Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

PD-113

Patient responses following hypoglycemia in the IO-HAT

study: A population-based study of insulin-treated patients

with diabetes in 9 countries

Yong BEE

*, Ida KSHANTI

, Mahomed OMAR

, Ramazan SARI

Vicky CHAN

, Jain ANAND

, Nazrul SIDDIQUI

Singapore

General Hospital, Singapore;

Fatmawati Hospital, Indonesia;

University of KwaZulu Natal, South Africa;

Akdeniz University,

Turkey;

Novo Nordisk, Switzerland;

Mymensingh Medical College,

Bangladesh

Background and aims:

Hypoglycemia is a key consideration in

the individualization of treatment in patients with diabetes

and has broad sociological and economic impacts on patients,

their families, healthcare providers and businesses. As obser-

vational studies are mainly limited to Western countries, and

by number and consistency of design, actual hypoglycemia

rates and their impact on patients

’

lives, remain unclear for

many countries in the clinical practice setting.

Materials and methods:

The International Operations (IO)

Hypoglycemia Assessment Tool (HAT) is a real-world, obser-

vational study of self-reported (using self-assessment ques-

tionnaires) hypoglycemic events in Bangladesh, Colombia,

Egypt, Indonesia, the Philippines, Singapore, South Africa,

Turkey and the UAE among 7,289 patients with insulin-treated

type 1 (T1D; n = 1016) and type 2 diabetes (T2D; n = 6273). This

abstract describes patient responses to hypoglycemic episodes

pre-baseline and 4 weeks post-baseline among patients with

insulin-treated diabetes in the IO-HAT study. Data are reported

as mean (SD).

Results:

Rates of any hypoglycemia (per patient, per month)

were 4.8 and 6.9 in patients with T1D and 1.6 and 2.4 in those

with T2D during the retro- and prospective periods, respect-

ively. For patients with T1D or T2D, reporting of any and severe

hypoglycemic events was significantly higher (p < 0.001) in the

prospective period, while nocturnal hypoglycemic events were

significantly higher (p < 0.001) in the retrospective period. At

baseline, patients reported fear of hypoglycemia on a scale of

–

10 (not afraid

–

absolutely terrified). Mean (SD) score of 5.5

(3.3) and 4.5 (3.3) was reported by patients with T1D and T2D,

respectively. While 17.1, 13.2 and 12.7% of patients with T1D

rated their fear as 10, 5 and 0, respectively, this pattern was

reversed in those with T2D with 10.8, 13.4 and 19.2% choosing

these ratings. A greater proportion of patients with T1D,

compared with T2D, reported taking action following hypo-

glycemia. The most common responses during the retro/

prospective periods were increased blood glucose monitoring

(T1D 51.6/43.8%; T2D 28.0/20.0%), requiring any form of

medical assistance (T1D 56.0/34.9%; T2D 41.0/24.8%) and

consulting a doctor/nurse (T1D 54.6/34.3%; T2D 39.6/24.5%).

Conclusion:

These results suggest that symptomatic hypogly-

cemia occurs frequently and the fear it generates has a

significant impact on the daily lives of patients with diabetes.

Further, as patients may compromise their general health and

glycemic control to avoid hypoglycemia, improved education

and treatment management strategies are needed.

PD-114

Once-weekly DPP-4 inhibitors: The clinical efficacy and

treatment satisfaction in 51 Japanese patients with type 2

diabetes mellitus

Takahiro TOSAKI

*, Hideki KAMIYA

, Tatsuhito HIMENO

Yoshiro KATO

, Masaki KONDO

, Akemi INAGAKI

Yuka YAMAMOTO

, Kaori TSUBONAKA

, Chie OSHIRO

Yuki NAKAYA

, Tomoyo HAYASAKI

, Jiro NAKAMURA

TDE

Healthcare Corporation TOSAKI Clinic for Diabetes and

Endocrinology,

Division of Diabetes, Department of Internal

Medicine, Aichi Medical University School of Medicine,

Japanese Red

Cross Nagoya Daini Hospital,

Meieki East Clinic, Japan

DPP-4 inhibitors (DPP-4i) play an important role in treating

patients with type 2 diabetes mellitus in Japan. Once-weekly

DPP-4i have recently become available with their usefulness

anticipated. We have investigated the clinical efficacy and

Treatment Satisfaction of weekly DPP-4i, trelagliptin or

omarigliptin, in 51 out-patients with type 2 diabetes mellitus.

20 patients previously treated with other daily DPP-4i were

switched to weekly DPP-4i with the rest of anti-diabetics

unchanged. 31 patients naive to DPP-4i were treated with

weekly DPP-4i as add-on to previous treatment. Random

capillary blood glucose (RCBG) test, HbA1c, glycoalbumin

(GA), body weight, and Diabetes Treatment Satisfaction

Questionnaire (DTSQs) were evaluated. Patients who have

been switched from other daily DPP-4i had no significant

change in HbA1c and GA at 3 months. HbA1c and GA of

patients who had been naive to DPP-4i significantly improved

from 9.46 ± 2.59% to 67.11 ± 1.28% (p < 0.001) and 26.6 ± 12.1% to

17.6 ± 5.6% (p < 0.001) respectively. Nausea and diarrhea were

observed as side effects in 2 cases. In DTSQs, total score of the

first factor consisted of the six treatment satisfaction items

significantly improved from 24.3 ± 8.2 to 28.9 ± 6.6 (p < 0.05) in

patients switched to weekly DPP-4i and from 19.6 ± 8.2 to

27.9 ± 5.7 (p < 0.001) in patients who had been naive to DPP-4i.

Scores of 6 items including overall satisfaction, convenience,

flexibility, level of understanding, recommendation, and

satisfaction to continue treatment significantly improved in

patients who had been naive to DPP-4i and the trend was

similar and significant in 42 patients who were taking other

daily medication. Weekly DPP-4i are effective and well-

tolerated treatment which improves patients

’

treatment

satisfaction.

PD-115

Deteriorating glycemic control after fixed-dose anti-diabetic

combinations were equally shifted to free-drugs regimens

Bing Ru GAU

, Pin Fan CHEN

*, Wei Cheng LIAN

Ting Chang CHEN

Division of Endocrinology and Metabolism,

DaLin Tzuchi General Hospital, Taiwan

Aims:

Fixed-dose combination anti-diabetic drugs have well

glycemic control and can further lower glycated hemoglobin

(HbA1c) by 0.5

–

1.0%. This study aimed to investigate the

glycemic effects when fixed-dose combinations were shifted

to free-drugs regimens on outpatients with type 2 diabetes

mellitus.

Methods:

Between March and April 2015, a total 57 patients

(mean age, 63.2 years), who used fixed-dose combination

anti-diabetic drugs (Sitagliptin/Metformin 50 mg/500 mg,

Vildagliptin/Metformin 50 mg/500 mg and Glimepiride/

Metformin 2 mg/500 mg), and were equally shifted to free-

drugs agents were enrolled. Those free-drugs agents were

maintained for at least 3 months. The fasting blood glucose

(FBG) levels and HbA1c were collected and analyzed by paired

sample t test.

Results:

The FBG levels elevated from 125 ± 29 mg/dL to

139 ± 41 mg/dL (the difference was 13.8 ± 38.3 mg/dL, p = 0.009)

and the HbA1c increased from 6.7% to 7.0% (the difference was

0.3 ± 0.8, p < 0.001) after changing to free-drugs therapy 3

months later. Both FBG levels and HbA1c increased 14 mg/dL

and 0.3%, respectively. In addition, the ratio of HbA1c <7%

decreased from 67.9% to 58.9% (p = 0.007).

Conclusions:

Changing Fixed-dose combination anti-diabetic

drugs to free-drugs regimen could deteriorate glycemic control

3 months later. Patients with type 2 diabetes with optimal

glycemic control (HbA1c <7%) should not change fixed-dose

combinations to free-drugs regimens.

PD-116

The effects of once-weekly semaglutide on beta-cell function

in subjects with type 2 diabetes

Christoph KAPITZA

*, Kirsten DAHL

Jacob BONDE JACOBSEN

, Mads Buhl AXELSEN

Eirik Quamme BERGAN

, Anne FLINT

Profil, Neuss, Germany;

Novo Nordisk A/S, Søborg, Denmark

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

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S211

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