149 / 244
Methods:
A randomized, controlled, open-labeled, multicenter
study was performed for 52 weeks. Starting dose for sitagliptin
was 50 mg per day, could be increased up to 100 mg (25
–
50 mg;
30
≦
GFR < 50). Starting dose for glimepiride was 0.5 mg per day,
could be increased up to 6.0 mg. After that, each investigator
titrated dose to aim at FPG <130 mg/dL, with concerning about
hypoglycemia.
Results:
Analyzed subjects were 291 patients (148/143: sita-
gliptin/glimepiride) whose written informed consent were
obtained and who started administration of the study drugs.
Average age was 70.3 ± 5.6/71.1 ± 5.6 (yr), BMI was 24.1 ± 3.3/
24.5 ± 3.9 and HbA1c was 7.5 ± 0.7/7.5 ± 0.7 (%), respectively.
Any parameter did not have significant difference between the
randomized two groups. HbA1c decreased significantly within
24 weeks in both groups. The changes in HbA1c from baseline
to 24 weeks were
−
0.69 ± 0.62% (sitagliptin) and
−
0.86 ± 0.65%
(glimepiride), respectively. While glimepiride group had sig-
nificantly larger decrease in HbA1c (p = 0.008) at 24 weeks,
there was no significant difference between the two groups at
52 weeks (
−
0.65 ± 0.59%/
−
0.78 ± 0.69% p = 0.069). A significant
difference was observed in the changes in body weight from
baseline to 52 weeks between the two groups (
−
0.37 ± 2.44 kg/
0.31 ± 2.92 kg p = 0.043). The incidences of hypoglycemiawere 7
(sitagliptin) and 23 (glimepiride) patients, respectively.
Glimepiride group had significantly more frequent occurrence
of hypoglycemia (p = 0.002).
Conclusion:
Our results showed that sitagliptin had slightly
lower efficiency in 24 weeks, but had no significant difference
in 52 weeks and higher safety about hypoglycemia. We
propose from this trial that Sitagliptin is effective and safe
for elderly Japanese type 2 diabetes patients as a first line
therapy.
Delay Diabetes Complication: What Can
We Do?
PE-01
Factors associated with diabetic retinopathy in patients with
early and late diagnosed type 2 diabetes in Bangladeshi
population
Rula HADDAD
1
*.
1
Ms Rula, Jordan
Aim:
To assess the determinants of severity and progression of
DR among early and late diagnosed type 2 diabetic, and to
assess the proportion of sight threatening and visual impair-
ment in type 2 diabetes patients attending BIRDEM hospital in
Bangladesh.
Background:
Early onset type 2 DM may affect the develop-
ment of diabetic retinopathy (DR) at a relatively younger
age. DR is a serious problem that is well characterized by
impaired vision; a condition known as sight threatening
retinopathy (STR). The prevalence and incidence of STR in
developed countries have been noticed and well recognized.
However, there was only one national survey that empha-
sized on causes of visual impairment and blindness among
adults in Bangladesh, but it revealed that DR is not the main
cause for blindness or visual loss among this population. No
other studies have been conducted in Bangladesh that
estimate the magnitude of STR, and the impact of prognostic
indicators on STR, visual impairment and blindness. Moreover
there is no study that identifies the determinants of severity
and progression of DR among early and late diagnosed type
2DM.
Method:
A cross sectional study was conducted in outpatient
ophthalmic clinic at BIRDEM, Dhaka. Dilated color fundus
photography was performed in all patients who have type 2
diabetes, and those showing some degree of retinopathy
were included. Data on socio-demographic characteristics,
anthropometric measures and blood pressure were obtained
from patients meeting the eligibility criteria.
Biochemistry blood test was recorded from the patient book
file.
Results:
Two hundred and fifty seven patients (110 female, 147
men) with type 2 diabetic were included in the study. Diabetic
retinopathy was distributed as follows; NPDR (36%), CSME
(43%), and PDR (21%). The proportion of patients with STR and
visual impairment (moderate and severe) were 64% and 56.4%
respectively. Severe visual impairment was observed in 2.7% of
the cases. HDL, FBS, and being diagnosed early with diabetes
were associated with progression of DR. The risk of SRT
increased with age (P < 0.01). The median time to STR onset
was estimated at 17 years for females, and 15 years for men.
Hypertension and HbA1c were not significantly associated
with STR, visual impairment or progression of DR.
Conclusion:
Our study showed that the prevalence of visual
impairment was much higher than the national estimate of
13.8%. In resource limited countries, regular screening for
diabetic complications should be supported fully by govern-
ment health institutions if the prevalence of STR and visual
impairment are to be reduced substantially.
PE-02
Prevalence of retinopathy in population with prediabetes in
China: Results from a cross-sectional survey and retrospective
analysis
Zhenping ZHAO
1
, Tengfei MAN
2
, Mei ZHANG
1
,
Tongtong WANG
3
, Zhengjing HUANG
1
, Shusen LIU
2
,
Yichong LI
1
, Qian DENG
1
, Samuel S. ENGEL
3
,
R. Ravi SHANKAR
3
, Kimberly G. BRODOVICZ
3
, Yingmei TU
2
,
Limin WANG
1
, Lihong WANG
1
*.
1
National Center for Chronic and
Non-communicable Disease Control and Prevention, Chinese Center
for Disease Control and Prevention,
2
Merck Sharp & Dohme (China)
R&D Co., Ltd., Beijing, China;
3
Merck Research Laboratories, Merck &
Co., Inc., Kenilworth, NJ, USA
Background:
It has been estimated that 50.1% Chinese adults
(about 480 million) have prediabetes in China. Quantifying
prevalence of retinopathy among prediabetic adults, espe-
cially those continuously remaining prediabetic, could be used
to estimate future healthcare costs and justify priority
intervention for prediabetes. However, there is limited data
in the Chinese population.
Objective:
This cross-sectional survey was designed to esti-
mate the prevalence of retinopathy among those with
diabetes, prediabetes and population with normal glucose
tolerance (NGT) in China in 2014. This study also retrospect-
ively determined the glucose tolerance status of the cohort in
2010, and compared the prevalence of retinopathy among
those who remained prediabetic or NGT from 2010 to 2014.
Method:
Chinese adults aged above 18 years old with
prediabetes and NGT were identified from four counties/
districts in 2010, and were followed up to 2014. Fundus
photography was implemented at the end of the follow-up.
Retinopathy was diagnosed by two trained ophthalmologists
independently using modified Airlie House classification. If
the diagnoses were different from each other, a third
ophthalmologist was to recheck the fundus photography and
make a final diagnosis. Three groups, diabetes, prediabetes,
and NGT using ADA diabetes diagnosis definition, were
compared according to self-reported diabetic status or based
on blood testing in 2014. A further analysis between the
subgroups who remained prediabetic or NGT in the 4-year
’
s
follow-up was also conducted.
Results:
Out of 830 subjects who were successfully followed up
in 2014, 92, 342 and 396 were found to be diabetic, prediabetic,
and NGT, respectively. Retinopathy was diagnosed in 17
(18.5%), 51 (14.9%), and 46 (11.6%) of the diabetic, prediabetic
and NGT individuals, respectively. According to their diabetic
status in 2014, compared to NGT individuals, the odds ratio of
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S131