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

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2. Second episode:
When he was 59 y/o, his GAD antibody became positive
after the start of 6 months of SGLT2 inhibitor treatment.
In addition, Serum amylase was elevated together with
rise of CA19-9, elastase-I, lipase, tripsin and IgG4. The
reassessment of the radiological diagnosis has not
identified pancreatic mass as a manifestation of focal
pancreatitis. Because of high IgG4, he was tentatively
diagnosed as having had autoimmune pancreatitis (AIP).
3. Discrepancy:
Interestingly, during the first episode, glycemic control
got abruptly worse according to the elevation of GAD
antibody titer. GAD antibody titer and HbA1c elevation
had seemingly close relationship. In contrast, during the
second episode, glycemic control was stable, seemingly
having no relationship between GAD antibody titer and
HbA1c level. While the difference of two times episodes
was apparent, true aetiology was unknown.
In conclusion, this is the first case report of mitochon-
drial diabetes, in which GAD antibodies were detected
once positive and soon after became negative two times
in life. The aetiology and pathophysiology are not fully
elucidated.
PB-08
Evaluation of the web-based nutritional management
program for pregnant women with diabetes mellitus
Jin-Hee LEE 1, Sun-Young LIM1, Hyun-Jung YOO1,
Hun-Sung KIM 1,2, Yoon-Hee CHOI2, Jae-Hyoung CHO1,2,
Kun-Ho YOON 1,2*. 1Catholic Institute of U-Healthcare, The Catholic
University of Korea, 2 Department of Endocrinoloty and Metabolism,
College of Medicine, The Catholic University of Korea, Korea
Objective: This study aimed to evaluate the effectiveness of
the web-based nutritional management program by applying
to pregnant womenwith gestational diabetes (GDM) and type 2
diabetes mellitus (T2DM).
Methods: FromJune 2008 toMay 2010, 96 pregnantwomenwith
GDM and T2DM were included. At entrance they were
instructed to record their dietary intake using the 24-hour
recall method and then received nutritional education by
dietitian. Since then, they had received well designedmanage-
ment by the web-based program for 4 weeks. Weekly nutri-
tional intake status was assessed using data they recorded
meal diary in the web-based program. Repeated measures
ANOVAwere performed to compare the change of intake level.
Results: At entrance, mean weeks of gestation and energy
intakes were 26.4, 12.3 weeks and 1590.7, 1620.6 kcal in the
GDM and T2DM group, respectively and carbohydrate intakes
compared with total calorie were highly presented in both
group. After applying the web-based program for 4 weeks, the
percentages of total energy from carbohydrate were decreased
significantly (from 57.2% to 50.2% in GDM and from 63.7% to
51.6% in T2DM group) with increasing protein and fat intakes
close to recommended levels. Also, weight management
especially in the overweight/obese subjects was improved.
Conclusion: This study showed that an effective management
of nutrition intake and weight control for pregnant women
with GDM and T2DM will be available by using the web-based
nutritional management program and it is expected to
influence positively for decrease of the maternal and fetal
complications.
PB-09
Study of frailty prevalence and status of elder diabetic patients
in a primary care clinic
Yuan-Ching LIU1,2, Neng-Chun YU2, Shu-Hua FENG2,
Lan-Fen LIN 2, Chia-Hui CHENG2, Mei CHANG YEH 1*.
1 Department of Nursing, College of Medicine, National Taiwan
University, Taipei, 2Neng-Chun Diabetes Clinic, Yilan County,
Taiwan
Background: Frailty is characterized by multi-system decline
and vulnerability to adverse health outcomes. Elder diabetic
patients were considered to have high risk of frailty. The goal of
this study was to analyze the frailty prevalence and status of
those elder diabetic patients.
Methods: This pilot study was conducted in a local diabetes
clinic located at Yilan County, Taiwan. A total of 181 patients
aged 65 years or older were selected by randomly systematic
sampling from August to December in 2015. Frailty was
measured by the Chinese version of Tilburg Frailty Indicator
(TFI) including 15 items. When total scorewas 5 or greater, they
were determined to have frailty. Other baseline characteristics
were evaluated by Activities of Daily Living (ADLs) scales,
instrumental ADL scale, Taiwan Geriatric Depression Scale,
Mini-Mental State Examination, demographic datum, and
clinical parameters.
Results: 181 elder diabetic patients were included in this study.
Participants’ average agewas 74.3 ± 5.8 years old, and themean
DMdurationwas 15.0 ± 9.2 years. 58.0%weremale. The average
A1C and BMI were 7.1 ± 1.1% and 25.3 ± 3.9 kg/m2, respectively.
Hypertension (66.3%), hyperlipidemia (72.9%), diabetic
nephropathy (56.4%), retinopathy (16.0%), neuropathy (4.4%),
and stroke (3.9%) were reported. The average disease number
of those patients was 2.7 ± 1.5. Those patients used 3.2 ± 1.7
types of medicine. The self-reported frequency of fall and
hypoglycemia of those patients were 0.6 ± 1.2 and 1.7 ± 5.2 in
the past year, respectively. The frailty prevalence rate for all
participants was 32.0%, for male was 27.6% and for female was
38.2%. The age-specific frailty prevalence rates were 22.9%,
40.8%, and 55.6%, for 65–74.9, 75– 84.9, and ≥85 y/o respec-
tively and significantly different among age groups (χ2 = 8.63,
p = 0.013). Compared to patients without frailty, patients with
frailty had significantly higher percentage of stroke and fall,
worse physical function, higher depressive level, and worse
cognitive impairment.
Conclusions: The frailty prevalence was determined to be
32.0% by TFI in a local primary care clinic. The prevalence
increased with age. Patients with frailty had higher percentage
of stroke and fall. They also had worse physical function,
higher depressive level, and worse cognitive impairment than
those patients with no frailty. More patients will be involved to
verify related factors of causing frailty of elder diabetic patients
in future studies.
PB-10
Association study of WFS1 rs10010131 and type 2 diabetes
microvascular complication in a Chinese population
Yeping HUANG1,5, Rong ZHANG1–5, Cheng HU1–5 *,
Weiping JIA1– 5. 1Shanghai Diabetes Institute, 2 Shanghai Key
Laboratory of Diabetes Mellitus, 3Shanghai Clinical Center for
Diabetes, 4Shanghai Key Clinic Center for Metabolic Diseases,
5Shanghai Jiao Tong University Affiliated Sixth People’s Hospital,
China
Objective: Genome-wide association studies found WFS1
rs10010131 was associated with type 2 diabetes by affecting
beta cell function. Diabetic nephropathy (DN) and diabetic
retinopathy (DR) are both the common microvascular compli-
cations. Besides poor blood glucose control and long duration
of the disease, genetic factors do predispose to diabetic
nephropathy and retinopathy. The aim of the study is to
investigate the association of WFS1 rs10010131 and diabetic
nephropathy and diabetic retinopathy in the Chinese
population.
Methods: The study was conducted in two stages. In the first
stage, 1251 individuals with type 2 diabetes were recruited and
stratified into 4 groups: 313 with diabetic retinopathy but
without diabetic nephropathy, 419 with nephropathy but
without retinopathy, 281 with both retinopathy and nephro-
pathy, and 238 with diabetes of ≥10 years duration but
without microvascular complications. In the second stage,
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211 S78