Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

Diabetes Complications: Epidemiology

and Biomarkers

OL03-1

Examination of sleep disorders of 1023 type2 diabetic

outpatients

Akiko TESHIMA

*, Junpei SHIKUMA

, Mamoru SAKURAI

Ketchu YANAGI

, Rokurou ITOU

, Tomono TAKAHASHI

Hiroyuki SAKAI

, Kazuo HARA

, Takashi MIWA

Masato ODAWARA

Tokyo Medical University Hospital, Japan

Objective:

Diabetic neuropathy can cause sleep disorders.

Sleep disorders, meanwhile, increase insulin resistance, and

affect leptin and ghrelin which enhance appetite. This study

examined the relationship between diabetes mellitus (DM)

and sleep disorders in type-2 DM (T2DM) patients, using a

cross-sectional design.

Methods:

The participants in the study were 1033 Japanese

outpatients with T2DM (age, 62.9 ± 13.1 years; M/F, 710/323

persons; DM duration, 16.3 ± 16.7 years; Hemoglobin A1c

[HbA1c], 7.4 ± 1.3%) who visited our hospital in February 2014.

We investigated sleep disorders, quality of life (QOL), and

depression (assessed by the Pittsburgh Sleep Quality Index

[PSQI], the Center for Epidemiologic Studies Depression Scale

[CES-D], and the SF-8 Health Survey [SF-8]). We then compared

the results with the data of 572 age- and sex-matched people

from the general population without a diabetes history.

Results:

The mean PSQI score (cutoff

≥

5.5) was 5.6 ± 3.3

(mean ± SD) in the participants, and 454 patients (44%) had

PSQI scores of

≥

5.5. Patients with a lower PSQI score tended to

be obese. However, PSQI scores were not significantly corre-

lated with glycemic control, diabetes duration, and insulin

intake, respectively. In terms of CES-D (0

–

11 normal, 12

–

moderate, 21

–

36 severe), 929 patients (90%) were categorized as

normal, 73 (7.1%) moderate, and 29 (2.9%) severe. PSQI scores

and CES-D scores showed a positive correlation, whereas PSQI

scores and SF-8 scores showed a negative correlation.

In comparison with the non-diabetic population (n = 572), the

diabetic group (n = 572) had significantly higher PSQI scores

(5.7 ± 3.2 vs 5.2 ± 2.8) with significantly shorter sleep duration

and lower sleep efficiency. Similarly, on SF-8, the diabetic

group scored significantly lower in the Physical Functioning

(PF), Role Physical (RP), Body Pain (BP), General Health (GH), and

physical summary components. We observed no significant

difference in CES-D scores between the two groups.

Discussion:

This study showed that many patients with T2DM

suffer sleep disorders. Sleep quality is associated with

depression and deteriorated QOL. While it is quite difficult to

assume whether the diabetic patient has a sleep disorder

through their patient characteristics, BMI

–

both the present

and past maximum

–

had a correlation, pointing to the

importance of noting patients

’

body weight history. Sleep

disorders should be widely recognized as a diabetic complica-

tion: intervention in the disorders can alleviate depression,

and improve QOL and probably blood glucose control as well.

OL03-2

Global and Chinese prevalence of diabetic foot

Pengzi ZHANG

*, Dalong ZHU

, Yan BI

Nanjing Drum Tower

Hospital affiliated to Nanjing University Medical School, China

Background:

Diabetic foot is a severe public health issue

worldwide and in China, and updating its epidemiologic

characteristic is beneficial for future policy, prevention strat-

egy and care management. However, there is a lack of

studies to investigate the epidemiologic characteristics of

diabetic foot. Here we performed a systematic review and

meta-analysis to generate global and Chinese diabetic foot

prevalence.

Methods:

In the systematic review and meta-analysis of global

diabetic foot prevalence, we searched Pubmed, EMBASE, ISI

Web of science and Cochrane and identified 67 studies. In the

study of Chinese diabetic foot prevalence, we searched

Pubmed, EMBASE, ISI Web of science, and Chinese databases:

Chinese Biochemical Literature on Disc, Wanfang data

resource and China National Knowledge Infrastructure data-

base and included 39 studies. Random effects model meta-

analysis was used to obtain the pooled prevalence of diabetic

foot. Subgroup analysis and meta regression were also

conducted to evaluate the sources of heterogeneity.

Results:

Global diabetic foot prevalence was 6.9% (95%CI: 5.9

–

7.8%). North America had the highest prevalence (13.0%, 95%

CI: 8.2

–

15.9%), and Oceania

’

s prevalence was the lowest (3.0%,

95%CI: 0.9

–

5.0%). The prevalence in Asia, Europe and Africa

was 6.2% (95%CI: 5.2

–

7.2%), 5.7% (95%CI: 4.5

–

6.8%) and 8.8%

(95%CI: 6.2

–

11.4%), respectively. Diabetic foot was more

prevalent in males (4.5%, 95%CI: 3.7

–

5.2%) than in females

(3.5%, 95%CI: 2.8

–

4.2%), and more prevalent in type 2 diabetes

(9.4%, 95%CI: 6.4

–

12.4%) than type 1 diabetes (5.6%, 95%CI: 3.6

–

7.6%). Patients with diabetic foot were older, with longer

diabetic duration, higher HbA1c, larger percentage of smokers,

hypertension and diabetic retinopathy as well as lower body

mass index when compared with patients without diabetic

foot. Chinese diabetic foot prevalence was 5.7% (95%CI: 4.9

–

6.5%), which was higher in eastern region (6.9%, 95%CI: 5.6

–

8.2%) than in western region (4.2%, 95%CI: 3.0

–

5.4%), and

higher in males (6.6%, 95%CI: 2.1

–

11.2%) than in females (4.8%,

95%CI: 1.9

–

7.8%).

Conclusion:

We for the first time demonstrated that overall

diabetic foot prevalencewas 6.9%worldwide and 5.7% in China

as well as its epidemiologic characteristics. Prevention of

diabetic foot may include glycemic control and quit smoking.

Our findings provide evidence for future policy making in

diabetic foot, and thus alleviate the economic burden.

OL03-3

Bilateral atrophy of extensor digitorum brevis muscle may be

useful for diagnosis of diabetic polyneuropathy in Japanese

diabetic men

Hideyuki SASAKI

*, Seigo KURISU

1,2

, Kenichi OGAWA

Shohei KISHIMOTO

, Mika YAMANEKI

, Hiroto TANAKA

Hiroto FURUTA

, Masahiro NISHI

, Kishio NANJO

Takashi AKAMIZU

Department of Medicine, Kihoku Hospital,

Wakayama Medical University,

First Department of Medicine,

Wakayama Medical University,

Wakayama Rosai Hospital, Japan

Aims:

We aimed to evaluate validity and reliability of

observation of extensor digitorum brevis muscle (EDB). EDB

atrophy for diagnosis of diabetic symmetric polyneuropathy

(DPN). Firstly, we examined the relations between EDB atrophy

and neurological findings in regional population-based

Japanese subjects (Study I). Secondly, we investigated relations

between EDB atrophy and quantitative neurological findings in

the hospital-based diabetic patients (Study II).

Methods:

Study I. 548 non diabetic persons who received

medical screening program were subjected. Subjective symp-

toms (numbness in toes and sole, pain and/or paresthesia in

feet), quantitative vibratory perception at the tips of toe (QVP;

using vibrometer Rion AU-02B), bilateral Achilles tendon

reflexes (ATR) and EDB atrophy were evaluated. We judged

EDB atrophy as positive when both EDB could not be identified

by inspection and palpation. We also interviewed about Seiza

habit (Japanese sit-down style with the buttocks on top of the

ankles).

Study II. In 193 diabetic patients, neurological examination as

same as Study I were examined. Additional 8 objective nerve

function tests were evaluated. Relationships among these

findings were analyzed.

Results:

Study I. Prevalence (%) of EDB atrophy and Seiza habit

in women (36, 73) were significantly higher than those in men

Oral Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S40

–

S64

S45