86 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0154 Diabetes
Do Diabetic Patients Use Their Glucometers Effectively:
Awareness of the Importance of Self-Monitoring in Diabetes
Feray AKBAS1, Hanife USTA ATMACA1, Ilker NIHAT OKTEN1, Eda NUHOGLU1, Mustafa BOZ1
Istanbul Training and Research Hospital, Turkey1
Background: Home glucose monitoring is vital for diabetic patients to maintain ac- ceptable glucose levels. We aimed to demonstrate how effective home glucose moni- toring was among diabetic patients who were followed in internal medicine outpatient clinics of our hospital.
Methods: Randomly selected 89 diabetic patients who were admitted to internal medicine outpatient clinic in a week and who had glucometers were included in the study and a questionnaire was administered. The answers were categorized and the results were evaluated with SPSS.
Results: The questions and the percentage of answers are shown in Table 1. Although diabetes duration of the patients was mostly more than 5 years, only half of them had a glucometer for that period. Most of the patients didn’t calibrate their devices.
Most strikingly, only 25% of the patients in general were given a proper education for the usage of glucometers. 72% of patients who claimed to have been educated were mostly given instructions by a pharmacist that cannot be considered as education and only 35% of this group were educated by a diabetes nurse or a doctor. Only 40% of the patients monitored their glucose levels regularly, rest of the patients used their glucometers rarely or none.
Conclusions: Home monitoring of glucose levels for diabetic patients would approve blood glucose levels by making necessary treatment adjustments available. Providing the optimal treatment would prevent/delay diabetes related complications, improve quality of life and contribute to decrease health costs. Thus; it’s necessary to educate and follow our diabetic patients better and assure that they use their glucometers more effectively and frequently. To include the patients to the treatment and to monitoring of diabetes seems to be the only way to achieve a better outcome of the disease.
PS 0155 Diabetes
Associated Polymorphisms in Type 2 Diabetes of Early Initiation in Mexico
Roberto MONREAL ROBLES1, Hugo L. GALLARDO BLANCO2, Fernando J. LAVALLE GONZÁLEZ1, Ricardo M. CERDA FLORES2, Pavel CARRILLO MOLINA1, Minerva G.
MARTÍNEZ CAVAZOS1, Laura E. MARTÍNEZ GARZA2, Jesús Z. VILLARREAL PÉREZ1 Endocrinology Service, Internal Medicine Division, Mexico1, Department of Genetics, Mexico2 Background: Currently there are a growing number of individuals with type 2 diabe- tes (T2D) imposing a signifi cant public health burden due to disability and premature death. Diabetes is the most common cause of death in Mexico. It is estimated that 11.7 million Mexicans will have diabetes by the year 2025. The risk of developing T2D is determined by genetic and environmental factors. However, large differences in prevalence between ethnic groups exist and seem to depend on genetic factors. Nearly 40 different T2D susceptibility loci, mainly in Europeans have been identifi ed. The aim of this study was to identify susceptibility loci related to T2D in our population.
Methods: We studied 128 SNPs in or near 42 genes, most of which had been replicat- ed in other populations. A case-control association study comprising 186 controls, 211 early-onset T2D (diagnosed before 45 years of age) and 173 late-onset T2D individuals was conducted. Actually we preliminary reported the genotypifi cation analyses of 256 individuals.
Results: Subjects with T2D independently of age at diagnosis have higher mass body index than controls (27.5 vs 25.7 kg/m2, P= <0.0001). The median age for early-onset T2D, late-onset T2D and controls individuals were 46, 61 and 62 years, respectively.
Age at diagnosis for early-onset and late-onset T2D individuals was 35 and 52 years, respectively. The allelic variants of genes KCNJ11 (rs5219), LEPR (rs11208654), IGF2BP2 (rs4402960), VLDLR (rs2242103), KCNQ1 (rs2237892), RPTOR (rs12946115), SLC25A18 (rs1296819) show association with T2D in this preliminary analysis. These polymor- phism previously mentioned affect directly or indirectly over insulin release and pe- ripheral sensitivity.
Conclusions: We found our population to have an important genetic predisposition to T2D. The associated susceptibility loci for T2D support the hypothesis that insulin re- lease defects and peripheral resistance are the main mechanisms predisposing to T2D in Mexican population.
PS 0156 Diabetes
The Infl uence of Diabetes Mellitus on the Survival Rate of Dental Implants – A Retrospective Study
Gadeer MUKATASH NIMRI1 MSC, Jordan1
Background: Diabetes Mellitus is a major endocrine disorder where patients are sub- jected to greater incidence and severity of alveolar bone resorption. Approximately 75% of these patients suffer from periodontal disease and exhibit increased alveolar bone loss and infl ammatory gingival changes.
Purpose: To evaluate the infl uence of Diabetes Mellitus on the survival rate of dental implants one year after implant placement.
Materials and Methods: This clinical study the survival rate of placing implants in 50 patients with diabetes who were treated with 143 various implants systems and pro- cedures were used. Outcome measures were prosthesis and implant survival.
Results: Upon uncovering, 140 of the 143 implants were found to have osseointe- grated, a survival rate of 97.9 percent. Of the three failed implants, one occurred in non-smoker patient, the other two occurred in smoker patients. All the failed implants are in the upper jaw, two in the canine region and one in the premolar region.
Conclusion: The results of this clinical study indicate that a high success rate is achievable when dental implants are placed in patients with diabetes mellitus whose disease is under control.
PS 0157 Diabetes
Diabetes Mellitus : A Synonym to Functional Hypopar- athyroidism
AMIT SARAF1
Swami Vivekanand Hospital, India1
Background: Poor blood glucose control in diabetes mellitus has been attributed with reduced bone mass, but the pathogenetic mechanisms still largely remains unknown.
It has been hypothesized that poor blood glucose control results in a form of renal hypercalciuria which by parathyroid stimulation, might in part contribute to osteo- penia. In view of this, the present study undertakes to investigate, simultaneously, parameters of calcium metabolism in relation to diabetic control
Methods: 250 patients with diabetes and normal renal function ( 70 Type 1 and 180 Type 2) were studied. In all patients plasma calcium (Ca), serum phosphate (PO4), serum parathyroid hormone (PTH), and 24-h urinary calcium (uCa) were determined under both poor and improved control (for at least 7 days) as ascertained by four blood glucose determinations daily.
Results: Improvement of blood glucose control (p = 0.001) was associated with re- duction of uCa both in Type 1 (6.5 ± 1 vs 4.5 ± 0.8 mmol per day, mean ± SEM, p = 0.02) and in Type 2 patients (4.0 ± 0.5 vs 3.0 ± 0.4 mmol per day, mean ± SEM, p = 0.002).
Type 1 patients (33 out of 70) had PTH values below the detection limit (1.5 pmol per l) during poor than during improved control (10 out of 70). Under poor control of blood sugar levels, Ca and PTH were lower (p = 0.03), while uCa was higher (p = 0.003), and after improved control, only uCa continued to be higher (p = 0.035).
Conclusions: These fi ndings suggest that increased uCa excretion in association witih
‘functional hypoparathyroidism’ (especially in Type 1 diabetes) is observed during poor blood glucose control, and may be one of the factors leading to reduced bone mass in diabetes mellitus.
