The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
WCIM 2014 SEOUL KOREA 335
Poster Session
PS 1327 Endocrinology
Clinical Characteristics of Normoalbuminuric Patients with Renal Insuffi ciency in Diabetic Nephropathy
Ho Jin Kim1, Jae Ho Cho1, Jun Sung Moon1, Kyu Chang Won1, Hyoung Woo Lee1, Ji Sung Yoon1
Yeungnam University Medical Center, Korea1
Background: In diabetic nephropathy, microalbuminuria is widly used as the early surrogate marker of renal impairment. But little is known about characteristics of patients without albuminuria. The aim of this study is to investigate the clinical char- acteristics of patients with diabetic nephropathy who have renal insuffi ciency without albuminuria.
Methods: We conducted a cross-sectional study of total 1,061 subjects (F:M=477:584, mean age : 61.57±12.01) with type 2 diabetes, who visited Yeungnam University Hos- pital in 2012. We included subjects with renal insuffi ciency, which was chronic kidney disease stage 2 and 3 calculated by the Modifi cation of Diet in Renal Disease (MDRD) formula (15<estimated glomerular fi ltration rate (eGFR) <60 ml/min/1.73m2). Albu- minuria was evaluated by spot urine albumin-creatinine ratio (ACR).
Results: Among 1,061 patients with type 2 diabetes, 267 (25.1%) patients were en- rolled as renal insuffi ciency. Of subjects with renal insuffi ciency, 81 subjects (30.3%) were normoalbuminuric (ACR <0.05).
Conclusions: Comparing the albuminuric group, patients without albuminuria showed distinctive features such as the higher risk of stroke even though similar eGFR. These results suggest normoalbuminuric patients with renal insuffi ciency also are needed individualized risk stratifi cation, and further studies are needed.
PS 1328 Endocrinology
Effect of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 DM
Sejeong Park1, So Young Park1, Soo Min Hong1, Sang Youl Rhee1, Suk Chon1, Seungjoon Oh1, Jeong-taek Woo1, Sung-Woon Kim1, Young Seol Kim1
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Korea1
Background: Atypical gastrointestinal symptoms are common in patients with type 2 diabetes mellitus (T2DM). The current study was designed to evaluate the symptom improvement after the administration of rebamipide, a mucoprotective drug that stimulates prostaglandin biosynthesis in patients with T2DM.
Methods: T2DM subjects whose age was 18 to 80 years with atypical gastrointestinal symptom were enrolled. Participants were obliged to answer DBSQ (Diabetes Bowel Symptom Questionnaire) before and after the 12 weeks administration of rebamipide and the change in gastrointestinal symptoms were assessed. DBSQ is comprised of 10 questions assessing the severity of gastrointestinal symptom by 1 to 6 scoring system.
Follow-up assessments were done to identify drug related side effects at 6 weeks and 12 weeks.
Results: Total 107 patients were enrolled and 84 patients completed the study. Mean age was 65.0±7.8, 24.8% of the subjects were male, and mean HbA1c level was 6.97±0.82%. Rebamipide 100mg was administered three times daily for each partic- ipant. DBSQ total score was reduced from 24.9±8.0 to 20.4±7.3 before and after the administration of rebamipide demonstrating a signifi cant change (p<0.001). Each score of the variables assessing heartburn, refl ux symptoms, postprandial dyspepsia, nausea or vomiting, abdominal bloating or distension, heartburn associated with gastric ulcer, abdominal pain, and constipation were improved after the administration of rebamipi- de (p<0.05). However, there were no signifi cant changes in irritable bowel symptoms and bowel incontinence. Severe adverse event was not reported throughout the study.
Conclusions: Treatment with rebamipide for 12 weeks could be an effective treatment option for atypical gastrointestinal symptoms in subjects with T2DM.
PS 1329 Endocrinology
The Prevalence of Nonproteinuric Diabetic Nephrop- athy and Different Parameters between Patients with Proteinuric and Nonproteinuric Diabetic Nephropathy
Jeong Han Sim1, Mi Young Lee1, Jung Soo Lim1, Jang Yel Shin1, Choon Hee Chung1, Seoung Wan Nam1, Young Jae Han1
Wonju Christian Hospital, Korea1
Background: The classical Natural history of diabetic nephropathy follows a sequence of hyperfi ltration, microalbuminuria, overt proteinuria, and renal dysfunction status.
It has been recently reported that a considerable portion of diabetic patients showed renal insuffi ciency with normoalbuminuria, called as nonproteinuric diabetic nephrop- athy.
Methods: We examined the prevalence of nonproteinuric diabetic nephropathy and the different characteristics between patients with proteinuric and nonproteinuric diabetic nephropathy who visited Wonju Severance Christian Hospital for diabetes mellitus.
Results: The prevalence of proteinuric and nonproteinuric diabetic nephropathy was 33.21 % (470/1415) and 4.52 % (470/1415), respectively. The value of HbA1C, fast- ing glucose, total cholesterol, triglyceride and low dense lipoprotein cholesterol was signifi cantly higher in patients with proteinuric diabetic nephropathy compared with patients with nonproteinuric diabetic nephropathy. Weights and body mass index were also signifi cantly higher in patients with proteinuric diabetic nephropathy compared with patients with nonproteinuric diabetic nephropathy.
Conclusions:In our study, the metabolic parameters were worsened in patients with proteinuric diabetic nephropathy than nonproteinuric diabetic nephropathy. The clini- cal signifi cance of these fi ndings should be evaluated at future study.
PS 1330 Endocrinology
Diet Stimulated C-Peptide and Δc-Peptide as a indica- tor of Insulin Secretion Function and its Clinical Useful- ness
Inseong Park1, Junghae Ko1 Wallace Memorial Baptist Hospital, Korea1
Background: Type 2 diabetes mellitus(T2DM) is a disease caused by a combination of insulin resistance and progressive failure of insulin secretion by the pancreatic ß cells. It is important to the diabetic patients that assess the residual pancreatic ß cell function to determine the method of therapy. Serum c-peptide(CP) as a marker for predicting insulin requirement in type 2 diabetes have been known. We examined the effi cacy of CP for helpful tool to determine the therapy.
Methods: We included 108 patients with T2DM. We obtained the records by chart review retrospectively. We used correlation analysis between HbA1c and other fac- tors(fasting CP(FCP),diet stimulated CP(DCP),DCP/FCP(ΔCP), ΔCP/Δglucose(impedence).
Diet served liberally.
Results: The main fi nding of our study were a consequent negative correlation be- tween HbA1c and DCP(r=-0.368, The main fi nding of our study were a consequent negative correlation between HbA1c and DCP(r=-0.368, P<0.001). Also there were negative correlation between HbA1c and ΔCP(r=-0.311, P<0.001). But impedence (r=- 0.127) and FCP(-0.291) were not correlated with HbA1c.
Conclusions: Diet stimulated C-peptide and ΔC-peptide are a simple examinations that you put only two point sample into practice. These can evaluate patient’s actual pancreatic function by brief clinical trial. It is thought that these can be helpful in de- termining insulin start or multiple daily insulin injection.
