WCIM 2014 SEOUL KOREA 89
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0164 Diabetes
Prevalence and Risk Factors of Gastroesophageal Re- fl ux Disease(GERD) in Patients with Type 2 Diabetes
Chanwon LEE1, Junouk HA1, Jayoung PARK1, Seongho CHOI1, Heeseung PARK1, Jaeseung LEE1, Seungheon LEE1, Younghwan LEE1
Busan St. Mary’s Medical Center, Korea1
Introduction: Gastrointestinal(GI) symptoms are common in patients with type 2 dibetes. These symptoms can infl eunce health related quality of life and affect dietary habits. The prevalaence of gastroesophageal reflux disease(GERD) in Korea is con- sidered to be increasing. The aim of this study is to analyze the prevalence and risk factors(including autonomic neuropathy) of GERD in patients with type 2 diabetes.
Methods: In this cross sectional case control study, the type 2 dibetic patients(n=258) and the controls(n=184) were enrolled and EsophagoGastroDuodenoscopy(EGD) is performed in all patients. Los Angeles(LA) classifi cation is used to grade GERD. We obtained physical examination, laboratory test, diabetic cardiac autonomic neuropa- thy(DiCAN, Medicare, Seoul, Korea) and bladder function(OABSS, Overactive Baldder Symptom Score). GERD was defi ned as LA grade A(or higher), or LA grade minimal with GERD symptoms. GERD symptoms were examined using the frequency scale of the symptoms of GERD. Data were expressed as means ± standard error. Independent t-test or chi-square test were used to make comparisons between groups, and Spear- man correlation for correlation analysis.(Table 1)
Results: The prevalence of GERD had no difference between type 2 DM patients and controls(Table 2). The prevalence of GERD symptoms also had no difference(Table 2).
There were no difference between GERD patients and non-GERD patients in presence of DM, DiCAN score, OABSS score and presence of overactive baldder(Table 2).
Conclusions: In this study, the prevalence of GERD in patients with type 2 diabetes had no difference from that of controls. Autonomic nerve function also was not asso- ciated factor for developing GERD and GERD symptoms.
PS 0165 Diabetes
Strong Correlation Between Glycemic Variability and Total Glucose Exposure in Type 2 Diabetes are Limited to Subjects with a Satisfactory Glycemic Control
Sunghwan SUH1, Kyoung-Nyoun KIM1, Mi Kyoung PARK1, Duk Kyu KIM1, Moon-Kyu LEE2, Jae Hyeon KIM2
Dong-A University Medical Center, Korea1, Samsung Medical Center, Korea2
Background: To investigate the relationship between markers of overall glucose expo- sure, postprandial glucose excursions and glycemic variability in patients with type 2 diabetes mellitus (T2DM).
Methods: Sixty three patients with T2DM (mean age of 56 years) were enrolled, and all wore a continuous glucose monitoring system (CGMS) for 72 hours. We investi- gated the interrelationships between markers of overall glucose exposure, markers of postprandial glucose excursions and glycemic variability parameters from a CGMS.
Results: Spearman’s correlation analysis revealed a signifi cant correlation between all markers of overall glucose exposure and various parameters related to glucose excur- sion. Percent coeffi cient of variation (CV) showed the strongest correlation with the GA (r = 0.470, p < 0.01). In participants with HbA1c levels < 7.5% (n = 33), almost all of glycemic markers and glycemic variability parameters were signifi cantly correlated with each other. All postprandial glucose excursion parameters also showed signifi cant correlation with other glycemic markers. In participants with HbA1c levels < 7.5% (n
= 33), all markers of overall glucose exposure showed signifi cant interrelationships with mean glucose, postprandial glucose excursion and glycemic variability parameters (except CV). However, in participants with HbA1c levels = 7.5% (n = 30), postpran- dial glucose excursion and glycemic variability parameters were not related with any chronic glycemic marker.
Conclusions: The postprandial glucose excursions may explain the glycemic variability and the total glucose exposures in well-controlled diabetic participants.
PS 0166 Diabetes
Repeated Attack of Left Upper Arm Hemichoreic Movement Following to Uncontrolled Hyperglycemia in Type 2 Diabetes Mellitus
Sol Mi HUO1, Sang Min LEE1, Gui Hwa JEONG1, Sung Rae CHO1 Changwon Fatima Hospital, Korea1
Introduction : Choreic ballism is a rare neurologic complication of metabolic origin in non ketotic hyperglycemia although the etiologic mechanism is still unclear. Some- times, It was reported in poorly controlled old female type 2 diabetes mellitus. We experienced repeated attacks of left upper arm hemichoreic movement following to uncontrolled hyperglycemia in type 2 diabetes mellitus patient.
Clinical case: A 68-year-old woman with 11-year history of type 2 diabetes mellitus who was admitted to our hospital for recurred attack of hemichoreic movement in the left upper limb of the body. On admission day, her glycosylated hemoglobin was 13% (N:4-6%). Her calculated serum osmolarity peaked at 310 mOsm/kg (N: 275- 295mOsm/kg), and the serum glucose level reached 475 mg/dl (N:80-140mg/dl). The initial serum sodium level was 135 mmo/L (N:135-145 mmol/L), which normalized to 142 mmol/L over 1 day. The physical examination revealed left hemichorea with a bal- listic component without no focal neurologic fi nding. Unenhanced computed tomog- raphy of the brain was negative. At magnetic resonance imaging, the right putamen showed high signal intensity on T1-weighted images. During the hospitalization, an adequate diet therapy and insulin therapy resulted in progressive normalization of blood glucose values and an improvement of dyskinesia. According to medical records, she was admitted previously due to hemichoreic movement attack 4 times whenever her blood glucose was uncontrolled.
Conclusions: The pathogenesis of chorea seems to be related to both vascular and neuro-metabolic alterations in the basal nucleus due to inadequate glycemic control continuously in type 2 diabetes mellitus. But this rare complication is a pathological entity to be considered benign, since it is generally transient and reversible. So early recognition and differentiation from other causes of this manifestation in uncontrolled type 2 diabetes mellitus is important.
