Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

recommended by American Diabetes Association in 2010.

Trends across different progression categories were deter-

mined using the Wald chi-square test for trend. Logistic

regression was used to assess the association between

progression states of pre-diabetes and CKD.

Results:

Among 1,293 successfully followed subjects in 2014

(follow-up rate was 60%), 46% were normoglycemic, 42% had

prediabetes (impaired fasting glucose or impaired glucose

tolerance or both), and 12% had diabetes. The overall

prevalence of CKD among adults with diabetes, prediabetes

and NGT was 13.6%, 10.9% and 8.1% respectively. Compared

with NGT, subjects with dysglycemia (diabetes or prediabetes)

were more likely to have CKD (OR = 1.4, 95% CI: 0.9

–

2.0) after

adjusting age, sex, BMI, central obesity, smoking, drinking,

hypertension, dyslipidemia, and family history. The CKD

proportions were 8.6%, 12.6% and 15.7% among those who

had reverted from prediabetes to NGT, remained prediabetic,

or progressed to diabetes between 2010 and 2014, respectively.

Trend test indicated that the CKD prevalence increased with

the progression categories (p = 0.006). Logistic results showed

the risks of having CKD were 1.2 (95% CI: 0.7, 2.1) and 1.5 times

(95% CI: 0.8, 3.0) higher among subjects who remained

prediabetic and progressed from prediabetes to diabetes,

respectively, than in those who remained NGT (adjusted

variables were the same as before).

Conclusions:

There was no significant association between

CKD and diabetes status in 2014. Although a significant trend

was observed suggesting an association between pre-diabetes

progression and CKD, casual association cannot be conclu-

sively determined due to lack of baseline CKD status.

PE-30

Utilizing team cooperation for improving retinal screening

compliance and follow-up of diabetes patients

Li-Yuan GUO

*, Jia-Yu TIAN

, Ya-Wen CHANG

, Shin-Te TU

Lukang Christain Hospital, Taiwan

Purpose:

Retinopathy is one of the diabetes chronic comorbid-

ities. Therefore, the use of team cooperation and care pro-

cess improvements can be used to improve diabetes patient

health self-management and participation to increase the

retinal screen compliance and early detection for diabetes

patients.

Methods:

In this study, the diabetes medical team established

a complete retinal screening examination process and many

methods such as telephone reminder, follow-up reminder

forms, establish outpatient electronic reminders, and remind

outpatient physician and nursing personnel for assistance and

follow-up; were established to remind those patients who

haven

’

t received retinal screening. After the implementation

of the improvements, the compliance of retinal screening were

determined and followed.

Results:

After implementation, the retinal screening rate in our

hospital from Jan to April, 2014 was 23.4%, the screening rate

during the sample period in 2013 was 22.4%. Therefore, the

implementation of the outpatient reminder forms and elec-

tronic reminder was able increase the retinal screening rate

by 1%.

Conclusion:

The hospital systematically identified those

patients who have not received examination and utilized

telephone reminder, outpatient reminder forms, and elec-

tronic reminders to outpatient physician to remind the patient

to receive their retinal screening. However, some patients

have refused the examination due to a lack of knowledge

regarding the importance of the screening and the unease

towards the use of dilating agents. Further improvements such

as the physician can actively inform the patient regarding the

important of the examination, establishing health consult-

ation education pamphlets for increasing the awareness and

motivation for retinal examination can be used to improve

examination compliance and follow-up rate.

PE-31

The relationship between mitochondrial dynamics and

insulin resistance in diabetes susceptible cybrid cells

Shao-Wen WENG

, Pei-Wen WANG

*, Hung-Yu LIN

Jiin-Haur CHUANG

, Cheng-Feng TSAO

, Ching-Yi LIN

Tsu-Kung LIN

, Chia-Wei LIOU

Department of Internal

Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang

Gung University College of Medicine,

Department of Neurology,

Kaohsiung Chang Gung Memorial Hospital and Chang Gung

University College of Medicine,

Department of Surgery, Kaohsiung

Chang Gung Memorial Hospital and Chang Gung University College

of Medicine, Kaohsiung, Taiwan

Background:

Mitochondrial dynamics has been proposed as a

bridge between mitochondrial dysfunction and insulin resist-

ance (IR). In our previous studies, by comparing cybrid cells

derived from osteosarcoma cell harboring diabetes susceptible

(B4) and protective (D4) mitochondrial haplogroups, we

demonstrated the independent role of mitochondria in the

pathogenesis of IR in T2DM. However, how the mitochondrial

dynamics affect mitochondrial and cellular functions in

insulin-resistant cells remain unanswered.

Methods:

To dissect the mechanisms between mitochondrial

dynamics and IR in diabetes susceptible cybrid B4, silencing of

target genes by siRNA or gain function by plasmid transfection

was performed. We constructed Mfn-1, Mfn-2, Drp-1, Fis-1-

over-expressing vectors and cybrid cell lines. Mitochondrial

membrane potential, mitochondrial network and the insulin

signal pathway were compared in the B4 cells with over-

expression or knock down of the dynamic proteins.

Results:

Cybrid B4 cells had impaired mitochondrial dynamics

as compared with D4 cells. Cybrid B4 mitochondrial mem-

brane potential (MMP) was not significantly altered by the

chemicals (lipo 2000, GFP) used in the experimental procedure,

and the transfection rates of fusion and fission-related

molecules (Mfn1/Mfn2/Fis1/Drp1) were satisfactory. By over-

expression study, fusion-related molecules increase mito-

chondrial network while fission-related molecules increase

fragmented mitochondria in B4 cells. Further, fusion-related

molecules increase MMP, while fission-related molecules

decrease MMP of B4 cells. Knock-down of fusion-related

molecules also showed decreased MMP. Over-expression of

fusion-related molecules enhanced the activation of IRS1-Akt

for glucose uptake. Knock down fission-related molecules

enhanced the activation of IRS1-Akt for glucose uptake. There

was also increased translocation of GLUT1/GLUT4 onto the cell

membrane upon over-expression of fusion-related molecules.

Conclusion:

Fusion-related molecules increased insulin sig-

naling and glucose uptake while fission-related molecules

may inhibit insulin signaling and decreased glucose uptake.

These data suggest a causal relationship between mitochon-

drial dynamics and IR.

PE-32

In situ eNOS/NO up-regulation

–

A simple and effective

therapeutic strategy for diabetic skin ulcer

Ye YANG

1,2

*, Dengke YIN

School of Pharmacy, Anhui University

of Chinese Medicine,

Department of Endocrinology, The First

Affiliated Hospital of Anhui University of Chinese Medicine, China

Nitric oxide (NO) plays a key role in the physiological regu-

lation of vascular functions. High serum concentrations

of glucose and advanced glycation end products in people

with diabetes results in reduced eNOS activation and NO

synthesis and in increasedNO consumption. Various diabetes-

related complications are associated with the consequently

impaired vascular tone and inadequate delivery of oxygen

and nutrients to tissues

—

including refractory skin ulcers.

Statins have proved protective effects on endothelial function

involving increasing eNOS expression and NO bioavailability,

and promotive effect on neovascularization of ischaemic

tissue.

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

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