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Compliance with, and understanding of, mealtime advice in patients with type 2 diabetes
Track 2. Clinical Research
R= -0.26). In a multivariate analysis BMI, duration, age, HbAt, and therapy with sulphonylureas could only explain 17% of ppCp variation. Sixteen patients with low ppCp (to.6 nmol/I) were identified, indicating a need for more intensified insulin therapy, but in the majority of our patients ppCp was not clinically useful in choosing treatment. Based on these data routine analysis of postprandial C-peptide in patients with type 2 diabetes cannot be recommended.
& Care
S55
effect independent of gender, age (above or less than 60) or BMI value (above or less than 27 kgs/m2). Diabetic individuals whose HbAlc above 8% at baseline had constant reduction of HbAlc level one year later. There was also no alteration of glycemic control in subjects with non-SDM group. In conclusion, SDM program was effective in reducing fasting plasma glucose levels both short term and one year after administration of SDM. Only diabetic subjects with poor glycemic control showed constant reduction of HbAlc level one year later. It is suggested that SDM program is applicable in Chinese type 2 diabetic subjects at Taiwan.
P278 The Diahcare-Asia, Bangladesh Project: Management of Diabetes in Bangladesh H. MAHTAB, M.G. Kibriya. DiabCare-Asia Bangladesh Project: Research Division, BIRDEM, Diabetic Association of Bangladesh.
The Diabcare-Asia Project is a large-scale multinational study including 12 Asian countries. The study aims to provide an overview of diabetes management and late complication status in Asia. This paper presents an overview on diabetes care in Bangladesh. Total 1503 Type-2 diabetic patients (m=901, f=602) were randomly selected from our out-patient department. The mean (&SD) age was 50.95f10.32 yr., duration of diabetes was 6.78f5.38 yr. Overall mean body mass index (BMI) was 24.29f3.27 kg/m’ and the majority (62.3%) had BMI ~25 kg/m’. BMI>25 was more frequently encountered among the female compared to male (50.7% vs. 28.8%. p-zO.001). Hypertension (BP>=140/90 mm Hg or on antihypertensive medication) was found in 35.8% cases and Isolated Systolic Hypertension (ISH) was found in 13.4% cases. Overall hypertension was more frequently encountered among female (54.5% vs. 47.4%, p=O.O03). Glycaemic control assessed by HbAlc (n=1373) and fasting blood glucose (FBG) (n=1364) was unsatisfactory. Mean HbAlc was 7.9&1.85%; 36.7% of patients had HbAlc =<7%, 24.4% had HbAlc 7.8% and the rest 38.9% had HbAlc 28%. Mean FBG was 9.07~t3.3 mmol/l; only 15.0% patients had FBG =<6.1 mmou1, 27.9% had FBG 6.1-7.8mmolfl and rest 57.1% had FBG 27.8 mmol/l. Mean total cholesterol (CHOL) (n=ll76) and triglycerides (TG) (n=852) was 195.42f39.67 mg% and 204.7&l 16.22 mg% respectively. Hypercholesterolaemia (CHOL>200 mg%) was found in 43.4% cases and hypertriglycerideaemia (TG> 150 mg%) in 63.4% cases, Proportion of patients on diet control alone, oral hypoglycaemic agent (OHA), insulin and combination of insulin & OHA was 19.5%, 58.7%, 14.6% and 7.2% respectively. The data suggest the need of improvement of diabetic care delivery in Bangladesh.
P279 Application of the Staged Diabetes Management (SDM) in Diabetic Subjects at Taiwan - A Prospective One-Year Follow-Up Study S.J. LIU, Wayne H.H. Sheu, S.Y. Lin, M.Y. Hsu. Diabetic Center; Taichung Veterans General Hospital, Taichung, Taiwan, Province of China
Recent introduction of disease state management system for diabetes, called staged diabetes management (SDM) has been implemented worldwide. However, its long-term application and adherence in Asian diabetic subjects remains unjustified. A total of 115 Chinese type 2 diabetic individuals (meanfSD) (mean age 64flO years, mean BMI 25.7f3.6 kg/m2) were subjected to SDM program for 6-9 months and 79 of diabetic individuals served as control at same period. Administration of SDM reduced levels of fasting plasma glucose (210f68 vs 181f37 mg/dl, p
P280 Pancreatic Reserve and Early Evolution in Type 1 Diabetes Mellitus C. LAMAS, J. Alfaro, N. GaValcfcel, T. Motilla, P. Martinez, P. Manzano, A. Simal, F. Botella. Diabetes and Nutrition Unit, Puerta de Hierro Hospital, Madrid, Spain
Introduction: The pancreatic reserve test is a useful tool for the evaluation of the residual beta cell function, for the classification of diabetic patients and for the decision of starting insulin therapy in patients with type 2 diabetes mellitus. Some studies have shown a correlation between the results of this test and the presence of autoantibodies, the insulin requirements during the first months after diagnosis and the probability of a period of remission of the disease. Patients and methods: 49 patients with diabetes mellitus type 1, classified by clinical criteria and pancreatic reserve test, were evaluated at diagnosis with determination of the C-peptide at baseline and six minutes after a stimulus with 1 mg of I.V. glucagon, anti-islet cell (ICA), antiGAD and antithyroid antibodies. Daily dose of insulin per kg of body weight, glycosilated hemoglobine (HbAlc) and spontaneous remission rate were evaluated one year after diagnosis. Results: C-peptide was 0.87f0.63 t&ml at baseline and 1.46f1.06 ng/ml after glucagon. ICAs, antiGAD and antithyroid antibodies were positive in 53.1%, 13 out of 15 and 5 out of 43 patients, respectively. Mean insulin requirements one year after diagnosis were 0.6f0.3 U/kg/d. Mean HbAlc was 7.06f1.27% (normal values 4.3-6.3%). Three was not significant correlation between pancreatic reserve at diagnosis (C-peptide at baseline and after glucagon) and insulin requirements or metabolic control one year after. Fourteen patients presented a partial remission and 6 a complete remission. We did not find significant differences in the pancreatic reserve or the autoinmunity between this group and the others patients. Conclusions: The pancreatic reserve test is useful in the diagnosis of type 1 diabetes mellitus, but it does not correlate with the early evolution of the disease in our patients. We could not find any predictor parameter of spontaneous remission.
P281 Compliance with, and Understanding of, Mealtime Advice in Patients with ‘Qpe 2 Diabetes KIRSTINE BROWN FRANDSEN, Jorgen Smedegaard Kristensen. Novo Nordisk, Copenhagen,
Denmark
Outcome in Type 2 diabetes is improved when strict targets of glycaemic control are met with intensive treatment. However, regimens including sulphonylureas or insulin demand careful attention to carbohydrate intake. Poor compliance to regular mealtimes increases the risk of major hypoglycaemia, and the fear of repeated hypoglycaemia may jeopardize compliance to antidiabetic treatment. In this study, 123 patients with Type 2 diabetes, currently taking oral hypoglycaemic agents (> 60% receiving sulphonylureas) were surveyed to assess their understanding of/compliance with advice on mealtimes and carbohydrate intake. Groups of 8-10 patients in the USA, UK, Germany, France and Spain completed questionnaires and participated in informal, investigator-led group discussions. Most patients had received dietary advice, but many felt inadequately informed about their diabetes and drug treatment. Dietary advice was often vague, but universally recognised directives included the
Poster Session
S56
need to lose weight, eat ‘healthily’and take meals at regular intervals. Most patients thought regular carbohydrate intake was necessitated by their diabetes rather than their treatment. Patients found changing eating patterns and diet among the most difficult of the lifestyle changes demanded of them: 20% often or always skipped breakfast, 12% often or always skipped lunch, 27% regularly postponed lunch, 12% regularly skipped dinner, and 21% regularly postponed dinner. There was a consensus that strict mealtimes and dietary restrictions created lifestyle limitations and stigma. In conclusion, patients with Type 2 diabetes find dietary changes and compliance to strict meal patterns difficult, and are confused about the reasons for doing so.
P282 The Inlluencing Factors on Blood Sugar and Insulin Levels in OGTT N. SAITO ’ , S.Saito ’ , A. Yamaguchi 2, K. Sakai 2, M. Yamana3, E Ootsujis, T. Kannagi3, H. Sayama3. ’ Dept of Internal Medicine and Adult Disease Research, Miyazaki Aiwa Hospital, Miyazaki, Japan; ’ Cooking Science, Kyoto Women University; 3 Kyoto Prevention Medicial Center
This study aims to clarify the factors influencing on blood sugar and insulin levels in oral GTT(OG’lT). In this study 403 subjects of both sexes without drug administration were recruited, consisting of 116 ones aged below 39 years, 209 ones aged between 40 and 59 years and 78 ones aged over 60 years. OG’IT was measured using 75g of treran Cl at fasting in the early morning. Three types such as normal, borderline and diabetic types were diagnosed by the criteria of Japanese Diabetic Society. Diabetic type was over 126 mg/dl of FBS and over 200 mg/dl at 120 min in GG’IT, while normal type was below 110 mg/dl and below 140 mg/dl, respectively. The grades of glucose intolerance and aging influenced the blood sugar and insulin levels in OGTT. The peak values of blood sugar in OGTT were 30 min in normal type, 60 min in borderline type and 60 to 90 min in diabetic type. The peak values of insulin were 60 min, 60 to 120 min and 120 min, respectively. In the aged subjects over 60 years old blood sugar levels did not decrease remarkably after 90 min in OGTT. By obesity insulin levels increased as compared to normal weight, even when blood sugar levels were almost same in OGTT of the three types, indicating the presence of insulin resistance. Summary: The grades of glucose intolerance, aging and obesity influenced on the changing patterns of blood sugar and insulin in OGTT.
P283 The Effect of Methylcobalamin on the Secretion of Testosterone in STZ-Induced Diabetic Rats J.T. DOU, S.P. Zhang, C.Y. Pan, A.Y. Guo. Department of Endocrinology,
General Hospital of PLA, Beijing, China
Aim: To investigate the effect of methylcobalamin on the secretion of testosterone in diabetic rats. Methods: 30 male Wistar rats were randomly divided into 3 groups: normal group,diabetic rats treated with Methylcobalamin group and diabetic rats(DM) group. The diabetic rat model was induced by Streptozotocin(STZ). Methylcobalamin(5OO~g!kg)was injected intramuscularly in Methylcobalamin treated group and same volume of saline was injected in the other groups. At the end of 2 months triaLthe blood glucose, body weight,testoeterone and hCG binding site of testis were measured. Results: Body weight was significantly higher and blood glucose was lower in normal group than that of other groups. There were no significant differences in body weight and blood glucose between Methylcobalamin treated group and DM group. The level of testosterone and hCG binding site in normal group were significantly higher than those in other two groups (p
1
terone secretion and hCG binding site, both of them being reduced. Methylcobalamin may protect Leydig cells from damage of diabetes, but the mechanism is unclear. Moreover the Methylcobalamin has no effect on body weight and blood glucose of diabetic rats,
P284 How Precise Is Blood Pressure Measurement in the Wrist in Patients with a Long History of Diabetes Mellitus? S. ECKERT, N. Lotz, D. Horstkotte. Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany Blood pressure self-measurement in the wrist is increasingly applied in patients (pts) with diabetes mellitus. Pts with a long history of diabetes mellitus often present endothelial dysfunction due to diffuse arteriosclerosis. We tested the accuracy of the blood pressure measuring device Omron R3 applied in the wrist in long-term diabetics in comparison to non-diabetics by simultaneous invasive comparative measurements according to DIN 58130. Following cardiac catheterization, we performed 5 subsequent invasive comparative measurements in 30 pts with sinus rhythm (n=150 measurements) according to protocol DIN 58 130. Group A: 15 non-diabetics without coronary artery diseases; group B: 15 diabetics with diabetes present for 23f6 years. Nine pts had severe, six moderate coronary disease. The systolic and diastolic reference values were determined from the highest and lowest invasive values during noninvasive measurements of blood pressure. The differences and the standard deviation between the arterial reference values and the noninvasive blood pressure measurements were calculated: systolic
A: non-diabetics 8: diabetics European standard
diastolic
(mm&)
CmHg)
-2.2+3.9 -3.4ztE.O
-0.2i2.7 +1.5*7.8
*5*s
f5fS
Group A. the device finished all of the measurements meaumnents in 4 pts.
started. Group B: the device aborted
17
The Omron R3 blood pressure self-measuring device for the use in the wrist fulfils the European Standard approvol requirements in terms of invasive validation method for both groups.
p285 Esophageal Motility in Patients with ‘Qpe-1 Diabetes Mellitus MONA SALEM, Eman Monir, Hesham Ezz El Din ’ , Heba El-Khashab. Pediatric and ’ Internal Medicine Departments, Faculty of Medicine, Ain Shams University
Gastrointestinal motility disorders are common in diabetic patients particularly those complicated by autonomic neuropathy. Thirty-one patients (20 males and 11 females) with type-l diabetes mellitus attending the Diabetes Clinic Children’s Hospital Ain Shams University were enrolled in this study. Their ages ranged from 10 to 20.5 years with a mean of 15.19f3.95 years. They were divided into two groups; group I, comprised 17 patients without autonomic neuropathy and group II, 14 patients complicated by autonomic neuropathy. Mean random blood glucose, mean glycosylated hemoglobin (HbAiC), microalbumin, autonomic cardiovascular reflexes and esophageal manometric studies were performed. The results revealed esophageal dysmotility in both groups in the form of decreased lower esophageal sphincter pressure, decreased amplitude, velocity and duration of esophageal contractions. Comparing the two groups all esophageal manometric parameters were more evident in the diabetic group complicated by autonomic neuropathy especially so in the amplitude of esophageal contractions (PcO.05) which was statistically significant.
R= -0.26). In a multivariate analysis BMI, duration, age, HbAt, and therapy with sulphonylureas could only explain 17% of ppCp variation. Sixteen patients with low ppCp (to.6 nmol/I) were identified, indicating a need for more intensified insulin therapy, but in the majority of our patients ppCp was not clinically useful in choosing treatment. Based on these data routine analysis of postprandial C-peptide in patients with type 2 diabetes cannot be recommended.
& Care
S55
effect independent of gender, age (above or less than 60) or BMI value (above or less than 27 kgs/m2). Diabetic individuals whose HbAlc above 8% at baseline had constant reduction of HbAlc level one year later. There was also no alteration of glycemic control in subjects with non-SDM group. In conclusion, SDM program was effective in reducing fasting plasma glucose levels both short term and one year after administration of SDM. Only diabetic subjects with poor glycemic control showed constant reduction of HbAlc level one year later. It is suggested that SDM program is applicable in Chinese type 2 diabetic subjects at Taiwan.
P278 The Diahcare-Asia, Bangladesh Project: Management of Diabetes in Bangladesh H. MAHTAB, M.G. Kibriya. DiabCare-Asia Bangladesh Project: Research Division, BIRDEM, Diabetic Association of Bangladesh.
The Diabcare-Asia Project is a large-scale multinational study including 12 Asian countries. The study aims to provide an overview of diabetes management and late complication status in Asia. This paper presents an overview on diabetes care in Bangladesh. Total 1503 Type-2 diabetic patients (m=901, f=602) were randomly selected from our out-patient department. The mean (&SD) age was 50.95f10.32 yr., duration of diabetes was 6.78f5.38 yr. Overall mean body mass index (BMI) was 24.29f3.27 kg/m’ and the majority (62.3%) had BMI ~25 kg/m’. BMI>25 was more frequently encountered among the female compared to male (50.7% vs. 28.8%. p-zO.001). Hypertension (BP>=140/90 mm Hg or on antihypertensive medication) was found in 35.8% cases and Isolated Systolic Hypertension (ISH) was found in 13.4% cases. Overall hypertension was more frequently encountered among female (54.5% vs. 47.4%, p=O.O03). Glycaemic control assessed by HbAlc (n=1373) and fasting blood glucose (FBG) (n=1364) was unsatisfactory. Mean HbAlc was 7.9&1.85%; 36.7% of patients had HbAlc =<7%, 24.4% had HbAlc 7.8% and the rest 38.9% had HbAlc 28%. Mean FBG was 9.07~t3.3 mmol/l; only 15.0% patients had FBG =<6.1 mmou1, 27.9% had FBG 6.1-7.8mmolfl and rest 57.1% had FBG 27.8 mmol/l. Mean total cholesterol (CHOL) (n=ll76) and triglycerides (TG) (n=852) was 195.42f39.67 mg% and 204.7&l 16.22 mg% respectively. Hypercholesterolaemia (CHOL>200 mg%) was found in 43.4% cases and hypertriglycerideaemia (TG> 150 mg%) in 63.4% cases, Proportion of patients on diet control alone, oral hypoglycaemic agent (OHA), insulin and combination of insulin & OHA was 19.5%, 58.7%, 14.6% and 7.2% respectively. The data suggest the need of improvement of diabetic care delivery in Bangladesh.
P279 Application of the Staged Diabetes Management (SDM) in Diabetic Subjects at Taiwan - A Prospective One-Year Follow-Up Study S.J. LIU, Wayne H.H. Sheu, S.Y. Lin, M.Y. Hsu. Diabetic Center; Taichung Veterans General Hospital, Taichung, Taiwan, Province of China
Recent introduction of disease state management system for diabetes, called staged diabetes management (SDM) has been implemented worldwide. However, its long-term application and adherence in Asian diabetic subjects remains unjustified. A total of 115 Chinese type 2 diabetic individuals (meanfSD) (mean age 64flO years, mean BMI 25.7f3.6 kg/m2) were subjected to SDM program for 6-9 months and 79 of diabetic individuals served as control at same period. Administration of SDM reduced levels of fasting plasma glucose (210f68 vs 181f37 mg/dl, p
P280 Pancreatic Reserve and Early Evolution in Type 1 Diabetes Mellitus C. LAMAS, J. Alfaro, N. GaValcfcel, T. Motilla, P. Martinez, P. Manzano, A. Simal, F. Botella. Diabetes and Nutrition Unit, Puerta de Hierro Hospital, Madrid, Spain
Introduction: The pancreatic reserve test is a useful tool for the evaluation of the residual beta cell function, for the classification of diabetic patients and for the decision of starting insulin therapy in patients with type 2 diabetes mellitus. Some studies have shown a correlation between the results of this test and the presence of autoantibodies, the insulin requirements during the first months after diagnosis and the probability of a period of remission of the disease. Patients and methods: 49 patients with diabetes mellitus type 1, classified by clinical criteria and pancreatic reserve test, were evaluated at diagnosis with determination of the C-peptide at baseline and six minutes after a stimulus with 1 mg of I.V. glucagon, anti-islet cell (ICA), antiGAD and antithyroid antibodies. Daily dose of insulin per kg of body weight, glycosilated hemoglobine (HbAlc) and spontaneous remission rate were evaluated one year after diagnosis. Results: C-peptide was 0.87f0.63 t&ml at baseline and 1.46f1.06 ng/ml after glucagon. ICAs, antiGAD and antithyroid antibodies were positive in 53.1%, 13 out of 15 and 5 out of 43 patients, respectively. Mean insulin requirements one year after diagnosis were 0.6f0.3 U/kg/d. Mean HbAlc was 7.06f1.27% (normal values 4.3-6.3%). Three was not significant correlation between pancreatic reserve at diagnosis (C-peptide at baseline and after glucagon) and insulin requirements or metabolic control one year after. Fourteen patients presented a partial remission and 6 a complete remission. We did not find significant differences in the pancreatic reserve or the autoinmunity between this group and the others patients. Conclusions: The pancreatic reserve test is useful in the diagnosis of type 1 diabetes mellitus, but it does not correlate with the early evolution of the disease in our patients. We could not find any predictor parameter of spontaneous remission.
P281 Compliance with, and Understanding of, Mealtime Advice in Patients with ‘Qpe 2 Diabetes KIRSTINE BROWN FRANDSEN, Jorgen Smedegaard Kristensen. Novo Nordisk, Copenhagen,
Denmark
Outcome in Type 2 diabetes is improved when strict targets of glycaemic control are met with intensive treatment. However, regimens including sulphonylureas or insulin demand careful attention to carbohydrate intake. Poor compliance to regular mealtimes increases the risk of major hypoglycaemia, and the fear of repeated hypoglycaemia may jeopardize compliance to antidiabetic treatment. In this study, 123 patients with Type 2 diabetes, currently taking oral hypoglycaemic agents (> 60% receiving sulphonylureas) were surveyed to assess their understanding of/compliance with advice on mealtimes and carbohydrate intake. Groups of 8-10 patients in the USA, UK, Germany, France and Spain completed questionnaires and participated in informal, investigator-led group discussions. Most patients had received dietary advice, but many felt inadequately informed about their diabetes and drug treatment. Dietary advice was often vague, but universally recognised directives included the
Poster Session
S56
need to lose weight, eat ‘healthily’and take meals at regular intervals. Most patients thought regular carbohydrate intake was necessitated by their diabetes rather than their treatment. Patients found changing eating patterns and diet among the most difficult of the lifestyle changes demanded of them: 20% often or always skipped breakfast, 12% often or always skipped lunch, 27% regularly postponed lunch, 12% regularly skipped dinner, and 21% regularly postponed dinner. There was a consensus that strict mealtimes and dietary restrictions created lifestyle limitations and stigma. In conclusion, patients with Type 2 diabetes find dietary changes and compliance to strict meal patterns difficult, and are confused about the reasons for doing so.
P282 The Inlluencing Factors on Blood Sugar and Insulin Levels in OGTT N. SAITO ’ , S.Saito ’ , A. Yamaguchi 2, K. Sakai 2, M. Yamana3, E Ootsujis, T. Kannagi3, H. Sayama3. ’ Dept of Internal Medicine and Adult Disease Research, Miyazaki Aiwa Hospital, Miyazaki, Japan; ’ Cooking Science, Kyoto Women University; 3 Kyoto Prevention Medicial Center
This study aims to clarify the factors influencing on blood sugar and insulin levels in oral GTT(OG’lT). In this study 403 subjects of both sexes without drug administration were recruited, consisting of 116 ones aged below 39 years, 209 ones aged between 40 and 59 years and 78 ones aged over 60 years. OG’IT was measured using 75g of treran Cl at fasting in the early morning. Three types such as normal, borderline and diabetic types were diagnosed by the criteria of Japanese Diabetic Society. Diabetic type was over 126 mg/dl of FBS and over 200 mg/dl at 120 min in GG’IT, while normal type was below 110 mg/dl and below 140 mg/dl, respectively. The grades of glucose intolerance and aging influenced the blood sugar and insulin levels in OGTT. The peak values of blood sugar in OGTT were 30 min in normal type, 60 min in borderline type and 60 to 90 min in diabetic type. The peak values of insulin were 60 min, 60 to 120 min and 120 min, respectively. In the aged subjects over 60 years old blood sugar levels did not decrease remarkably after 90 min in OGTT. By obesity insulin levels increased as compared to normal weight, even when blood sugar levels were almost same in OGTT of the three types, indicating the presence of insulin resistance. Summary: The grades of glucose intolerance, aging and obesity influenced on the changing patterns of blood sugar and insulin in OGTT.
P283 The Effect of Methylcobalamin on the Secretion of Testosterone in STZ-Induced Diabetic Rats J.T. DOU, S.P. Zhang, C.Y. Pan, A.Y. Guo. Department of Endocrinology,
General Hospital of PLA, Beijing, China
Aim: To investigate the effect of methylcobalamin on the secretion of testosterone in diabetic rats. Methods: 30 male Wistar rats were randomly divided into 3 groups: normal group,diabetic rats treated with Methylcobalamin group and diabetic rats(DM) group. The diabetic rat model was induced by Streptozotocin(STZ). Methylcobalamin(5OO~g!kg)was injected intramuscularly in Methylcobalamin treated group and same volume of saline was injected in the other groups. At the end of 2 months triaLthe blood glucose, body weight,testoeterone and hCG binding site of testis were measured. Results: Body weight was significantly higher and blood glucose was lower in normal group than that of other groups. There were no significant differences in body weight and blood glucose between Methylcobalamin treated group and DM group. The level of testosterone and hCG binding site in normal group were significantly higher than those in other two groups (p
1
terone secretion and hCG binding site, both of them being reduced. Methylcobalamin may protect Leydig cells from damage of diabetes, but the mechanism is unclear. Moreover the Methylcobalamin has no effect on body weight and blood glucose of diabetic rats,
P284 How Precise Is Blood Pressure Measurement in the Wrist in Patients with a Long History of Diabetes Mellitus? S. ECKERT, N. Lotz, D. Horstkotte. Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany Blood pressure self-measurement in the wrist is increasingly applied in patients (pts) with diabetes mellitus. Pts with a long history of diabetes mellitus often present endothelial dysfunction due to diffuse arteriosclerosis. We tested the accuracy of the blood pressure measuring device Omron R3 applied in the wrist in long-term diabetics in comparison to non-diabetics by simultaneous invasive comparative measurements according to DIN 58130. Following cardiac catheterization, we performed 5 subsequent invasive comparative measurements in 30 pts with sinus rhythm (n=150 measurements) according to protocol DIN 58 130. Group A: 15 non-diabetics without coronary artery diseases; group B: 15 diabetics with diabetes present for 23f6 years. Nine pts had severe, six moderate coronary disease. The systolic and diastolic reference values were determined from the highest and lowest invasive values during noninvasive measurements of blood pressure. The differences and the standard deviation between the arterial reference values and the noninvasive blood pressure measurements were calculated: systolic
A: non-diabetics 8: diabetics European standard
diastolic
(mm&)
CmHg)
-2.2+3.9 -3.4ztE.O
-0.2i2.7 +1.5*7.8
*5*s
f5fS
Group A. the device finished all of the measurements meaumnents in 4 pts.
started. Group B: the device aborted
17
The Omron R3 blood pressure self-measuring device for the use in the wrist fulfils the European Standard approvol requirements in terms of invasive validation method for both groups.
p285 Esophageal Motility in Patients with ‘Qpe-1 Diabetes Mellitus MONA SALEM, Eman Monir, Hesham Ezz El Din ’ , Heba El-Khashab. Pediatric and ’ Internal Medicine Departments, Faculty of Medicine, Ain Shams University
Gastrointestinal motility disorders are common in diabetic patients particularly those complicated by autonomic neuropathy. Thirty-one patients (20 males and 11 females) with type-l diabetes mellitus attending the Diabetes Clinic Children’s Hospital Ain Shams University were enrolled in this study. Their ages ranged from 10 to 20.5 years with a mean of 15.19f3.95 years. They were divided into two groups; group I, comprised 17 patients without autonomic neuropathy and group II, 14 patients complicated by autonomic neuropathy. Mean random blood glucose, mean glycosylated hemoglobin (HbAiC), microalbumin, autonomic cardiovascular reflexes and esophageal manometric studies were performed. The results revealed esophageal dysmotility in both groups in the form of decreased lower esophageal sphincter pressure, decreased amplitude, velocity and duration of esophageal contractions. Comparing the two groups all esophageal manometric parameters were more evident in the diabetic group complicated by autonomic neuropathy especially so in the amplitude of esophageal contractions (PcO.05) which was statistically significant.