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

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PG-08
A probe into the improvement in HbA1c among diabetic
patients on multiple insulin injections along with
carbohydrate substitute diet
Yu Feng TENG1 *. 1Division of Metabolism, Chang Gung Memorial
Hospital-Kaohsiung Medical Center, Taiwan
Many factors for a good control of diabetic conditions are in the
hands of the patients themselves, including diet content and
portion, approaches to regular monitoring of blood glucose
level, patients ’ physical activity levels, and the consistency in
medication dose taken. Sticking to a fixed diet portion
regularly and taking medication in line with doctor ’s advice
can substantially improve blood glucose level control and
reduce the occurrence of diabetes-related complications, such
as coronary artery diseases, kidney diseases and the risk of
nerve injury.
Accurate carbohydrate calculation and more frequent blood
glucose monitoring are associated with reduction in type 1
diabetic patients ’ glycated hemoglobin levels. This study is to
probe the improvement in glycated hemoglobin levels among
type 1 diabetic patients on multiple insulin injections along
with carbohydrate substitute diet.
Method: Type 1 diabetic patients receiving more than 4 insulin
injections were lodged and boarded for 1 to 2 weeks in the
hospital. During their stay, they followed a fixed portion of
carbohydrate in each meal and a fixed amount of exercise.
Their blood glucose levels were checked before the 3 meals, 2
hours after the 3 meals and before sleep, for a total of 7 times
daily. Pre-prandial and postprandial targets for blood glucose
level were set. Nutritionists and health educators engaged in
teaching the patients how to keep their own dietary diaries and
educating them about carbohydrate substitute diet, for them
to find out about their own carb-to-insulin ratio based on the
carbohydrate intake/activity level and the flexible titration of
insulin. Eventually, 25 cases were included in this study,
whose HbA1c and total insulin changes were tracked inmonth
0, 3, 6, 9 and 12. The average HbA1c before the session was
11.81%; in month 3 8.63%; in month 6, 8.26%; in month 9, 8.8%
and in month 12, 8.3%. The average total insulin before the
session was 42.89u; in month 3, 41.39u; in month 6, 42.21u; in
month 9, 43.36u and in month 12, 43.5u. This study shows that
accurate carbohydrate substitute and a flexible titration of
insulin can significantly improve patients’ glycated hemoglo-
bin levels. Despite an increase in total insulin by 0.61u, with a
more flexible diet, patients ’ glycated hemoglobin levels were
still improved. Diabetic patients on multiple insulin injections
should execute carbohydrate substitute in their diet for a
better control of their blood glucose levels and a better quality
of life.
PG-09
Analysis of food order’s effect on postprandial glycated
hemoglobin level among diabetic patients from a medical
center in southern Taiwan
Yu Hsuan CHIEN1*. 1Division of Metabolism, Kaohsiung Chang
Gung Memorial Hospital, Taiwan
Objective: Diabetes is a chronic disease; its patients’ diet is
predominant in their blood glucose control. The article: Food
Order Has a Significant Impact on Postprandial Glucose and
Insulin Levels published in one of Diabetes Care journals in
2015, pointed out that adjusting patients ’ food order can help
control their postprandial blood glucose levels. For this, we
have designed a questionnaire in an attempt to find out if
Taiwanese nationals ’ diet may affect their postprandial blood
glucose control in a similar manner.
Method: By means of questionnaire, this study took place
between December 14th and 31st, 2015, in a diabetes health
education room at the Metabolism Department of a medical
center, where a nutritionist entrusted by a diabetes educator
inquired the patients about their food order, and made a
comparison between three different food orders’ effects upon
the patients’ glycated hemoglobin level control.
Result: According to ANOVA, which analyzed the differences
in glycated hemoglobin levels among the three groups of
patients, food order’s effect on postprandial glycated hemo-
globin level is not statistically significant. Neither is significant
in the effects of work patterns and sex on the food order amd
the glycated hemoglobin levels.
Conclusion: Sub-factors that affect blood glucose level such as
exercise, medication, diet portion can also trigger the variance
in blood glucose level, which leaves the assumption that food
order affects postprandial glycated hemoglobin level still in
question
PG-10
A probe into the analysis of cause of hypoglycemia among
patients joining diabetes health improvement program
Chia Hui LIN1*. 1Division of Metabolism, Kaohsiung Chang Gung
Memorial Hospital, Taiwan
Objective: To foresee the risk factors that cause severe
hypoglycemia to provide references for diabetes clinical
healthcare.
Method: This is a questionnaire-based study, whose object
must be patients that have received diabetes healthcare for
over a year, and also meet one of the three criteria as follows:
1. over 70 years old; 2. receiving insulin injection for over a year;
3. GFR < 60. A total of 200 patients meet these requirements.
Result:
1. Length of healthcare received: The highest occurrence
rate of hypoglycemia is 55.6%, among patients receiving
healthcare for more than 10 years; the lowest occurrence
rate is 38.4% (P < 0.001), among patients on healthcare
between 3 and 6 years.
2. Age: In groups aged 31– 40 and 41–50, the occurrence rate
of hypoglycemia is 100% (P < 0.43); the lowest occurrence
rate of 36% (n = 100; P < 0.001) is in group aged >70.
3. HA1C: Group HA1C 8.1– 9% has the highest occurrence rate
of 51.5%; Group HA1C≦6% has the lowest occurrence rate
of 23.1% (P < 0.001).
4. GFR: Group GFR < 15 has an occurrence rate of 60%; Group
GFR≧90 has the lowest occurrence rate of 34.6% (P < 0.001).
5. Use of Insulin: patients on solely oral medication have an
occurrence rate of 30.7%; patients on insulin injection
have an occurrence rate of 90.9% (P < 0.001).
Conclusion: According to the data analysis in this study, a
more advanced CKD stage and insulin injection treatment are
the main factors for a high occurrence rate of hypoglycemia.
The factors such as receiving long-term healthcare, old ages, a
strict control of HA1C are statistically significant and corre-
lated with the occurrence of hypoglycemia. These factors
are not the same as those hypoglycemia risk factors men-
tioned in previous literatures. They are likely attributable to
the smaller sample size, a single-center study, etc.
PG-11
The investigation of mobile communication software “Line”
intervention for diabetes nutrition and health education
Hsiang-Hsun CHUANG1 *, Chieh-Hsiang LU1,2,3. 1 Ditmanson
Medical Foundation Chia-Yi Christian Hospital, 2Department of
Business Administration, College of Management, National Chung
Cheng University, 3Department of Nursing, DAYEH University,
Taiwan
Purpose: With the ever increasing prevalence of diabetes,
self-health management for diabetes patient has become
an important health care topic. Also, with the progressive
improvement of communication technologies, more and more
people have started using the internet or mobile devices as
their primary communication tool. Therefore, this study
was aimed to utilize health care instant messages for aiding
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S162