Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

PF-20

Predictors of polypharmacy among diabetes in Japan

Takeshi HORII

1,2

*, Yusuke KABEYA

, Masuomi TOMITA

Takeshi KATSUKI

, Jyunichi SHIMIZU

, Youichi OIKAWA

Saisekai Central Hospital,

Shimokitazawa Hospital, Japan

Objectives:

According to published works, polypharmacy

can be simply defined as the use of multiple medications by

a patient. It is clearly highlighted that the use of greater

number of prescriptions has been independently associated

with increased health care cost and risk for adverse

drug events. Polypharmacy has been shown to be associated

with many risk factors, such as renal function and age.

However, whether diabetes is a risk factor of polypharmacy

is not well established. The present study aimed to determine

the predictors of polypharmacy among diabetic patients

in Japan.

Subjects and methods:

We recruited 6,706 in-patients (with

diabetes n = 2,766, without diabetes n = 3,940) between January

2014 and January 2016. We defined polypharmacy as the

concurrent use of six or more prescriptions. To assess the odds

ratio (OR) of polypharmacy, we constructed a logistic regres-

sion analysis, having adjusting for age, gender, BMI, eGFR,

number of prescriptions and with or without diabetes.

Results:

At baseline, age, BMI, eGFR and number of prescrip-

tions were significantly different between patients with and

without diabetes (age; 69.6 vs.55.8 years, BMI; 24.1 vs.22.4 kg/

, eGFR; 57.3 vs. 67.5 mL/min/1.73 m

, number of prescrip-

tions; 7.4 vs. 4.9, respectively). In multivariate logistic regres-

sion analysis, diabetes (OR: 2.8, 95% CI; 2.5

–

3.1), age (65

–

<75 y:

1.6, 95% CI; 1.4

–

18, 75 y

≦

: 3.0, 95% CI; 2.7

–

3.5) and CKD (G3: 2.0,

95% CI; 1.6

–

2.5, G4: 3.3, 95% CI; 2.3

–

4.7, G5: 8.1, 95% CI; 5.4

–

12.2)

were associated with the presence of polypharmacy.

Conclusion:

This study shows that diabetes, as well as the

elderly and CKDG4-5, was associated with the presence of

polypharmacy. In diabetic patients, prescribing and managing

multiple regimens need regular reviews and evaluations to

ensure that medications are appropriately and effectively

continued. Patients and providers need to regularly discuss

the goals of therapy, and address concerns about adherence,

unnecessary healthcare cost, avoidance of adverse health

outcomes, and other matters of significance in achieving an

individualized and realistic therapeutic plan.

PF-21

Using models of group therapy in diabetes patients with

enhancing the effectiveness of self-health care

Shiu-Feng LU

*, Ching-Feng HUANG

Department of Nursing,

Kaohsiung Veterans General Hospital, Kaohsiung,

Department of

Nursing, Chang Gung University of Science and Technology at Chiayi

Campus Kaohsiung Veterans General Hospital, Chiayi, Taiwan

Objective:

Patients with psychosomatic disorders and dia-

betes, often because of lack of diabetes knowledge and strong

oral, lazy, lack of regular exercise and diet control concepts, nor

received conventional drug therapy, so the concept of group

therapy in patients with diabetes amounted to 5 to help

promote self-health care of patients with diabetes efficacy and

self-control, adjustment capabilities.

Method:

1. Notwithstanding the time 60 minutes per week, a

total of 3 groups to teach diabetes knowledge. 2. the integration

of professional communication and assessment: the note

nutritionist, and diabetic diets and dietary education and

week, 1 hour per day group therapy time. 3. implementation of

the plan of care: encouraging the daily 20-minute morning

exercises, and movement of every 10 minute walk after meals,

and by assessing the degree of implementation of the active

evaluation.

Results:

(A) enhancing medical compliance and trust: through

the curriculum, from passive to active acceptance of oral

medications and insulin regular treatment of the concept. (B)

to promote positive learning and motivation for change,

health habits: understanding the concept of diet and exercise

to control blood sugar and learn healthy lifestyle. (C) restore

confidence: through the power of group therapy affect learning

and change motivation, and the capacity of maintaining

healthy behaviors.

Application:

Using the power of group therapy to strengthen

efficiency of self-health care, mining groups implement

treatment activities, strengthen compliance and sustainabil-

ity, this programme guide nursing staff to provide quality care,

for health promotion purposes.

PF-22

Associations between insomnia and glycemic control in Hong

Kong Chinese patients with type 2 diabetes

Chenzhao DING

, Eric Siu Him LAU

, Andrea On Yan LUK

1,3,4

Theresa YEUNG

, Wai Sze CHAN

, Jihui ZHANG

Yun Kwok WING

, Wing Yee SO

, Ronald Ching Wan MA

1,3,4

Juliana Chung Ngor CHAN

1,3,4

, Kai Chow CHOI

Alice Pik Shan KONG

1,3,4

Department of Medicine and

Therapeutics, The Chinese University of Hong Kong,

Department of

Psychiatry, The Chinese University of Hong Kong,

Li Ka Shing

Institute of Health Sciences, The Chinese University of Hong Kong,

Hong Kong Institute of Diabetes and Obesity, The Chinese University

of Hong Kong,

Nethersole School of Nursing, The Chinese University

of Hong Kong, Hongkong

Increasing evidence suggest insomnia may play a role in

increasing insulin resistance and worsening glycemic control

in patients with type 2 diabetes. Around 10% of Hong Kong

Chinese adults suffered from insomnia while the rate of

insomnia in diabetic population is under-explored. We aimed

to explore the rate of insomnia in Hong Kong Chinese patients

with type 2 diabetes and its associations with glycemic control.

This was a cross-sectional study including a consecutive

cohort of patients with type 2 diabetes recruited from the

Hong Kong Diabetes Registry between July 2010 and June 2015.

Shift workers and patients with obstructive sleep apnea (OSA)

were excluded. Indices of glycemic control including fasting

plasma glucose (FPG) and glycated hemoglobin (HbA1c) were

measured and sleep parameters were assessed by validated

questionnaires including Insomnia Severity Index (ISI).

Insomnia was defined as ISI score >14 whereas HbA1c

≤

7.0%

was considered as reaching glycemic goal.

A total of 4,786 patients with type 2 diabetes were enrolled

during the study period. After excluded shift workers and

patients with OSA (11.8%), 4,221 eligible patients were included

in this analysis. Mean age was 54.0 ± 8.6 (standard deviation,

SD) years and 57.9% were men. Median disease duration of

diabetes was 7.0(3.0

–

11.0) (inter-quartile range, IQR) years.

Mean score of ISI was 6.5 ± 5.6. Among the cohort, 9.7% had

insomnia. Compared to non-insomniac subjects, type 2

diabetic patients with insomnia had higher FPG (7.9 ± 3.1

mmol/L versus 7.5 ± 2.4 mmol/L, P = 0.022) and higher HbA1c

(7.7 ± 1.7% versus 7.5 ± 1.4%, P = 0.005), as well as longer disease

duration of diabetes [8.0 years (IQR: 3.0

–

14.8) versus 7.0 years

(IQR: 3.0

–

13.0), P = 0.026]. After adjustment for age, gender, BMI

and disease duration of diabetes, insomniac state was

positively associated with FPG and HbA1c (P = 0.030 and

P = 0.012 respectively). Higher percentage of type 2 diabetic

patients with insomnia did not reach glycemic goal compared

to their non-insomniac counterparts (59.4% versus 52.9%,

P = 0.02).

Insomnia is prevalent in Hong Kong Chinese patients with

type 2 diabetes. Type 2 diabetic patients with insomnia were

associated with poorer glycemic control compared to type 2

diabetes without insomnia.

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

–

S211

S158