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Aspart
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65–S211
oxidation with subsequent chronic inflammation play an important role in diabetic macroangiopathy. Astaxanthin (AX) is one of the carotenoids with excellent anti-inflammatory and antioxidative capacity. Purpose: The purpose of this study was to investigate the effect of astaxanthin and astaxanthin formula (AXF) on metabolic and thrombogenic risks in type 2 diabetic patients. Material and method: One hundred and three type 2 diabetic patients were recruited from department of metabolism and endocrinology of Cheng Ching Hospital in Taichung city. After exclusion of unqualified patients, all subjects were randomly assigned into three groups including placebo group (P), AXF (AX 6 mg + vitamin E 150 mg + Tocotrienol 45 mg/day) group and AX (AX: 14 mg/day) group, respectively. After two month’s supplementation, plasm concentration of AX, fasting blood glucose (FBG), HbA1c, lipid profiles, markers of hepatic and renal function, oxidative and inflammatory markers, coagulation and anti-coagulation factors were measured. Results: The results showed the plasma levels of AX increased by supplementation in a dose-dependent manner. Plasma concentration of HbA1c, CRP and vWF was significantly decreased in AXF group. Plasma concentration of HbA1c, Triglyceride and Total Cholesterol, GPT, TNF-α, CRP and vWF was significantly decreased in AX group. In addition, plasma concentration of coagulation factor VII and PAI-1 was significantly decreased, and AT-III level was significantly increased in AX group. Conclusion: In conclusion, AX supplementation for two months may have beneficial effects on type 2 diabetic patients in ameliorating hyperglycemia and hyperlipidemia. AX supplementation also decreases oxidative stress and restrains chronic inflammations, therefore mends endothelial damage and thrombogenic risk in type 2 diabetic patients. PD-64 The usefulness of newly long acting insulin as Degludec for 2 years in Japanese Type 1 Diabetes Takaichi MIYAKAWA1 *, Noriaki KAWAGOE1, Yuko WATANABE1, Miyuki NOGAWA2, Hiroko YOSHIMURA2, Makoto HASEGAWA1, Hitomi FUJII1. 1Tama-center Mirai Clinic, 2 Kunitachi Mirai Clinic, Japan Objective: We have used the newly long acting insulin as Degludec for 69 Type 1 diabetes outpatients for 2 years. And 29 outpatients of them we performed CGMS (Continuous Glucose Monitering System; Medtronic iProTM2). To assess the usefulness of Degludec (1) for 2 years and (2) for daily profile used CGMS. Subjects and methods: To analyze (1) the time course of HbA1c, body weight, insulin dose for 2 years in type 1 outpatients, who switch from insulin glargine (n = 36; GroupA) or insulin detemir (n = 28;GroupB) to insulin degludec. n = 69, 53.0 ± 16.8 y/o, BMI 21.6 ± 2.9. C-peptide 0.24 ± 0.41 ng/ dL, (2) the time course of blood glucose profile who switch from insulin glargine or insulin detemir to insulin degludec, by CGMS) at the time of switching (n = 19) and 1–3 months after switching (n = 10). We investigated indicators of the dawn phenomenon (DP); ⊿BG ( pre-breakfast BG minus minimum BG at 2–6 AM). Results: (1) The mean HbA1c was significantly improved from 7.94 ± 1.03 to 7.59 ± 1.03 ( p < 0.0001). Body weight was slightly increased from 56.1 to 57.0 kg (P < 0.01). 31 cases were improved >0.5% of HbA1c level without severe hypoglycemia. 28 cases were not changed HbA1c level. Only 7 cases were worsened >0.5%. 3 cases were dropout or changed insulin. Group A; The mean HbA1c was improved slightly from 8.00 to 7.80 ( p < 0.01). Body weight was slightly increased. Insulin doses were not changed.
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Group B: The mean HbA1c was from 7.86 to 7.58 ( p < 0.01). Body weight was not changed. Insulin doses was decreased from 16.8 to 11.7 (2) Frequency of nocturnal hypoglycemia was decreased than former insulins (P < 0.01). Nighttime and daytime hypoglycemia was correlated with ⊿BG (P < 0.01). ⊿BG and CPR were correlated (P < 0.03). Conclusion: (1) For 2 years Degludec is useful to improve HbA1c level switching from Glargine and Detemir in Japanese Type1 diabetes patients. (2) Frequency of nocturnal hypoglycemia was decreased However, Dawn phenomenon during use is dependent on residual intrinsic insulin secretions, and the patients with more marked Dawn phenomenon tended to experience hypoglycemia during the day or night. Careful titration of the stable insulin degludec is required in response to fasting blood glucose levels in type 1 diabetes. (3) As a result 45% of patients have continued improvement >0.5% of HbA1c level without severe hypoglycemia for 2 years. PD-65 Evaluation of the CGMs in type-2 diabetic patients switched from Liraglutide and Insulin Degludec to Liraglutide and Insulin Degludec/Aspart Yusuke KAKIZAKI1 *, Tomoko FUJITA1, Tomono TAKAHASHI1, Takashi MIWA1, Masato ODAWARA1. 1Division of Diabetes, Endocrinology and Metabolism and Rheumatology, Tokyo medical University, Japan Background: The combination of Liraglutide (Lira) and Insulin Degludec (IDeg) is often used. However, there are also some cases therapeutic goals cannot be achieved. Insulin Degludec/ Aspart (IDeg/Asp) was newly released. Switching from Lira and IDeg to Lira and IDeg/Asp might possibly improve the glycemic control, without changing the number of injections. However, there are no reports on the effects of the therapy. Aim: We switched Lira and IDeg to Lira and IDeg/Asp in type-2 diabetic patients, and evaluated CGMs. Purpose: A patient with type-2 diabetes had been administered Lira and IDeg before breakfast, and we switched the medication to Lira and IDeg/Asp, with same amount of IDeg, during hospitalization. We measured the CGMs over 72 hours, and evaluated average blood glucose levels and the MAGE. Results: Average blood glucose level for a day decreased from 195 ± 47 mg/dL before the switch to 177 ± 32 mg/dL after the switch. The MAGE decreased from 66 before the switch to 41 after the switch. In the time period from before breakfast to before lunch, the average blood glucose level decreased from 237 ± 49 mg/dL before the switch to 162 ± 22 mg/dL after the switch, and the MAGE decreased from 58 before the switch to 28 after the switch. In the time period from before lunch to before dinner, the average blood glucose level decreased from 230 ± 27 mg/dL before the switch to 180 ± 31 mg/dL after the switch, and the MAGE was 34 before the switch and 37 after the switch. In the time period from before dinner to before sleep, the average blood glucose level was 196 ± 12 mg/dL before the switch and 196 ± 18 mg/dL after the switch, and the MAGE increased from 17 before the switch to 43 after the switch. In the time period from before sleep to before breakfast on the following day, the average blood glucose level was 150 ± 17 mg/ dL before the switch and 153 ± 17 mg/dL after the switch, and the MAGE was 26 before the switch and 30 after the switch. Hypoglycemia was not observed during the observation period. Conclusion: It was shown switching IDeg to IDeg/Asp might make it possible to improve glycemic control during the time after breakfast and before dinner, without increasing the number of injections and burden on the patient. We will investigate more cases and report on them at the conference.
oxidation with subsequent chronic inflammation play an important role in diabetic macroangiopathy. Astaxanthin (AX) is one of the carotenoids with excellent anti-inflammatory and antioxidative capacity. Purpose: The purpose of this study was to investigate the effect of astaxanthin and astaxanthin formula (AXF) on metabolic and thrombogenic risks in type 2 diabetic patients. Material and method: One hundred and three type 2 diabetic patients were recruited from department of metabolism and endocrinology of Cheng Ching Hospital in Taichung city. After exclusion of unqualified patients, all subjects were randomly assigned into three groups including placebo group (P), AXF (AX 6 mg + vitamin E 150 mg + Tocotrienol 45 mg/day) group and AX (AX: 14 mg/day) group, respectively. After two month’s supplementation, plasm concentration of AX, fasting blood glucose (FBG), HbA1c, lipid profiles, markers of hepatic and renal function, oxidative and inflammatory markers, coagulation and anti-coagulation factors were measured. Results: The results showed the plasma levels of AX increased by supplementation in a dose-dependent manner. Plasma concentration of HbA1c, CRP and vWF was significantly decreased in AXF group. Plasma concentration of HbA1c, Triglyceride and Total Cholesterol, GPT, TNF-α, CRP and vWF was significantly decreased in AX group. In addition, plasma concentration of coagulation factor VII and PAI-1 was significantly decreased, and AT-III level was significantly increased in AX group. Conclusion: In conclusion, AX supplementation for two months may have beneficial effects on type 2 diabetic patients in ameliorating hyperglycemia and hyperlipidemia. AX supplementation also decreases oxidative stress and restrains chronic inflammations, therefore mends endothelial damage and thrombogenic risk in type 2 diabetic patients. PD-64 The usefulness of newly long acting insulin as Degludec for 2 years in Japanese Type 1 Diabetes Takaichi MIYAKAWA1 *, Noriaki KAWAGOE1, Yuko WATANABE1, Miyuki NOGAWA2, Hiroko YOSHIMURA2, Makoto HASEGAWA1, Hitomi FUJII1. 1Tama-center Mirai Clinic, 2 Kunitachi Mirai Clinic, Japan Objective: We have used the newly long acting insulin as Degludec for 69 Type 1 diabetes outpatients for 2 years. And 29 outpatients of them we performed CGMS (Continuous Glucose Monitering System; Medtronic iProTM2). To assess the usefulness of Degludec (1) for 2 years and (2) for daily profile used CGMS. Subjects and methods: To analyze (1) the time course of HbA1c, body weight, insulin dose for 2 years in type 1 outpatients, who switch from insulin glargine (n = 36; GroupA) or insulin detemir (n = 28;GroupB) to insulin degludec. n = 69, 53.0 ± 16.8 y/o, BMI 21.6 ± 2.9. C-peptide 0.24 ± 0.41 ng/ dL, (2) the time course of blood glucose profile who switch from insulin glargine or insulin detemir to insulin degludec, by CGMS) at the time of switching (n = 19) and 1–3 months after switching (n = 10). We investigated indicators of the dawn phenomenon (DP); ⊿BG ( pre-breakfast BG minus minimum BG at 2–6 AM). Results: (1) The mean HbA1c was significantly improved from 7.94 ± 1.03 to 7.59 ± 1.03 ( p < 0.0001). Body weight was slightly increased from 56.1 to 57.0 kg (P < 0.01). 31 cases were improved >0.5% of HbA1c level without severe hypoglycemia. 28 cases were not changed HbA1c level. Only 7 cases were worsened >0.5%. 3 cases were dropout or changed insulin. Group A; The mean HbA1c was improved slightly from 8.00 to 7.80 ( p < 0.01). Body weight was slightly increased. Insulin doses were not changed.
S111
Group B: The mean HbA1c was from 7.86 to 7.58 ( p < 0.01). Body weight was not changed. Insulin doses was decreased from 16.8 to 11.7 (2) Frequency of nocturnal hypoglycemia was decreased than former insulins (P < 0.01). Nighttime and daytime hypoglycemia was correlated with ⊿BG (P < 0.01). ⊿BG and CPR were correlated (P < 0.03). Conclusion: (1) For 2 years Degludec is useful to improve HbA1c level switching from Glargine and Detemir in Japanese Type1 diabetes patients. (2) Frequency of nocturnal hypoglycemia was decreased However, Dawn phenomenon during use is dependent on residual intrinsic insulin secretions, and the patients with more marked Dawn phenomenon tended to experience hypoglycemia during the day or night. Careful titration of the stable insulin degludec is required in response to fasting blood glucose levels in type 1 diabetes. (3) As a result 45% of patients have continued improvement >0.5% of HbA1c level without severe hypoglycemia for 2 years. PD-65 Evaluation of the CGMs in type-2 diabetic patients switched from Liraglutide and Insulin Degludec to Liraglutide and Insulin Degludec/Aspart Yusuke KAKIZAKI1 *, Tomoko FUJITA1, Tomono TAKAHASHI1, Takashi MIWA1, Masato ODAWARA1. 1Division of Diabetes, Endocrinology and Metabolism and Rheumatology, Tokyo medical University, Japan Background: The combination of Liraglutide (Lira) and Insulin Degludec (IDeg) is often used. However, there are also some cases therapeutic goals cannot be achieved. Insulin Degludec/ Aspart (IDeg/Asp) was newly released. Switching from Lira and IDeg to Lira and IDeg/Asp might possibly improve the glycemic control, without changing the number of injections. However, there are no reports on the effects of the therapy. Aim: We switched Lira and IDeg to Lira and IDeg/Asp in type-2 diabetic patients, and evaluated CGMs. Purpose: A patient with type-2 diabetes had been administered Lira and IDeg before breakfast, and we switched the medication to Lira and IDeg/Asp, with same amount of IDeg, during hospitalization. We measured the CGMs over 72 hours, and evaluated average blood glucose levels and the MAGE. Results: Average blood glucose level for a day decreased from 195 ± 47 mg/dL before the switch to 177 ± 32 mg/dL after the switch. The MAGE decreased from 66 before the switch to 41 after the switch. In the time period from before breakfast to before lunch, the average blood glucose level decreased from 237 ± 49 mg/dL before the switch to 162 ± 22 mg/dL after the switch, and the MAGE decreased from 58 before the switch to 28 after the switch. In the time period from before lunch to before dinner, the average blood glucose level decreased from 230 ± 27 mg/dL before the switch to 180 ± 31 mg/dL after the switch, and the MAGE was 34 before the switch and 37 after the switch. In the time period from before dinner to before sleep, the average blood glucose level was 196 ± 12 mg/dL before the switch and 196 ± 18 mg/dL after the switch, and the MAGE increased from 17 before the switch to 43 after the switch. In the time period from before sleep to before breakfast on the following day, the average blood glucose level was 150 ± 17 mg/ dL before the switch and 153 ± 17 mg/dL after the switch, and the MAGE was 26 before the switch and 30 after the switch. Hypoglycemia was not observed during the observation period. Conclusion: It was shown switching IDeg to IDeg/Asp might make it possible to improve glycemic control during the time after breakfast and before dinner, without increasing the number of injections and burden on the patient. We will investigate more cases and report on them at the conference.