference, accom-

panied by dose reduction of glimepiride.

These results indicate that dapagliflozin is a useful anti-

hyperglycemic agent that possibly improves the obesity in the

real clinical practice.

PD-103

To investigate the efficacy of dipeptidyl peptidase-IV (DPP-IV)

inhibitor therapy in multiethnic Asian patients with type 2

diabetes mellitus

Julia ANDRES

*, Jia Xuan YEO

, Chin Meng KHOO

National

University of Singapore,

National University Hospital, Singapore

Objective:

To investigate the efficacy of dipeptidyl peptidase-

IV (DPP-IV) inhibitor therapy in multiethnic Asian patients

with type 2 diabetes mellitus (T2DM).

Research design and methods:

This is a retrospective single-

center study of 343 Singaporeans with T2DM from Jan 2014 to

May 2015. Inclusion criteria included patients started on DPP-

IV inhibitor therapy for at least 12 months. We examined the

changes in the glycemic control (HbA1c) and body weight at

baseline and at 12 months after initiation of DPP-IV inhibitor

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

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