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

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Method and materials: We collect adult participants in our
OPD with a body mass index of 25 or higher; with type 2
diabetes mellitus; and who received liraglutide once daily at
clinically relevant doses for at least 24 weeks. We assess the
effect of weight loss and assessed markers of glycaemic
control: fasting plasma glucose, glycated haemoglobin (per-
centage of HbA1c.).
Results: During Jun 2015 to April 2016, we collect 128 diabetic
patients (M:F = 65:63, age around 20–60 years old, BMI = 27 + 10),
who had already received two or three kinds of oral hypogly-
cemic agents and long-acting GLP-1 receptor agonist
(Liraglutide) for more than 24 weeks. In the overall analysis,
GLP-1R agonists had beneficial effects on body weight loss. But
did not have a significant effect on glycemic control (HbA1c).
GLP-1R agonists were associated with nausea, diarrhoea, and
vomiting.
Conclusions: The real world experience in our hospital showed
that although treatment with GLP-1R agonists deed leads to
weight loss in overweight or obese patients with type 2
diabetes mellitus, but no improvement of A1c during 24
weeks treatment in most of the patients.
PD-123
The short-term glycemic effects of a smartphone-based
communication application management
Pin Fan CHEN 1, Bing Ru GAU1*, Wei Cheng LIAN1,
Ting Chang CHEN 1. 1Division of Endocrinology and Metabolism,
DaLin Tzuchi General Hospital, Taiwan
Aims: Web-based telemedicine is proved to improve glycemic
control in patients with diabetes. However, around the clock
care for diabetes has rarely studied. This study aimed to
investigate the impact of a smartphone-based communication
technology (Health2Sync) on glycemic control.
Methods: From October 2015 to January 2016, a total 174 type 2
diabetic patients (mean age 51.7 years) with glycohemoglobin
(HbA1c) >7%was introduced to participatewith a smartphone-
based diabetes health care application. Those patients were
divided into a novel glycemicmanagement group (n = 24) and a
traditional group (n = 150). The novel diabetic management
included 2 or 3 nearly full-dose oral antidiabetics drugs
initially. Then the regimens were adjusted aggressively to
prevent glucose levels less than 100 mg/dL. The medical
history and following laboratory tests including glucose
levels were collected and analyzed. The Analysis of Variance
with adjustment of age, gender, diabetes duration, renal
function and baseline HbA1c were used to test the difference
of glycemic control.
Results: Overall, HbA1c improved from 8.8 ± 1.6% to 8.0 ± 1.3%
(p < 0.001) after patients participated with this smartphone-
based diabetes health care application. The baseline HbA1c
between the novel glycemic management group (n = 24) and
the traditional group are 9.9 ± 1.2% and 8.6 ± 1.5% (mean ± SD),
and the HbA1c level improved to 7.2 ± 0.3% and 8.1 ± 0.1%
(marginal mean ± SE) in 3months later, respectively (p = 0.003).
There is no episode of severe hypoglycemia during this
period.
Conclusions: The application of around the clock smartphone-
based diabetic management can successfully improve the
glycemic control of type 2 diabetic patients. In addition, a novel
diabetic management with aggressive medication adjustment
significantly improves patient ’s glycemic control without
further increase in risk of severe hypoglycemia.
PD-124
Influence of digestible carbohydrate in glycaemic index of
healthy individuals and diabetes
Asha Murshida MUTHALIB1*, Kamal Abdul NASER 2,
Ramaiya SIVAKANESAN 3, Badurdeen Mohamed NAGEEB4.
1 Institute of Indigenous Medicine, University of Colombo, Rajagiriya,
Sri Lanka; 2King’s Mill Hospitl, Sutton in Ashfeild, Nottinghamshire,
United Kingdom; 3Department of Biochemistry, Faculty of Medicine,
University of Peradeniya, 4Institute of Indigenous Medicine,
University of Colombo, Sri Lanka
South East Asia is second highest number of deaths attribut-
able to diabetes of any of the seven IDF regions, after the
Western Pacific Region. More than half (53.2%) of these deaths
occurred in people under 60 years of age. In South East Asia,
one quarter of all births are affected by high blood glucose in
pregnancy. Management of diabetes at the initial stage and
prevention of future onset could be easily achieved by dietary
management. There is currently much scientific and popular
interest in the role of low glycaemic index (GI) food and
digestible carbohydrate in the management of diabetes. The
digestible carbohydrate content in a food is an important
factor in determining Glycaemic index of the food. The
objective of the study was to determine the digestible
carbohydrates of white, brown rice flour and white wheat
flour (white flour/plain flour) made food and glycaemic index
(GI) for same flour made food in healthy and diabetic patients.
Available carbohydrate of each food was determined in
duplicates using 6 replicates by Megazyme essay kit.
The mean age and body mass index of healthy individuals and
controlled diabetes were 36 ( ± 8.89) years, 22.7 ( ± 1.46) kgm−2,
46 ± 9.5 years and 27.6 ± 4.7 kgm−2 respectively. The available
carbohydrate in white, brown rice flour and white wheat flour
made food were 24.2 ± 2.5%, 23.1 ± 0.9 and 25.4 ± 2.1 respect-
ively. The GI of white, brown rice flour and white wheat flour
made food in healthy individuals, controlled and uncontrolled
diabetes were 75.1 ± 3.3, 72 ± 2.74 and 84.7 ± 3.7; 89 ± 2.6, 84 ± 1.4
and 98.3 ± 3.5; 97 ± 1.1, 95 ± 1.3 and 103.4 ± 1.2 respectively.
Digestible carbohydrate is low in brown rice flour compared
to white rice & white wheat flour. Healthy individual shows
low GI compared to both controlled and uncontrolled diabetes
for the same amount of digestible carbohydrates contained
food. From this study it is obvious that whole grain flour made
food contained less digestible carbohydrate and refined grain
made out of flour contained high digestible carbohydrate.
Same digestible carbohydrate contained foods showed differ-
ent GI in healthy individuals and diabetes. Digestible carbo-
hydrate of a food is important to determine the GI and when it
comes to healthy individuals and diabetes even though low
digestible carbohydrate foods showed high GI.
PD-125
Efficacy and safety comparison of sitagliptin and glimepiride
in elderly Japanese patients with type 2 diabetes: START-J
Nobuyuki SHIHARA1*, Yasuo TERAUCHI1,2, Hitoshi ISHIDA1,3,
Masafumi KITAOKA1,4, Jo SATOH1,5, Daisuke YABE1,6,7,
Yuichiro YAMADA1,8 , Yutaka SEINO1,6,9. 1Japan Association for
Diabetes Education and Care, 2 Department of Endocrinology and
Metabolism, Yokohama City University Graduate School of Medicine,
3Third Department of Internal Medicine, Division of Diabetes,
Endocrinology and Metabolism, Kyorin University School of Medicine,
4IMS Miyoshi General Hospital, 5TohokuMedical and Pharmaceutical
University Wakabayashi Hospital, 6Kansai Electric Power Medical
Research Institute, 7Department of Diabetes, Endocrinology and
Nutrition, Kyoto University Graduate School of Medicine,
8Department of Endocrinology, Diabetes and Geriatric Medicine,
Akita University School of Medicine, 9Kansai Electric Power Hospital,
Japan
Objective: DPP-IV inhibitors which rarely cause hypoglycemia
are possible to be anti-diabetic agent as the first line therapy
for elderly patients with type 2 diabetes (T2DM) who could not
manage hypoglycemia sufficiently. The purpose of this study
was to compare the efficacy and the safety of sitagliptin and
glimepiride in drug naïve elderly Japanese patients with
T2DM.
Subjects: Patients with T2DM who were OHA naïve or on α-GI/
biguanide monotherapy (to be washed out 4 weeks prior to
randomization). Age ≧60 y.o., HbA1c ≦6.9%, >8.9%.
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S130