Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

Method:

Eligible cases were the patients who were hospita-

lized with infectious pneumonia in the Department of Internal

Medicine and Respiratory Medicine between March 2014 and

October 2015. We excluded non-infectious pneumonia and

pneumonia developed after admission. We retrospectively

reviewed medical charts and collected data about the patient

backgrounds, clinical and radiologic characteristics and clin-

ical course, and laboratory and microbiological data. We

compared Diabetes group with Non-diabetes group by t test

and chi-square test.

Result:

Among 274 pneumonia cases, 199 were eligible. One-

hundred eleven (55.8%) males were included, andmean ± SD of

age and BMI were 78 ± 15 years old and 20.9 ± 6.2 kg/m

respectively. Sixty-one patients had concomitant underlying

diseases. A number of community-acquired pneumonia (CAP)

was 91, and the number of nursing and healthcare-associated

pneumonia (NHCAP: a Japanese variant of healthcare-asso-

ciated pneumonia) was 108. Fifteen pneumococcal pneumo-

nia, one Legionella pneumonia and 103 aspiration pneumonia

were included. The mortality rate was 7.5%. The number of

patients in Diabetes group was 34 (type 1 diabetes, n = 1; type 2

diabetes, n = 33), mean ± SD of duration of diabetes, plasma

glucose and HbA1c were 18 ± 12 years, 181 ± 61 mg/dL, and

7.0 ± 0.8%, respectively.

Compared with Non-diabetes group, Diabetes group was

significantly younger (73.1 years vs 78.7 years) and had

significantly lower BMI (24.5 kg/m

vs 19.9 kg/m

). Aspiration

pneumonia tended to be fewer in Diabetes group than Non-

diabetes group (38.2% vs 54.5%). Diabetes group tended to have

longer period of antibiotics administration (17 days vs 12 days).

There were no significant differences in WBC, CRP, develop-

ment of the multiple infiltration, pleural effusion, and

empyema, length of hospital stay, and mortality.

Conclusion:

Diabetic patients hospitalized with pneumonia

were significantly younger and showed lower rate of aspiration

pneumonia than non-diabetic patients. There were no signifi-

cant differences in the severity and clinical outcomes.

PE-36

Association of leukocyte subtype counts with chronic

inflammation and atherosclerosis in type 2 diabetes mellitus

Sayuri TANAKA

, Ippei KANAZAWA

*, Toshitsugu SUGIMOTO

Internal Medicine 1, Shimane University Faculty of Medicine, Japan

Background:

Previous studies have shown that circulating

leukocyte subtype counts, especially monocyte count, are

associated with a risk of cardiovascular disease. However, little

is known about the association of circulating monocyte count

with chronic inflammation, visceral fat accumulation, serum

adiponectin level, and atherosclerosis in type 2 diabetes.

Subjects and Methods:

This is a cross-sectional study with a

total of 276 Japanese patients with type 2 diabetes (mean age,

62.3 years; 63% men). None of them had hepatic or renal

dysfunction so far. Intima-media thickness (IMT) of common

carotid artery was evaluated by high-resolution B-mode

ultrasonography. Fat areas of visceral (V) and subcutaneous

(S) were evaluated by performing computed tomography scan

at the level of the umbilicus. Serum total adiponectin levels

were measured by an ELISA kit.

Results:

Multiple regression analyses adjusted for age, dur-

ation of diabetes, body mass index (BMI), HbA1c, and

estimated glomerular filtration rate (eGFR) showed that V/S

ratio and high sensitive CRP (hsCRP) were significantly and

positively associated with monocyte count (

= 0.24, p < 0.001

and

= 0.17, p = 0.025, respectively), while serum adiponectin

was not (

−

0.12, p = 0.107). Multiple regression analyses

adjusted for risk factors of atherosclerosis such as age,

duration of diabetes, BMI, HbA1c, fasting C-peptide, eGFR,

albuminuria, systolic and diastolic blood pressure, triglyceride,

HDL-cholesterol, and LDL-cholesterol (model 1) showed a

significant and positive association of monocyte count with

maximum IMT, average IMT, and plaque score independently

of V/S ratio (

= 0.38, p < 0.001;

= 0.23, p = 0.004; and

= 0.22,

p = 0.005, respectively). However, when hsCRP was added as an

independent variable (model 1 + hsCRP), the association

turned into no significance (

= 0.11, p = 0.164;

= 0.12, p =

0.104; and

= 0.14, p = 0.056, respectively).

Conclusion:

These findings suggest that increased circulating

monocyte count is involved in chronic inflammation as well as

atherosclerosis in patients with type 2 diabetes.

PE-37

Healing process in diabetic patients with foot ulcer

Oyunbileg BAVUU

*, Sainbileg SONOMTSEREN

School of

Medicine, Mongolian National University of Medical Science,

Mongolia

Introduction:

Diabetic foot is one of diabetic chronic complica-

tions. Cause of Diabetic Foot Ulcer (DFU) and amputation are

long term hyperglycemia, peripheral neuropathy and periph-

eral artery disease.

Objective:

The aim of this study was to evaluate healing

progress of DFU.

Methods:

Cohort study included type 2 diabetic patients with

foot ulcer visited diabetic clinic last two years. Diabetic foot

complication was diagnosed by questionnaire and foot

examination, laboratory test and statistical analysis was

done by SPSS 19.

Results:

Mean age of diabetic patients was 59.4 ± 9.56 (37

–

78)

years old and mean diabetes duration was 11.44 ± 6.4 (1

–

year) years and mean HbA1C was 10.09 ± 1.96% (7

–

15%). By

questionnaire 9 (36%) of diabetic patients was with foot pain,

loss of pressure sensation were 44%, vibration sensation was

44% and absent achilles reflex was 88%. Diabetic patients with

no pulses of a.pedis dorsalis and a.tibialis posterior were 32%

and abnormal results of ABI were 32%. History of diabetic foot

amputation was 12% (hallux 4%, digits 8%). Mean initial visit

days of diabetic patients with foot ulcer were 25.16 ± 31.59 (2

–

150). Cause of DFU was trauma 88% (physical trauma 36%,

thermal trauma 4%, footwear 48%), ischemia and others 12%.

Ulcer size was 1

–

200 mm and ulcer depth was 0.5

–

40 mm. By

PEDIS wound classification I grade 28%, II grade 32%, III grade

24% and IV grade was 16%. By TEXAS wound classification 0

grade 32%, I grade 36%, II grade 20%, III grade 12% and stage

40%, stage

24%, stage C 4% and stage D was 32%. 83.5% of DM

patients with foot ulcer with foot amputation was 5 patients

(AKA 2, BKA 1, digits 2). Ulcer recurrence of DFU was 72% (once

48%, multiple 24%). Bacterial culture was done in 64% of

diabetic foot ulcer in first time and 56% of recurrence ulcer in

DFU. Staph.Aureus was 56%, Streptococcus epidermitis 25%

and others were 19%. Primary healed DFU <1 month was 60%,

–

3 months were 20%, 3

–

6 months were 12%, non healed more

6 months 4%, and mortality was 4%.

Conclusion:

1. Primary healed DFU <1 month was 60%, 1

–

3 months were

20%, 3

–

6months were 12%, non healedmore 6months 4%,

and mortality was 4%. Ulcer recurrence of DFU was 72%.

2. DM patients with foot ulcer were foot amputation

was 20%.

PE-38

Analysis of clinical factors influencing bone mineral density in

Japanese patients with diabetes

Shogo FUNAKOSHI

, Hiroshi TAKATA

, Seiki HIRANO

Kumiko YOSHIMURA

, Satoko OHMI

, Eri AMANO

Yoshio TERADA

, Shimpei FUJIMOTO

Endocrinology,

Metabolism and Nephrology, Kochi Medical School, Kochi University,

Japan

Aim:

Risk of bone fracture is increased in patients with

diabetes compared to that in healthy subjects. Bone mineral

density (BMD) is closely related to the risk of fracture. Clinical

factors affecting BMD in patients with diabetes were explored.

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

–

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S142