Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

provide up to 150

–

200 mg of elemental iron daily. Intravenous

iron infusion (preferably with ferric gluconate or sucrose) may

be needed for patients with severe intolerance to oral iron or

refractory deficiency due to severe iron malabsorption.

Baseline and postoperative evaluation for vitamin B12 defi-

ciency is recommended in all bariatric surgery and annually

in those with procedures that exclude the lower part of

the stomach (e.g., LSG, RYGB). Oral supplementation with

crystalline vitamin B12 at a dosage of 1,000

g daily or

more may be used to maintain normal vitamin B12 levels.

Parenteral (intramuscular or subcutaneous) B12 supplemen-

tation, 1,000

g/mo to 1,000

–

3,000

g every 6 to 12 months, is

indicated if B12 sufficiency cannot be maintained using oral or

intranasal routes.

In patients who have undergone RYGB, BPD, or BPD/DS,

treatment with oral calcium citrate and vitamin D (ergocalcif-

erol [vitamin D2] or cholecalciferol [vitaminD3]), is indicated to

prevent or minimize secondary hyperparathyroidism without

inducing frank hypercalciuria. 1,200

–

1,500 mg of elemental

calcium (in diet and as citrated supplement in divided doses),

at least 3,000 international units of vitamin D (titrated to

therapeutic 25-hydroxyvitamin D levels >30 ng/mL). In cases

of severe vitamin D malabsorption, oral doses of vitamin D2

orD3mayneedtobeashighas50,000units1to3timesweeklyto

daily, and more recalcitrant cases may require concurrent oral

administration of calcitriol (1,25-dihydroxyvitamin D). Amajor

clinical concern is the relationship between vitamin D defi-

ciencyandthedevelopmentofmetabolicbonediseases,suchas

osteoporosis or osteomalacia; metabolic bone diseases may

explain the increased risk of hip fracture in patients after RYGB.

Screening of Diabetes: How and Why?

S03-1

Screening and diagnosis of diabetes mellitus in Taiwan

Hung-Yuan LI

Department of Internal Medicine, National Taiwan

University Hospital, Taipei, Taiwan

In 2015, the Diabetes Association in Taiwan published its

clinical practice guidelines for diabetes care. There are 3

different screening methods for diabetes in asymptomatic

subjects suggested by the guideline. The first one is based on

the service by the National Health Insurance in Taiwan. In

adults aged 40

–

64 years, screening for diabetes every 3 years

should be considered. For adults aged 65 or over, annual

screening for diabetes is recommended. The second one is

based on Taiwan Diabetes Risk Scores, which is a risk assess-

ment calculator, to estimate the risk for undiagnosed diabetes.

For subjects with very high risk for undiagnosed diabetes,

annual screening is recommended. For subjects with high or

moderate risk for diabetes, screening every 3 years is recom-

mended. The third one is based on risk factors of diabetes.

Subjects who have impaired fasting glucose, impaired glucose

tolerance, or HbA1c 5.7

–

6.4% are suggested to be tested

annually. For subjects with two or more risk factors, screening

is recommended every 3 years. The guideline also suggests a

screening algorithmto confirmthe diagnosis of diabetes and to

determine the needof oral glucose tolerance test, basedondata

of fasting plasma glucose and hemoglobin A1c. The diagnostic

criteria for diabetes and for the category of increased risk for

diabetes (pre-diabetes) remain the same as in the previous

version. For the diagnosis of gestational diabetes mellitus

(GDM), both one-step strategy and two-step strategy are

recommended. The one-step strategy increases prevalence of

GDM, but results in an improvement in maternal and fetal

outcome and is cost-effective in Taiwan. Besides, the DAROC

has also createdan interactivewebsite for theusersto learnand

get familiar with the screening of diabetes, the diagnosis of

diabetes, and the treatment algorithm of the guideline.

S03-3

National survey on diabetes in China

Guang NING

State Key Laboratory of Medical Genomics, Key

Laboratory for Endocrine and Metabolic Diseases of Ministry of

Health, National Clinical Research Center for Metabolic Diseases,

Collaborative Innovation Center of Systems Biomedicine and

Shanghai Clinical Center for Endocrine and Metabolic Diseases,

Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine,

Shanghai, China

Non-communicable chronic diseases have become the leading

causes of mortality and disease burden worldwide. As the

most populous country, the rapid increase in morbidity and

mortality from non-communicable diseases in China con-

tributed to the pandemic, including diabetes. The prevalence

of diabetes has increased significantly in recent decades and

is now reaching epidemic proportions in China. The preva-

lence of diabetes was less than 1% in the Chinese population in

1980. In subsequent national surveys conducted in 1994 and

2000

–

2001, the prevalence of diabetes was 2.5% and 5.5%,

respectively, and 9.7% in 2007. Although different sampling

methods, screening procedures and diagnostic criteria were

used, these data document a rapid increase in diabetes in the

Chinese population. In 2010, wemeasured HbA1c, FPG, and 2-h

PG in a large and nationally representative sample of 98,658

adults aged 18 years or older to estimate the prevalence and

control of diabetes based on the 2010 ADA criteria in the

general Chinese population. The estimated prevalence of

diabetes and pre-diabetes in a representative sample of

Chinese adults was 11.6% and 50.1%, respectively. Projections

based on sample weighting suggest this may represent up to

113.9 million and 493.4 million adults, respectively. These

findings indicate the importance of diabetes as a public health

problem in China. The estimated percentage of ideal cardio-

vascular health was 0.2% in the general adult population in

China (0.1% in men and 0.4% in women). We also reported for

the first time, compared with the general population in China,

most cardiometabolic risk factors were less prevalent in

migrant workers. However, overweight, obesity and central

obesity were more prevalent in male migrant workers than

among men in the general population. Cardiometabolic risk

profiles for migrant workers are not optimal and effective

national interventions that can reach this special population

are needed.

Childhood Obesity and Diabetes:

Environmental Risk Factors, Screening,

and Intervention

S06-1

Environmental factors associated with obesity and diabetes in

Taiwanese children

Yang-Ching CHEN

1,2

, Yungling Leo LEE

3,4

Taipei City Hospital,

ZhongXing Branch,

School of Nutrition and Health Sciences, Taipei

Medical University,

Institute of Epidemiology and Preventive

Medicine, National Taiwan University, College of Public Health,

Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan

Background:

The prevalence of childhood obesity has

increased from 13% in 1986, 26.8% in 2001 and now 32.3% in

2010. The prevalence of impaired fasting glucose in Taiwanese

adolescents is 22%. The rate of newly identified diabetes was

9.0 per 100,000 for boys and 15.3 per 100,000 for girls. Of 253

children with newly diagnosed diabetes, 24 (9.5%) had type 1

DM, 137 (54.2%) had type 2 DM, and 22 (8.7%) had secondary

diabetes. Childhood obesity is themost contributing risk factor

leading to type 2 diabetes, and also metabolic syndrome. We

aim to explore the relationship amongst socio-demographic,

Speech Abstracts / Diabetes Research and Clinical Practice 120S1 (2016) S1

–

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