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

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in the process of macro-vascular complications in type 2
diabetes mellitus and provide theoretical evidences to sup-
press or delay the occurrence and development of macro-
vascular complications in type 2 diabetes mellitus effectually
for clinical research.
Methods: Paired design is applied in this research and 100
cases are selected including 54 men and 46 women. Those
two patients are paired with same gender and basically
equivalent age, blood sugar, blood pressure and blood-lipid
but opposite result of intima media thickness (IMT), so 100
cases are divided into two average groups. Type 2 diabetes
mellitus with astherosclerosis (AS-T2DM) group has 50 cases,
27 men and 23 women. So does type 2 diabetes mellitus
without astherosclerosis (nonAS-T2DM) group. There are no
significant differences in age, blood sugar (GHbA1c), blood
pressure (SBPandDBP) andblood-lipid (LDL-C) between the two
groups verified by paired samples T test. (t = − 0.334, 2.832,
− 5.001, 1.668, 4.502 and P = 0.796, 0.215, 0.127, 0.345, 0.138
respectively). The contents of t-PA and PAI-1 in the two groups
are measured quantitatively by double-antibody sandwich
ELISA at same time. Each sample is measured in three holes
to ensure the accuracy of the measurement and the mean is
used for statistics. The differences of t-PA and PAI-1 contents
between the two groups are compared by paired samples T test.
Result: Compared with nonAS-T2DM group, the content of
t-PA reduced significantly (t = −19.668, P = 0.031) while PAI-1
increased significantly (t = 20.394, P = 0.030) in AS-T2DM group.
Conclusion: The reduce of t-PA content and increase of PAI-1
content have played some role in the occurrence and
development of macro-vascular complications in type 2
diabetes mellitus.
PE-50
To increase smoking cessation rate among diabetic smokers
who participate in smoking cessation clinics by means of
effective health education
Chia Yu TIEN 1*, Shin-Te TU1. 1Lukang Christian Hospital, Taiwan
By implementing the diabetes try-out trial for diabetic
smokers and by utilizing clinical smoking cessation treatment
techniques: 5A (Ask, Advise, Assess, Assist, Arrange) and 5R
(Relevance, Risk, Reward, Roadblock, Repetition), the diabetic
smokers ’ participation and confidence in self health manage-
ment and attempts in quitting smoking were improved, which
resulted in a cessation rate of 34%.
Objectives/methods: The health education center team intro-
duces diabetic smokers to participate in health education
counseling at the center. The frontline team records their
smoking histories and transfers them to smoking-cessation
health education counseling. Themedical teamapplies 5A and
5R to raise diabetic smokers ’ health awareness and their
motivation to quit smoking. Physiciansmake use of e-message
boards at their clinics to effectively persuade smokers to
attending smoking-cessation therapies and be away from
smoking.
Result: According to statistics in 2014, 51 out of the 178
participants were diabetic and the smoking cessation rate
within 6 months was 35.3%. In 2015, 73 out of the 277
participants were diabetic and the smoking cessation rate
within 6 months was 35.6%. Comparison between the same
period of the two years shows that the number of participants
grew from 178 to 277 by 55.6%, and that the number of
participating diabetic smokers who quitted smoking grew
from 18 to 26 by 69.2%.
Conclusion: According to our experience, through the system-
atic search for smokers, giving them advice on cessation and
later on transferring them to smoking cessation treatments,
and education counseling and cessation prescription design,
smokers ’ health awareness can be improved and then so can
their motivation for cessation, which motivates them to keep
living a healthier lifestyle.
PE-51
Recurrent left hemichoreic movement following to severe
hyperglycemia in type 2 diabetes mellitus
Sung Rae CHO1*, Jay Cheol KWON2. 1Department of Internal
Medicine, Changwon Fatima Hospital, 2Department of Neurology,
Changwon Fatima Hospital, Korea
Choreic ballism is a rare neurologic complication of metabolic
origin in hyperosmolar hyperglycaemic state (HHS) although
the etiologic mechanism is still unclear. Sometimes, it was
reported in poorly controlled old female type 2 diabetes
mellitus. We experienced a case of recurrent left arm hemi-
choreic movement following to severe hyperglycemia in type 2
diabetes mellitus patient.
A 68-year-old woman with 11-year history of type 2 diabetes
mellitus who was admitted to our hospital for recurred attack
of hemichoreic movement in the left upper limb of the body.
On admission day, her glycosylated hemoglobin (HbA1c) was
13% (N:4–6%). Her calculated serum osmolarity peaked at
310 mOsm/kg (N: 275–295 mOsm/kg), and the serum glucose
level reached 475 mg/dL (N:80–140 mg/dL) with no evidence of
diabetic ketoacidosis. The initial serum sodium level was
135 mmol/L (N:135–145 mmol/L), which normalized to
142 mmol/L over 1 day. The physical examination revealed
left hemichorea with a ballistic component without focal
neurologic finding. Unenhanced computed tomography of the
brain was negative. At magnetic resonance imaging, the right
putamen showed high signal intensity on T1-weighted
images. During the hospitalization, an adequate diet and
insulin therapy resulted in progressive normalization of blood
glucose values and an improvement of dyskinesia. According
to medical records, she was admitted previously due to
hemichoreic movement attack 4 times whenever her blood
glucose was uncontrolled, HbA1c was over 10%.
HHS, an acute complication of diabetes mellitus, can be
associated with neurological involvement ranging from
seizures, involuntary movements to reversible focal neuro-
logical deficits without any structural lesions. This diabetic
choreic ballism is a pathological entity to be considered
benign, generally transient and reversible. So we think that
early recognition and differentiation from other causes of
reversible manifestation in uncontrolled Type 2 diabetes
mellitus is important.
PE-52
A nursing experience of implementing interprofessional
practice on a diabetic foot ulcer patient
Hsiang-Ning HUANG1*. 1Wound Care Clinic, Section of Plastic and
Reconstructive Surgery, Department of Surgery, Taiwan
Neuropathy, occlusive vascular disease, and infectionwill lead
to the formation of diabetic foot ulcers that affect the quality of
life of the patient. The diabetic foot ulcer can also lead to foot
infections that include cellulitis, osteomyelitis, necrosis and
even amputation. Here, we report a 61-year-old man with
diabetic foot ulcer. His medical history includes end-stage
renal disease under regular hemodialysis, hypertension, type 2
diabetes mellitus, peripheral arterial occlusive disease (PAOD)
of the left leg and triple-vessel coronary artery disease.
Percutaneous transluminal angioplasty has been performed
for PAOD of left lower limb. This time, he was sent to our
Emergency Department due to pain and swelling of left 4th
toe, without fever or chills. In ER, the wound of left 4th toe
presented with wet gangrene and dorsal foot swelling, redness
and tenderness were found. The plastic surgeon was con-
sulted, and amputation of left 4th toe was undertaken. After
the operation, he was admitted to our ward for care. During his
hospitalizations, the left foot wound got worse and worse at
the beginning. Then, we carried out wound care and several
times of debridement, and we consulted Orthopedics for
Hyperbaric Oxygen Therapy, Cardiovascular Surgeon for left
leg bypass surgery, and Endocrinologist for glycemic control
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S146