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PO278 BMI AND INSULIN RESISTANCE ACCORDING TO VITAMIN D IN TYPE 2 DM
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Posters / Diabetes Research and Clinical Practice 106S1 (2014) S47–S267
unique finding is that Gas6 level appears inverse relationship with concentrations of creatinine, BUN and uric acid in all subjects. In multivariate logistic regression analysis, after adjustment for established diabetes risk factors, higher plasma Gas6 concentrations were significantly associated with a decreased risk of type 2 diabetic uremia. Moreover, the association became slightly stronger after further adjustment for sex and fasting glucose. Conclusion: It can be concluded from this study that plasma Gas6 levels are associated with uric acid and renal function in type 2 diabetic uremia. Plasma Gas6 concentration may represent an independent risk factor of type 2 diabetic uremia. These results support the hypothesis that modulation of Gas6 activity may provide an important point for intervention. Gas6/TAM signaling may represent a new class of therapeutic targets. PO277 ANALYSIS OF THE EFFECT OF 2030 DIABETES CAMP PROGRAM ON IMPROVING DEPRESSION, ANXIETY, AND STRESS IN PATIENTS WITH DIABETES J.H. Lee1 , J.-H. Jung2 , S.Y. Park3 , J.M. Lee4 , on behalf of 2030 Camp Committee by Korea Diabetes Association. 1 Diabetes Center, Kyung-Hee University Hospital at Gangdong, Seoul, 2 Department of Nursing, Diabetes Education Team, Seoul National Bundang University Hospital, Seongnam-si, 3 Diabetes Center, Sahmyook Medical Center, Seoul, 4 Diabetes Center, Kwang Myung Sung Ae hospital, Gyeong Gi, Korea, Republic of Background: Diabetes Camp program has been implemented as a part of the self-management education for patients with diabetes. This study is to evaluate the effectiveness of 2030 Diabetes Camp Program, organized by Korea Diabetes Association (KDA), on improving depression, anxiety, and stress in diabetic patients. Method: Among 25 patients who came to 2030 Diabetes Camp Program from the 5th to 7th of July 2013, 17 patients participated in this camp for the first time and agreed to be part of this study to evaluate the level of depression, anxiety, and stress before and after the camp. 2030 Diabetes Camp Program lasted two days and one night and it had various programs as diet, exercise, recreation, blood glucose monitoring, insulin injection method, and fellowship. The BDI (Beck Depression Inventory) scale was used to evaluate depression, and the State-Trait Anxiety Inventory of Spielberg was used for the anxiety level. The level of stress was assessed with the Problem Area in Diabetes (PAID). Higher scores mean depression, anxiety, and stress are more intense. Result: The mean age of the subjects was 27.7±10.1 years old, and 57.8% of the subjects (n = 10) were male. The mean BMI was 22.1±3.1 kg/m2 . The average duration of illness was 6.4±5.1 years. 82.4% of the subjects (n = 14) have been suffered with type 1 diabetes. 52.9% of the subjects (n = 9) had family history of diabetes. 76.5% of the subjects (n = 13) was with diabetes complications. On the camp day, the average HbA1c level of the subjects was 8.7±2.3%. 88.3% of the subject (n = 15) was using insulin as a treatment method. 76.5% (n = 13) check their blood glucose level regularly by themselves. 64.7% of the subjects (n = 11) had had more than one episodes of hypoglycemia. 82.4% (n = 14) thought the diabetes management became economic burden Conclusion: The depression score after the camp was 13.0±7.1 and it is not statistically significant (p = 0.11) compared to the score before the camp, which was 14.8±8.2. According to the depression score before the camp, 35.3% of the subjects (n = 6) had mild depression and 41.2% (n = 7) had moderate depression. The anxiety level before the camp was 45.6±9.5 and after the camp was 41.9±10.6, which is considered to be a significant difference (p = 0.02). The diabetes related stress level was 46.9±10.8 before the camp and it was significantly decreased
to 43.4±11.2 (p = 0.03) after the camp. Diabetes Camp Program was effective to improve patients’ anxiety and stress level, but was not for depression. The long term study to evaluate the effect of the Diabetes Camp Program will be necessary. Considering depression of diabetic patients was severe, a program to help depressed diabetic patients should be developed. PO278 BMI AND INSULIN RESISTANCE ACCORDING TO VITAMIN D IN TYPE 2 DM J.M. Lee1 , H.M. Yu1 , K.S. Park1 . 1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Eulji University-Hospital, Deajeon, Korea, Republic of Background: Low concentrations of plasma vitamin D (25(OH)D) have been associated with the development of metabolic syndrome, obesity and diabetes. The objective of this study was to investigate the impact of vitamin D concentration on the relationship of body mass index (BMI) status and insulin resistance in type 2 diabetes. Method: Retrospective study of all patients who had attended the diabetic clinics in a Eulji hospital between January 1st and July 31th 2013 and whose concentrations of vitamin D, fasting glucose, and fasting insulin had been determined (n = 257, 44.4% women). We used the BMI for obesity and the HOMA-IR index for insulin resistance. The vitamin D status of subjects was categorized into quartiles of serum 25(OH) D in those analyses where vitamin D was treated as a categorical variable: I (19 ng/mL), II (19 ng/mL < serum(OH)D 25 ng/mL), III (25 ng/mL < serum(OH)D 31 ng/mL), and IV (> 31 ng/mL). Result: The negative correlation between serum vitamin D and BMI with type 2 diabetes was significant (r = 0.268, p < 0.0001) and the negative correlation between vitamin D and insulin resistance in type 2 DM was also remained significant (r = 0.124, p < 0.0001). Multiple regression analysis demonstrated that vitamin D was not associated with BMI (p = 0.681) but associated with insulin resistance (p < 0.042). BMI status and HOMA-IR status were taken out of the analyses investigating the association between serum vitamin D quartile, separately. It was found that individuals with the lowest quartile of 25(OH)D levels had significantly higher rates of unfavorable conditions of BMI and HOMA-IR levels compared to those in the fourth quartile (BMI: first quartile versus fourth quartile: OR 1.27, 95% CI 1.13–4.88; HOMA-IR: first quartile versus fourth quartile: OR 1.78, 95% CI 1.09–5.22). However, no significant association was found for those in the second versus those in the fourth quartile (BMI: OR 0.91, 95% CI 0.33–1.97; HOMA-IR: OR 0.97, 95% CI 0.27–2.16) or those in the third versus those in the fourth quartile (BMI: OR 0.64, 95% CI 0.31–1.63; HOMA-IR OR 0.74, 95% CI 0.47–2.44). Conclusion: As conducting a study of type 2 diabetes, plasma vitamin D has negative correlation with BMI and insulin resistnace. Especially, it is more strongly associated with insulin resistance. Therefore, we conclude that vitamin D deficiency is a valuable attributable risk for type 2 diabetes, especially combined with obesity. Plus, further prospective and not cross-sectional studies will be needed to confirm whether the supplement of vitamin D would be needed for improving the status of insulin resistance in type 2 diabetes patients.
Posters / Diabetes Research and Clinical Practice 106S1 (2014) S47–S267
unique finding is that Gas6 level appears inverse relationship with concentrations of creatinine, BUN and uric acid in all subjects. In multivariate logistic regression analysis, after adjustment for established diabetes risk factors, higher plasma Gas6 concentrations were significantly associated with a decreased risk of type 2 diabetic uremia. Moreover, the association became slightly stronger after further adjustment for sex and fasting glucose. Conclusion: It can be concluded from this study that plasma Gas6 levels are associated with uric acid and renal function in type 2 diabetic uremia. Plasma Gas6 concentration may represent an independent risk factor of type 2 diabetic uremia. These results support the hypothesis that modulation of Gas6 activity may provide an important point for intervention. Gas6/TAM signaling may represent a new class of therapeutic targets. PO277 ANALYSIS OF THE EFFECT OF 2030 DIABETES CAMP PROGRAM ON IMPROVING DEPRESSION, ANXIETY, AND STRESS IN PATIENTS WITH DIABETES J.H. Lee1 , J.-H. Jung2 , S.Y. Park3 , J.M. Lee4 , on behalf of 2030 Camp Committee by Korea Diabetes Association. 1 Diabetes Center, Kyung-Hee University Hospital at Gangdong, Seoul, 2 Department of Nursing, Diabetes Education Team, Seoul National Bundang University Hospital, Seongnam-si, 3 Diabetes Center, Sahmyook Medical Center, Seoul, 4 Diabetes Center, Kwang Myung Sung Ae hospital, Gyeong Gi, Korea, Republic of Background: Diabetes Camp program has been implemented as a part of the self-management education for patients with diabetes. This study is to evaluate the effectiveness of 2030 Diabetes Camp Program, organized by Korea Diabetes Association (KDA), on improving depression, anxiety, and stress in diabetic patients. Method: Among 25 patients who came to 2030 Diabetes Camp Program from the 5th to 7th of July 2013, 17 patients participated in this camp for the first time and agreed to be part of this study to evaluate the level of depression, anxiety, and stress before and after the camp. 2030 Diabetes Camp Program lasted two days and one night and it had various programs as diet, exercise, recreation, blood glucose monitoring, insulin injection method, and fellowship. The BDI (Beck Depression Inventory) scale was used to evaluate depression, and the State-Trait Anxiety Inventory of Spielberg was used for the anxiety level. The level of stress was assessed with the Problem Area in Diabetes (PAID). Higher scores mean depression, anxiety, and stress are more intense. Result: The mean age of the subjects was 27.7±10.1 years old, and 57.8% of the subjects (n = 10) were male. The mean BMI was 22.1±3.1 kg/m2 . The average duration of illness was 6.4±5.1 years. 82.4% of the subjects (n = 14) have been suffered with type 1 diabetes. 52.9% of the subjects (n = 9) had family history of diabetes. 76.5% of the subjects (n = 13) was with diabetes complications. On the camp day, the average HbA1c level of the subjects was 8.7±2.3%. 88.3% of the subject (n = 15) was using insulin as a treatment method. 76.5% (n = 13) check their blood glucose level regularly by themselves. 64.7% of the subjects (n = 11) had had more than one episodes of hypoglycemia. 82.4% (n = 14) thought the diabetes management became economic burden Conclusion: The depression score after the camp was 13.0±7.1 and it is not statistically significant (p = 0.11) compared to the score before the camp, which was 14.8±8.2. According to the depression score before the camp, 35.3% of the subjects (n = 6) had mild depression and 41.2% (n = 7) had moderate depression. The anxiety level before the camp was 45.6±9.5 and after the camp was 41.9±10.6, which is considered to be a significant difference (p = 0.02). The diabetes related stress level was 46.9±10.8 before the camp and it was significantly decreased
to 43.4±11.2 (p = 0.03) after the camp. Diabetes Camp Program was effective to improve patients’ anxiety and stress level, but was not for depression. The long term study to evaluate the effect of the Diabetes Camp Program will be necessary. Considering depression of diabetic patients was severe, a program to help depressed diabetic patients should be developed. PO278 BMI AND INSULIN RESISTANCE ACCORDING TO VITAMIN D IN TYPE 2 DM J.M. Lee1 , H.M. Yu1 , K.S. Park1 . 1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Eulji University-Hospital, Deajeon, Korea, Republic of Background: Low concentrations of plasma vitamin D (25(OH)D) have been associated with the development of metabolic syndrome, obesity and diabetes. The objective of this study was to investigate the impact of vitamin D concentration on the relationship of body mass index (BMI) status and insulin resistance in type 2 diabetes. Method: Retrospective study of all patients who had attended the diabetic clinics in a Eulji hospital between January 1st and July 31th 2013 and whose concentrations of vitamin D, fasting glucose, and fasting insulin had been determined (n = 257, 44.4% women). We used the BMI for obesity and the HOMA-IR index for insulin resistance. The vitamin D status of subjects was categorized into quartiles of serum 25(OH) D in those analyses where vitamin D was treated as a categorical variable: I (19 ng/mL), II (19 ng/mL < serum(OH)D 25 ng/mL), III (25 ng/mL < serum(OH)D 31 ng/mL), and IV (> 31 ng/mL). Result: The negative correlation between serum vitamin D and BMI with type 2 diabetes was significant (r = 0.268, p < 0.0001) and the negative correlation between vitamin D and insulin resistance in type 2 DM was also remained significant (r = 0.124, p < 0.0001). Multiple regression analysis demonstrated that vitamin D was not associated with BMI (p = 0.681) but associated with insulin resistance (p < 0.042). BMI status and HOMA-IR status were taken out of the analyses investigating the association between serum vitamin D quartile, separately. It was found that individuals with the lowest quartile of 25(OH)D levels had significantly higher rates of unfavorable conditions of BMI and HOMA-IR levels compared to those in the fourth quartile (BMI: first quartile versus fourth quartile: OR 1.27, 95% CI 1.13–4.88; HOMA-IR: first quartile versus fourth quartile: OR 1.78, 95% CI 1.09–5.22). However, no significant association was found for those in the second versus those in the fourth quartile (BMI: OR 0.91, 95% CI 0.33–1.97; HOMA-IR: OR 0.97, 95% CI 0.27–2.16) or those in the third versus those in the fourth quartile (BMI: OR 0.64, 95% CI 0.31–1.63; HOMA-IR OR 0.74, 95% CI 0.47–2.44). Conclusion: As conducting a study of type 2 diabetes, plasma vitamin D has negative correlation with BMI and insulin resistnace. Especially, it is more strongly associated with insulin resistance. Therefore, we conclude that vitamin D deficiency is a valuable attributable risk for type 2 diabetes, especially combined with obesity. Plus, further prospective and not cross-sectional studies will be needed to confirm whether the supplement of vitamin D would be needed for improving the status of insulin resistance in type 2 diabetes patients.