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

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PG-51
The impact of small interactive group education plus basal
insulin on the glycemic response of type 2 diabetes mellitus
Fei-Hsing CHIU 1*, Ting-I LEE1,2, Chiao-Ling LO1,
Ting-Wei LEE 1,3, Yu-Mei CHANE1, Han-Wen LIU 3,
Chuan-Liang CHOU 1, I-Shuan LEE1, Chun-Jen CHANG1.
1 Division of Endocrinology and Metabolism, Department of Internal
Medicine, Wan Fang Hospital-Taipei Medical University,
2 Department of General Medicine, College of Medicine, Taipei Medical
University, 3Graduate Institute of Clinical Medicine, College of
Medicine, Taipei Medical University, Taipei, Taiwan
Background: Type 2 diabetes is a progressive disease, and
most patients will eventually need insulin to achieve euglyce-
mia. Although it was observe that the rate of insulin injection
in Taiwan increased from 18% in 2006 to 21.6% in 2011, less
than 10% attained the recommended diabetic “ABC” targets.
To improve these suboptimal metabolic control, and reduce
the risk of diabetic-related complications, a more intensive
glycemic management is warranted. Management and
support to enable patients to effectively advocate diabetes
self-management.
Aim: To investigate the effect of early basal insulin therapy
with or without added intervention by diabetic educator on the
glycemic control of type 2 insulin naïve diabetic patients.
Method: A randomized controlled trial was conducted at Wan
Fang Hospital fromAugust 25 2014 to November 30, 2014. Basal
insulin was initiated to type 2 DM insulin naïve patients with
fasting blood glucose(FBS) >150 mg/dL and hemoglobin A1c
(HbA1c) > 8%. Patient with previous history of insulin injection
or refused insulin were excluded. Patients were randomly
divided into “intervention” by diabetic educators or “conven-
tional” group. Basic knowledge about insulin therapy was
given to all diabetic patients. The group with “intervention”
had regular small class session, weekly telephone communi-
cation from diabetic educators, and self-monitoring of blood
glucose Breeze 2 glucometer (BAYER) with smart cable Health2
Sync to optimize glucose monitoring.
Results: 52 patients were included in the “intervention” group
and 20 patients in the “convention group ”. 27 male and 25
female with mean age of 64.5 years in “intervention ” and 11
male and 9 female with mean age of 65.6 years in “conven-
tional” group. Baseline HbA1c and FBS of “intervention” and
“ conventional ” group were 9.5 ± 0.2% and 9.9 ± 0.3%; and
227 ± 7.9 mg/dL and 234 ± 10.7 mg/dL, respectively. After 3
months of treatment, HbA1c and FBS of “intervention” and
“ conventional ” group were 7.4 ± 0.1% and 8.9 ± 0.2% (p < 0.001);
135 ± 3.5 mg/dL and 192 ± 5.6 mg/dL (p < 0.001), respectively. A
decrement of HbA1c in the “intervention” and “conventional”
group were 2.17% and 0.9%, respectively. HbA1c < 7% and
FBS < 130 mg/dL attained by “intervention” and “conventional”
group were 28.9% and 0%; and 50% and 0%, respectively. On the
contrary, HbA1c > 8% and FBS > 200 mg/dL attained by “inter-
vention” and “conventional ” group were 9.6 and 85%; and 1.9%
and 85%, respectively.
Discussion: This randomized trial demonstrated that aggres-
sive diabetic educator intervention added to early basal insulin
lead to a better glycemic control than basal insulin therapy
alone.
PG-52
The role of diabetic education added to biphasic insulin on the
glycemic control of type 2 diabetes mellitus
Fei-Hsing CHIU 1*, Ting-I LEE1,2, Chiao-Ling LO1,
Ting-Wei LEE 1,3, Yu-Mei CHANE1, Han-Wen LIU3, I-Shuan LEE1,
Chun-Jen CHANG 1. 1Division of Endocrinology and Metabolism,
Department of Internal Medicine, Wan Fang Hospital-Taipei Medical
University, 2Department of General Medicine, College of Medicine,
Taipei Medical University, 3Graduate Institute of Clinical Medicine,
College of Medicine, Taipei Medical University, Taipei, Taiwan
Background: Glycemic control in diabetes mellitus (DM)
is a cornerstone in reducing its chronic complication.
Although glycated hemoglobin (HbA1c) remains the gold
standard for assessment of glycemic control, there is no
consensus whether fasting plasma glucose (FPG) or post-
prandial plasma glucose (PPG) is a better predictor of
glycemic control.
Aim: To investigate the effect of shifting to bi-phasic insulin in
patients who fail to achieve HbA1c in after basal insulin
therapy had achieved fasting glucose goal.
Method: A randomized controlled trial was conducted at Wan
Fang Hospital from April 1, 2015 to August 31, 2015. Type 2 DM
patients on basal insulin for more than 3 months but
FPG < 150 mg/dL and hemoglobin HbA1c > 7% were included
in this study. Patients were randomly divided into “interven-
tion” by diabetic educators or “conventional” group. Basic
education on insulin therapy was instructed to all DMpatients.
The group with “intervention” had regular small class session,
weekly telephone communication with diabetic educators,
and paired self-monitoring of blood glucose (SMBG) were done
to optimize glucose monitoring.
Results: A total of 44 patients (23 male and 21 female) with
mean age of 62.5 ± 2.2 years were included in this study. 25
patients (14 male and 11 female) with mean age of 69.4 ± 2.5
years were included in the “intervention” group and 19
patients (9 male and 10 female) with mean age of 53.4 ± 2.9
years were included in the “convention” group. Baseline FPG,
PPG, and HbA1c in the “intervention ” and “conventional”
group were 111.5 mg/dL ± 3.2, 211.0 mg/dL ± 8.2, 8.4% ± 0.2,
respectively. While the conventional group had a baseline
FPG, PPG, and Hb1Ac of 179.8 mg/dL ± 8.6, 170.9 mg/dL ± 4.7,
8.8% ± 0.24, respectively. After 3 months of treatment, FPG,
PPG, and HbA1c of “intervention” and “conventional” group
were 130.2 mg/dL ± 3.6 (p < 0.001), 176.3 mg/dL ± 4.0 (p < 0.001),
and 7.7 ± 0.1% (p < 0.01); and 154 mg/dL ± 6.2 (p < 0.05),
173.4 mg/dL ± 6.4 (p < 0.8) and 8.2 ± 0.27% and (p < 0.08),
respectively. The decrement of HbA1c in the “intervention”
and “conventional ” group were 0.85 ± 0.2% and 0.65 ± 0.2%,
respectively. In the “intervention” group, 7.8% and 40%
attained HbA1c of < 7% and 7.1–7.5%, respectively. While in
the “conventional” group, 10.5% and 21.2% attained HbA1c of
<7% and 7.1–7.5%, respectively. On the contrary, HbA1c of >8%,
FPG > 200 mg/dL and PPG > 200 mg/dL attained by the “inter-
vention” and “conventional” group were 16%, 0%, and 12%; and
42%, 0% and 21.1%, respectively.
Conclusion: This randomized control trial demonstrates
that aggressive intervention by diabetic educator with SMBG
added to bi-phasic insulin therapy attained better glycemic
control.
PG-54
The effectiveness of the camp of “Free Sugar, LOHAS” on type 2
diabetes patients, in the regional teaching hospital
Yu-Ting CHIANG1*, Chiao Hsin HUANG1 . 1National Yang-Ming
University Hospital, Taiwan
The incidence of type 2 diabetes in the world has been rising
year by year, the researchers forecast that to 2025 the world
will have 380 million adults suffer from diabetes. Diabetic
patients are exposed to a high risk of cardiovascular disease
and other chronic complications. The well blood sugar
controlled is needed to reduce the risk.
Aim: The aim of this study was to examine the effect of group
program (GP) on knowledge, attitude, self-efficacy in the
patient with type 2 diabetes under insulin control. This study
was pre-posttest design. Samples included in this study were
who had diagnosed with type 2 diabetes and A1C was great
than 7% of teaching hospital in Yilan County, Taiwan. The
intervention period is 3 months. Chart review for A1C and
Body weight collecting, structured questionnaires comprised
scale for determining the diabetes knowledge, diabetes
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S176