Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

PE-59

Outcome analysis of diabetic patients with or without

albuminuria

Wai Kin CHAN

, Szu-Tah CHEN

Division of Endocrinology and

Metabolism, Department of Internal Medicine, Chang GungMemorial

Hospital, Chang Gung University, Taiwan

Objective:

This study retrospectively compared the clinical

character and outcome of type 2 diabetic patients with normo-

(below 30 mg/L), micro- (30

–

299 mg/L) and macro- (above

300 mg/L) albuminuria

Research design andmethods:

79 type 2 diabetic nephropathic

(DN) patients were retrospectively reviewed from 2013/01 to

2016/01. All patients were treated with oral anti-diabetes drugs

and/or insulin; either angiotensin receptor blockers (ARB) or

angiotensin-converting enzyme inhibitors (ACEI) were given in

the albuminuria groups. Clinical data including urine albumin

creatinine ratio (UACR), glycosylated hemoglobin (HbA1c),

systolic blood pressure (SBP) and estimated glomerular filtra-

tion rate (eGFR) were analyzed. Patients were divided into

normo-, micro- and macro-albuminuria groups according to

their latest amount of spot urine albumin. All data were

analyzed with Generalized Estimating Equation (GEE) to

evaluate the changes in SBP, HbA1c, UACR and eGFR.

Results:

Our study includes 33 (41.8%) normal, 13 (16.5%)

micro- and 33 (41.8%) macro-albuminuria patients aged

62.1 ± 10.6, 57.8 ± 11.9 and 65.6 ± 11.4 year-old, respectively.

After adjusting age, sex and duration of diabetes, both

albuminuric groups showed statistical significance of higher

UACR (micro-: B = 103.66, SE = 40.24, p = 0.01, macro-: B = 1169,

SE = 164.5, p < 0.0001) during the 3-year follow-up period.

Macro-albuminuria group showed significantly higher level

of HbA1c (B = 1.067, SE = 0.48, p = 0.027) and SBP (B = 11.89,

SE = 4.25, p = 0.005) when compared to normal albuminuria

group. Both normo- (B =

−

2.03/year, SE = 0.98, p = 0.038) and

macro- (B = 200.76/year, SE = 86.31, p = 0.02) albuminuriagroups

showed significant annual UACR increment. Deterioration of

renal function was found statistically significance in both

normo- (B =

−

4.08/year, SE = 0.71, P < .0001) and macro- (B = 2.8/

year, SE = 0.87, P = 0.001) albuminuria groups by reducing

annual eGFR without significant difference in their decreasing

slope in all 3 groups. Finally, the rate of major adverse cardiac

events (MACE) was similar in all 3 groups.

Conclusions:

Renin-angiotensin system blockers may protect

DN patients from renal function exacerbation by reducing

eGFR but not by preventing urinary protein loss in the abnor-

mal albuminuria groups regardless of their degree of severity.

PE-60

A study of increasing access to diabetic retinopathy screening

and referral if indicated

Yu-Ying CHANG

*, Yen-Tzu LEE

, I-Chieh MAO

, Shih-Te TU

Lukang Christian Hospital, Taiwan

Objective:

The World Health Organization (WHO) statistics

show that the possibility of suffering from blindness among

diabetic patients is 10 to 20 times higher than that among

people without diabetes. One researcher

’

s study also shows

that the prevalence of diabetic retinopathy ranges from 15% to

45%. As such, a simplified ophthalmoscopy, ease of screening

and referral will hopefully increase the access to diabetic

retinopathy screening and referral if indicated, and more

importantly, the knowledge of and prevention against diabetic

eye disorders in diabetic patients.

Method:

Our Health Care Center has been equipped with

ophthalmoscopy instruments for screening. Healthcare edu-

cation and retinal photography may be performed at the same

venue, improving the accessibility to screening in patients.

The environmental features are designed to facilitate health

promotion, and moreover, referral if indicated to our ophthal-

mologists is available for further follow-up and treatment.

Result:

Through this program, 3,278 patients successfully

joined our hospital

’

s Diabetes Shared Care Network. During

the period when the program was active (May 25, 2015 to

October 23, 2015, for 5months), 1,772 diabetic patients received

screening. Compared with the same period in 2014, the

number grew by 616 with a growth rate of 53.3%. Out of the

24 patients receiving ophthalmoscopy and indicated for

referral, 14 were successfully referred to Ophthalmology,

with a success rate of 58.3%. According to the analysis of the

other 10 patients, 30% indicated that they did not feel ill while

the 20% reported that they were under follow-up by

Ophthalmology.

Conclusion:

Education on preventing diabetic eye complica-

tions and simple access may substantially improve the

screening of diabetic eye disorders. The referral if indicated,

however, is paramount. Over 40% of diabetic patients still

refuse to be referred to Ophthalmology; the referral rate is only

58.3%. The reason for most cases is that patients do not have

eye discomfort. The pre-program ophthalmoscopy focused on

the number of screened patients (quantity) rather than further

ophthalmology care for patients (quality). In the light of this

program, it is hopeful that diabetic patients may be accessible

to more comprehensive care for their eyes as a result of

increased referral rate in screened patients if indicated, as well

as widespread concept of early screening and early treatment

among healthcare professionals and patients.

PE-61

Correlation of glycemic control and arterial stiffness in patients

with type 2 diabetes mellitus

Jongky HENDRO PRAYITNO

*, Soebagijo ADI

, Ari SOETJAHJO

Askandar TJOKROPRAWIRO

, Agung PRANOTO

Sony WIBISONO

, Sri MURTIWI

Surabaya Diabetes and

Nutrition Centre, Indonesia

The PWV has been identified as an independent predictor for

cardiovascular related mortality. The uncontroled T2DM

induced hyperglycemic condition and caused depletion of

endothelial nitric oxide (NO) which further leading to endo-

thelial dysfunction.

In this study we showed that poor glycemic control in patients

with T2DM is associated with abnormal arterial stiffness.

Methods:

This is a cross sectional study. We recruited 50

patients with T2DM from out patient clinic. We excluded

patient undergo Dialysis treatment, haemoglobin level <10 gr/

dL, and all of the sample were performed baseline data

including the blood pressure, HbA1c levels and all patient

were measured the arterial stiffness using ba-PWV. We

evaluate the relationship of HbA1c levels and the result of

ba-PWV test.

Results:

Themean of agewas 58,98 ± 12,28 years, and themean

of HbA1c level: 7,69 ± 0,98%. The mean of PWV: 16,41 ± 2,43 m/

second. Test results showed the correlation between HbA1c

level and PWV and shows strong and significant result

(r = 0,403; P < 0,05).

Conclusion:

There was a significant correlation between

Glycaemic control and arterial stiffnes in T2DM.

PE-62

DESMOND

…

Does it deliver for Aboriginal and Torres Strait

Islander people

Deborah SCHOFIELD

, Asha SINGH

*, Helen MITCHELL

Melissa ROBINSON

, Kylie MAHONY

Diabetes WA, DESMOND

Australia, Perth, Australia

Background:

Traditional methods of health promotion

and education such as the distribution of materials and

didactic program delivery has had limited success in reducing

the burden of chronic diseases, especially in rural and

remote Aboriginal communities. Evidence behind using a

patient empowerment approach is mounting, with many

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

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