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

208 / 244

modification of the Edmonton obesity staging system (EOSS)
were analyzed. In addition to HbA1c and fasting plasma
glucose (FPG), a 75 g oral glucose tolerance test was performed
in all non-diabetic subjects. In patients with known or newly
diagnosed diabetes, 10-year atherosclerotic cardiovascular
disease risk was assessed using established tools (ASCVD,
UKPDS-risk score, ARRIBA).
Results: [mean ± SEM; female vs. male] Among the 143 (80
female/63 male) patients with known or newly diagnosed
diabetes, age (50.3 ± 1.5 vs. 49.0 ± 1.8 years), BMI (48.2 ± 1.4 vs.
47.9 ± 1.6 kg/m 2) and diabetes duration (7.4 ± 1.3 vs. 7.8 ± 1.3
years) were not different between men and women. In
contrast, we detected pronounced gender differences in the
prevalence of known diabetes (29.1 vs. 50.5%), rate of newly
diagnosed diabetes cases (33 vs.14.5%) and HbA1c (7.18 ± 0.2 vs.
8.15 ± 0.3%; p = 0.01). Clinical atherosclerosis was 2.8 times
more prevalent (10.4 vs. 28.8%) and estimated 10-year athero-
sclerotic cardiovascular disease risk was significantly higher
(factor 5.9/3.1/2.7 – ARRIBA/ASCVD/UKPDS) in themale cohort.
Conclusions: Systematic prebariatric screening discloses both
higher than expected diabetes prevalence in men and higher
than expected numbers of newly detected type 2 diabetes in
women. The rampant notion of diabetic women having the
same or even higher atherosclerotic cardiovascular disease
risk as compared to diabetic men, is apparently inapplicable in
the context of very high BMI. In fact, obese diabetic men have
2.5 times more clinical atherosclerosis and three to six times
higher 10-year atherosclerotic cardiovascular disease risk,
than women. Thus, in contrast to published perception,
female preponderance among qualifyers for bariatric surgery
may be a misallocation of resources and a waste of bariatric
risk reduction potential. Taken together, key aspects of
prebariatric screening strategies are diabetes in obese
women and ASCVD in obese men.
Abbreviations: ASCVD, atherosclerotic cardiovascular disease;
ARRIBA, absolute and relative risk reduction in general
practice.
PI-27
Increased overall mortality and presenting more advanced
TNM stage of well differentiated thyroid cancer patients with
type 2 DM
Sheng-Fong KUO1, Jen-Der LIN2*, Chuen HSUEH3,
Tzu-Chieh CHAO 4. 1 Division of Endocrinology and Metabolism,
Departments of Internal Medicine, Chang Gung Memorial Hospital,
Chang Gung University, Keelung, 2Division of Endocrinology and
Metabolism, Departments of Internal Medicine, Chang Gung
Memorial Hospital, Chang Gung University, Taoyuan, 3Departments
of Pathology, Chang Gung Memorial Hospital, Chang Gung
University, 4Departments of General Surgery, Chang Gung Memorial
Hospital, Chang Gung University, Taoyuan, Taiwan
Obesity, type 2 diabetes mellitus (DM) had been known
increased risk of certain cancers. Metformin treatment in
these patients may have better outcome. The purpose of our
study is to realize the characteristics of type 2 DMpatients with
well differentiated thyroid cancer patients. In addition, we had
compared clinical features and therapeutic outcome of thyroid
cancer with and without type 2 DM.
A retrospective analysis of adult thyroid cancer patients with
or without type 2 DM admitted between January 2001 and
December 2010 was performed at an institution. A total of
1,687 well-differentiated thyroid cancer patients with
different histological patterns were enrolled. Among these
subjects, 260 were type 2 DM patients. Patients with thyroid
cancer and type 2 DM were significantly older than non-DM
patients. The mean follow-up period of these patient were
6.1 ± 6.1 years. Thyroid cancer in type 2 DM was showed larger
tumor size, and more advanced TNM stage than non-DM
group. In addition, disease-specific mortality was higher in the
type 2 DM group (2.7% vs. 1.2%); but the difference was not
statistical difference. Overall mortality was higher in type 2 DM
patients (6.2% vs. 1.5%, p = 0.001). Thyroid cancer patients with
type 2 DM showed a higher percentage of secondary primary
cancers than those without DM (8.5% vs. 3.0%). In conclusion,
type 2 DM diagnosed as thyroid cancer need to be underwent
more aggressive surgical procedure and postoperative other
modalities treatment.
PI-28
Effect of bariatric surgery on diabetic nephropathy in obese
type 2 diabetes patients in a local retrospective 2 year study
Anthony CHAO1*, Chee Fang SUM1, Benjamin LAM2 ,
Anton CHENG3, Serena LOW4, Su Chi LIM1. 1 Diabetes Centre,
Khoo Teck Puat Hospital, 2Family & Community Medicine, Khoo Teck
Puat Hospital, 3General Surgery Dept, Khoo Teck Puat Hospital,
4Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
Background: Numerous studies have examined the benefits
and risks of Bariatric Surgery (BS) versus conventional therapy
in the treatment of obese patients with type 2 diabeticmellitus
(T2DM). BS has been shown to result in improvements in
weight reduction, glycemic control, and even remission of
diabetes. However, not many studies have looked at changes in
microvascular complications after BS. Local data in this area is
particularly lacking.
Objective: To evaluate the effect of BS on Diabetic
Nephropathy (DN) in obese T2DM subjects as measured by
changes in urine albumin-to-creatinine ratio (uACR) or urine
protein-to-creatinine ratio (uPCR).
Subjects and methods: This was an observational retrospect-
ive cohort study. Data of 46 multi-ethnic obese T2DM subjects
who were followed up for 2 years were retrieved from our
hospital database of all BS done from January 2011 to
December 2014 (n = 150). Glomerular filtration rate (eGFR)
was computed using the modified MDRD formula and
chronic kidney disease (CKD) stage was categorized based on
KDIGO 2012 clinical practice guidelines. Conversion of uPCR to
uACR was done by multiplying by 88.4: g/day = ×88.4 mg/
mmol. (KDIGO 2013).
Results: Surgery performed included sleeve gastrectomy,
Roux-en-Y gastric bypass and lap-band gastric bypass. Of the
46 subjects with T2DM, 23 had normal uACR and glomerular
filtration rates (eGFR) >60 mL/min (1.73 m2) before the oper-
ation, including 1 who died. 1 patient with eGFR in CKD3a
range had normal uACR before and after the operation. 8 had
missing data ie no uACR results either before or after surgery.
Only 14 T2DM patients had pre and post BS uACR data
available for analysis. Of these 14 patients, 9 had GFR
>60 mL/min (1.73 m2) before and after BS. 2 each had CKD
stage 3a and stage 3b and 1 had CKD stage 4 before and after BS.
In the 14 T2DM patients, the median uACR before and after BS
was 10.4 mg/mmol (Interquartile range (IQR) 7.2–92.3) and
2.8 mg/mmol (IQR 0.9–22.9) (p = 0.009).
12 out of the 14 subjects (85.7%) showed improvement of uACR
after surgery. The remaining 2 showed worsening of uACR
results, with one of them showing only insignificant increase
(from 4.90 mg/mmol to 7.24 mg/mmol).
Conclusions: Our data suggests that BS improves DN in obese
T2DM subjects. Larger studies and randomized controlled
trials, looking at local patients of different ethnic groups and
for longer duration, are needed to confirm our data on renal
profiles before and after BS.
PI-29
Prevalence, clinical characteristics, and risk factors of
sarcopenia in overweight patients with type 2 diabetes
Kentaro YAMADA1*, Hitomi NAKAYAMA1,
Munehisa TSURUTA1, Satomi KAKINO1, Seiko KAWANO1,
Shinpei IWATA1, Mamiko KAWAHARA1, Yoshie OHTSUKA1,
Yuji TAJIRI1. 1Division of Endocrinology and Metabolism,
Department of Medicine, Kurume University School of Medicine,
Japan
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S190