Diabetes Research and Clinical Practice - Volume 120 - Supplement 1

Methods:

In this cohort study of Taiwanese patients with BMI

above 25 who underwent metabolic surgery to ameliorate

T2DM between 2007 to 2013, 558 patients (339 young onset and

219 late onset T2DM patients) with minimum of one year

followup were included. Preoperative, peri-operative and post-

operative follow up clinical and laboratory data were prospect-

ively collected and compared between two groups. Diabetes

remission rate (HbA1c <6.0% without anti-glycemic medica-

tion) was primary outcome measure.

Results:

Young-onset patients had higher preoperative BMI

and HbA1c profiles than late-onset patients. Distribution of

surgical procedures and major complications were similar

between two groups. At one year, young onset group achieved

greater weight loss even though it was not statistically

significant. A higher complete diabetes remission rate was

observed in young onset patients (57.3% vs. 50.2%, p = 0.019). At

5-year, young-onset patients still maintained a higher weight

loss (11.8% versus 11.7%, p = 0.002) and higher remission rate

(65.3% versus 54.2%, p = 0.04) than late-onset patients. Age at

operation, duration of diabetes and C-peptide level were

independent predictors of diabetes remission. Remission rate

was directly related to extent of weight loss. Multivariate

analysis confirmed higher DM remission rates in young-onset

group.

Conclusion:

This report describes the largest, long-term study

examining metabolic surgery for young-onset diabetic

patients. Metabolic surgery may achieve better and more

durable glycemic control in selected young-onset than those

with late-onset T2DMpatients and early treatment is preferred.

OL06-8

Metabolic surgery for diabetes treatment: A comparative study

of sleeve gastrectomy and gastric bypass

Nawaf ALKHALIFAH

1,2

, Wei-Jei LEE

, Tan Chun HAI

2,3

Shu-Chu CHEN

, Jung-Chien CHEN

, Kong-Han SER

Department of Surgery, AlAdan Hospital, Kuwait;

Department of

Surgery, Min-Sheng General Hospital, Taiwan;

Department of

Surgery, Khoo Teck Puat Hospital, Singapore

Background:

Bariatric surgery has gained reputation for its

metaboliceffect and is increasinglybeingperformedtotreat type

2 diabetes mellitus (T2DM). However, there is still a grey area

regarding the choice of surgical procedure according to patient

characteristics due to inadequate evidences. We aim to com-

pare the efficacy of two most commonly performed bariatric/

metabolic surgeries, sleeve gastrectomy (SG) and gastric

bypass (GB) with regards to remission of T2DM after surgery.

Methods:

Outcomes of 579 (349 women and 230 male) patients

who underwent SG (109) or GB (470) for the treatment of T2DM

with one year follow-upwere assessed. The remission of T2DM

after SG or GB surgery was evaluated in matched groups using

the ABCD scoring system. The ABCD score is composed of the

age, BMI, C-peptide levels and duration of T2DM (years).

Results:

The weight loss of the SG patient at one year after

surgery was similar to the GB patients [26.3(1.1) % vs. 32.6(1.2)

%; p = 0.258]. The mean BMI decreased from 35.7(7.2) to 28.3

(3.7) Kg/m

in SG patients at one year after surgery and

decreased from 36.9(7.2) to 26.7(4.5) Kg/m

in the GB patients.

The mean HbA1c decreased from 8.8% to 6.1% of the SG group

and from 8.6% to 5.9% of the GB group. Sixty-one (56.0%)

patients of the SG group and 300 (63.8%) of the GB group

achieved complete remission of T2DM (HbA1c < 6.0%) at one

year after surgery without statistical difference. However, GB

exhibited significantly better glycemic control than the SG

surgery in groups stratified by different ABCD score. At 5-years

after surgery, GB had a better remission of T2DM than SG

(53.1% vs. 35.3%; p = 0.055).

Conclusions:

In conclusion, although both SG and GB are

effective metabolic surgery, GB carries a higher power on

T2DM remission than SG. ABCD score is useful in T2DMpatient

classification and selection for different procedures.

Laboratory Medicine for Diabetes

OL07-1

Time-dependent sensor performance is sustained during 4

years: Accuracy measurement with mean absolute difference

(MAD) in continuous glucose monitoring (CGM)

Shinichiro KOGA

, Aya KOMIKADO

, Yuko MURAYAMA

Kazunaga TAKAZAWA

Section for Disorders in Endocrine and

Kidney Systems, Department of Medicine, Tokyo Metropolitan Police

Hospital, Tokyo, Japan

Background:

Mean absolute difference (MAD) is a numerical

accuracy measures which is defined as closeness between

continuous glucose monitoring (CGM) and corresponding

in-time reference blood glucose (BG) measurements 1).

However, possible factor affected to MAD is not well docu-

mented so far 2).

Methods:

During May 2012 and March 2016, 55 diabetic

patients were unintentionally collected in a single institute

and consecutively recorded 96 CGMs with iPro2 (Medtronic

MiniMed, Northridge, CA) 2). Analyzed CGMs were assigned

to Term1 (n = 30), 2 (n = 29), and 3 (n = 30) by record starting day

[May-Dec 2012,-Nov 2013,-Mar 2016]. Among terms, patient

’

age, recoded duration days, sensored BG, effective calibration

times by metered BG reference were set as independent

variables and MAD was as dependent. Factorial ANOVA was

performed with SPSS Statistics version 22.0 (IBM, Chicago, IL).

Results:

Of consecutive 96 CGM recodings from 55 patients

(51.9+/

−

13.5 years old), 7 were excluded from this study due

not to assessed relative coeffficient (r) of MAD; 89 recordings,

type 1(45), type 2 (27), fulminant type 1 (13), tumor (insuli-

noma, etc) peri-operation (3), SPIDDM (1), were subjected to

this study. Of total 102,934 times sensored in 89 recordings

(1,156.6+/

−

439.9 times sensored per record), sensor BG was 9.5

−

2.5 mmol/L, and effectively calibrated 1,706 times by meter

BG reference; MAD was 12.24+/

−

1.51%, r was 0.917+/

−

0.075.

Among three terms [T1, T2, vs T3], patient number was [30, 27,

vs 29], patient agewas [55.3+/

−

14.0, 52.4+/

−

12.5, vs 48.0+/

−

13.3]

years old, and record duration was [4.1+/

−

0.4, 4.7+/

−

1.2, vs 6.7

−

0.7] days per recording. Sensored BG was [9.8+/

−

2.4, 9.9

−

2.9, vs 8.7+/

−

1.9] mmol/L, which was calibrated effectively

in [14.7+/

−

3.3, 17.4+/

−

7.0, vs 25.4+/

−

5.5] times per recording;

MAD was [11.09+/

−

2.77, 11.61+/

−

2.97, vs 13.3+/

−

5.03] %, and

’

s r was [0.932+/

−

0.114, 0.923+/

−

0.240, vs 0.905+/

−

0.173].

Both sensored BG 3) and MAD were not statistically dif-

ferent throughout Terms, whereas patient was younger,

record duration was longer, and calibration was most frequent

in Term 3.

Discussion:

Former and no experience users was not dif-

ferent in MAD 4). Relationship between age and frequency of

discontinuation 5) was not investigated in this study; Patient

’

level of numeracy, literacy, and cognitive function, and poor

reimbursement was not investigated.

Conclusion:

MAD is not affected by patient

’

s numerical

characteristics; within favorable values during 4 years.

OL07-3

Validation of a new formula (SMART2D) for estimation of LDL

cholesterol in patients with and without diabetes

Jeremy HOE

, Ester Chai Kheng YEOH

–

, Chee Fang SUM

–

Su Chi LIM

–

, Moh Sim WONG

, Aznan OMAR

, Steven TSAI

Ping Ying HENG

, Subramaniam TAVINTHARAN

–

Department of Medicine, Khoo Teck Puat Hospital,

Diabetes Centre,

Khoo Teck Puat Hospital,

Division of Endocrinology, Khoo Teck Puat

Hospital,

Clinical Research Unit, Khoo Teck Puat Hospital,

Department of Laboratory Medicine, Khoo Teck Puat Hospital,

Singapore

Background:

The Friedewald formula, widely used in clinical

laboratories to estimate LDL cholesterol (LDL-C), tends to

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

–

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