Fujimoto1, K. Hamamatsu1, T. Murakami1, H. Kimura2, K. Toyoda1, H. Saji3 and N. Inagaki1N. Fujita1Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 2Department of Analytical and Bioinorganic Chemistry, Kyoto Pharmaceutical University, Kyoto, Japan, 3Department of Patho‐Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, JapanWe aim to establish a non‐invasive method to quantify beta cell mass (BCM) by SPECT with indium‐labeled Exendin probe. We confirmed specific accumulation to beta cells by autoradiography with pancreatic sections of MIP‐GFP mice. We took SPECT imaging on 8 NOD mice after injecting the probe intravenously. Following the SPECT, we harvested mice’ pancreas and calculated BCM from immuno‐stained sections. On MIP‐GFP mice’ pancreatic sections, fluorescent signals corresponded to radioactive signals, and the intensity of both signals significantly correlated. BCM significantly correlated to SPECT signal from pancreas. The probe specifically accumulated to islets and BCM can be non‐invasively quantified with the probe without harvesting pancreas.1,2, Y. Sun1,2, D. Luo1,2, X. Niu3, H. Zhu1,2, Y. Wang3 and C. Wang1,2T. Zhao1Shanghai Diabetes Institute, Shanghai Jiao Tong University, Shanghai, China, 2Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China, 3Institute of Microsurgery on Extremities, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, ChinaThis study was to explore the effects of human urine‐derived stem cells (USCs) in treating animal models of diabetes. USCs isolated from the voided urine were transplanted into STZ‐treated nude mice. USCs expressed mesenchymal stem cell markers and could differentiate into the bone and fat in vitro. Transplantation of USCs into high‐dose STZ treated nude mice resulted in longer median survival time,and low‐dose STZ treated ones showed improved glucose tolerance. After the exendin‐4,activin‐A and niacinamide induction,USCs presented with dithizone positive staining, glucagon and PDX‐1 mRNA expression. Taken together, transplantation of USCs may be useful for diabetes treatment.The study was supported by Shanghai Nature Science Fund (16ZR1425800).1, C.‐Y. Chen1, C.‐W. Kao1, C.‐H. Kuo1 and C.‐T. Chen2J.‐H. Juang1Division of Endocrinology and Metabolism, Chang Gung University and Memorial Hospital, Taiwan, 2Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, TaiwanWe syngeneically transplanted 150 or 300 islets to each diabetic mouse, and then treated recipients with distilled water or LAF237 for 6 weeks. In mice transplanted with 150 islets, there were no differences between LAF237‐treated and control group in glucose tolerance test (GTT) at 2, 4 and 6 weeks and the graft β‐cell mass at 6 weeks. However, in mice transplanted with 300 islets, the GTT was lower in the LAF237‐treated group than controls at 4 and 6 weeks. At 6 weeks, LAF237‐treated group had more graft β‐cell mass than controls. Our results indicate posttransplant LAF237 treatment improves glucose tolerance and expands graft β‐cell mass in diabetic recipients transplanted with a sufficient but not marginal number of islets.J. Kim, Y.‐H. You and K.‐H. YoonDepartment of Endocrnology, The Catholic University of KoreaEx‐4 significantly reduced Ang II and TGF‐β1 production by inhibition of ROS production but not ERK phosphorylation. This inhibitory effect of Ex‐4 was largely related with cAMP/PKA signaling pathway. Thus these results suggest that Ex‐4 may be useful not only as an anti‐diabetic agent but also as an anti‐fibrotic agent in type 2 diabetes.1, K. Minami1, N. Yokoi1, H. Takahashi1, Y. Maejima2, K. Shimomura2, L. Pedro Herrera3 and S. Seino1S. Okechi Oduori1Molecular and Metabolic Medicine, Kobe University Graduate School of Medicine, 2Department of Electrophysiology and Oncology, Fukushima Medical University, Fukushima, Japan, 3Faculty of Medicine, University of Geneva, Geneva, SwitzerlandWe generated β‐cell KATP knockout (βKir6.2 KO) mice to investigate the role of the β‐cell KATP channel in insulin secretion and glucose homeostasis. βKir6.2 KO mice had elevated fasting blood glucose level and their tolerance to both oral glucose and meal ingestion was severely impaired. Glucose and meal induced insulin secretion and GIIS in isolated islets were severely impaired, but βKir6.2 KO islets had elevated basal insulin level. Glibenclamide had no hypoglycemic effect yet liraglutide completely normalized glucose tolerance and insulin secretion. GIP level in βKir6.2 KO mice was significantly elevated. Thus incretin signaling is enhanced in βKir6.2 KO mice, to possibly compensate for the impaired insulin response to glucose.J. Yan, F. Jiang, C. Hu and W. JiaShanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's HospitalN = 3412) and categorized them into insulin secretion (IS) or insulin resistance (IR) related loci. IS‐GRS and IR‐GRS were constructed to assess their predicting effects in a community‐based 9‐year prospective cohort (N = 2495) in the Chinese. IS‐GRS predicted incidence of T2D and IGR in the logistic regression  as well as in the Cox model  after adjusting for age, sex, body mass index (BMI) at baseline during the 9‐year follow‐up. IS‐GRS could predict deterioration of glucose tolerance in the Chinese population.We aimed to investigate the predicted effect of IS‐GRS and IR‐GRS on deterioration of glucose tolerance. We genotyped 89 T2D SNPs in NGT individuals , Matsuda Index (MI),and disposition Index (DI) were calculated after mixed meal ingestion.Patients were grouped into high MI [insulin sensitive (IS) ] group and low MI [insulin resistant (IR)] group by the mean value of baseline MIs. HbA1c decreased significantly from 8.9% to 6.6% in both groups. In the IS group, serum C‐peptide increased significantly but DI did not change during the 4‐years CSII therapy. Whereas, in the IR group, serum C‐peptide did not increase but the DI increased significantly. Therefore, achieving near euglycemia using long‐term insulin pump therapy seems to restore the original defect in each diabetic group.1, X. Lv1, L. Zhou2, Y. Geng1, J. Song1, A. Mina1, B. Puchi1, S. Yang1, S. Meng1 and L. Yang1Q. Ren1Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region2Department of Endocrinology and Metabolism, Peking University People's HospitalThe absolute risk of lactic acidosis in patients treated with metformin appears to be low in the general population. However, in the Tibetan plateau, an extreme oxygen‐deficient environment for human beings, there are no data available concerning the safety of metformin in the treatment of patients with T2DM. Using data of 166 inhabitants of the Tibetan plateau region, which is an oxygen‐deficient environment, we found treatment with metformin did not increase the risk of hyperlactacidemia or lactate acidosis. The level of lactate was significantly associated with FBG and HbA1c levels.Y. Hamamoto, N. Kitatani, F. Koshian, N. Makabe, H. Kuwata, K. Watanabe, T. Hyo, N. Tanaka, T. Kurose and Y. SeinoCenter for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital2. ARB/ACEI and statin were given in 80% and 70%. Whereas eGFR decreased before Lira, it tended to increase after Lira . HbA1c, BP and ACR did not change. In conclusion, Lira may improve eGFR even in patients who are on ARB/ACEI and statin and treated in DPP.Liraglutide (Lira) may have renoprotective effect. We examined the effect of Lira on renal function in T2D patients who were in dialysis prevention program (DPP). A total of 20  patients initiated Lira between Apr 2014 – Jul 2015 were retrospectively identified from database. Changes in eGFR, HbA1c, body weight, blood pressure (BP), and ACR were examined 1‐year prior and after Lira. Mean eGFR was 70.1 ± 17.4 mL/min/1.73 mX. Gao, X. Cai, W. Yang, Y. Chen and L. JiDepartment of Endocrinology and Metabolism, Peking University People's HospitalTotally 8 studies were included in this meta‐analysis. A fixed‐ratio combination of basal insulin and GLP‐1RA showed a significant HbA1c reduction, fasting plasma glucose and postprandial glucose reduction, body weight reduction from baseline. Compared with basal insulin, the fixed‐ratio combination therapy led to significant decreases in HbA1c and body weight, but a comparable decrease in FPG and a comparable incidence of hypoglycemia. Compared with GLP‐1RA, the fixed‐ratio combination therapy led to significant decreases in HbA1c and FPG, but a lower decrease in body weight and a higher rate of hypoglycemia.In a word, a fixed‐ratio combination of basal insulin and GLP‐1RA was superior to its components given alone in glycemic control.1, D. Yabe1,2,3,4, M. Iwasaki2,3, H. Kuwata1,2, Y. Hamamoto1,2,3, T. Kurose1,2, K. Sumita5, H. Yamazato5, S. Kanada5 and Y. Seino1,2T. Haraguchi1Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka, Japan2Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan3Center for Metabolism and Clinical Nutrition, Kansai Electric Power Hospital, Osaka, Japan4Division of Molecular and Metabolic Medicine, Department of Physiology and Cell Biology, Kobe University Graduate School of Medicine, Kobe, Japan5Medical Corporation Heishinkai OCROM ClinicMethodsIndividuals with type 2 diabetes (T2D) were randomly assigned to three different carbohydrate‐adjusted meals for 14 days. All subjects received luseogliflozin 2.5 mg once daily for the last 7 days.ResultsKetone bodies on Day 15 were significantly increased in LC‐HGI compared to HC‐HGI and HC‐LGI.ConclusionThis study shows that SGLT2 inhibitor luseogliflozin has similar efficacy and safety in Japanese individuals with T2D when meals contain 40–55% TEC, but a strict low‐carbohydrate diet on this class of drug should be avoided to prevent SGLT2 inhibitor‐associated diabetic ketoacidosis.S. Bolze, S. Dauchy, C. Tang, P. Fouqueray and Y. ItohPOXELImeglimin (IME) is a new glucose‐lowering agent improving insulin secretion and sensitivity. Phase 2b in Japan is ongoing. IME safety, tolerability and pharmacokinetics (PK) were assessed in Japanese healthy volunteers (HV) after repeated doses (RD) up to 2000 mg. The maximum tolerated dose (MTD) was assessed in Japanese and Caucasian HV after single doses (SD) up to 8000 mg. After RD IME exposure increased with dose up to 1500 mg with good tolerance. After SD exposure increased less than dose‐proportional and tolerance was good up to 6000 mg considered as the MTD in both populations. Overall the safety and PK of IME were similar in both Japanese and Caucasian populations.1, E.‐J. Yang2, S. A. Lee1,2 and G. Koh1,2S. Yoo1Department of Internal Medicine, Jeju national University Hospital2Department of Internal Medicine, Jeju National University School of MedicineWe measured intact GLP‐1 (iGLP‐1) and intact GIP (iGIP) levels in a fasted state and 30 min after ingestion of a standard mixed meal in 334 patients with type 2 diabetes (T2D). The ΔiGLP‐1 was significantly lower in those with metabolic syndrome (MetS). The ΔiGLP‐1 levels decreased significantly as the number of MetS components increased. In a hierarchical logistic regression analysis, the ΔiGLP‐1 level was found to be a significant contributor to MetS. Taken together, the impaired iGLP‐1 response is independently associated with MetS in T2D patients.1, X. Ma1, Y. Shen1, Y. Xu1, Q. Xiong1, X. Zhang1, Y. Xiao2, Y. Bao1 and W. Jia1Y. Luo1Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory2Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's HospitalNeck circumference (NC) is a new anthropometric index for estimating obesity. We aimed to determine the relationship between NC and body fat content and distribution as well as the efficacy of NC for identifying metabolic disorders. In 1943 subjects  with a mean age of 57.9 ± 7.3 years, visceral fat content was independently correlated with NC. A NC value of 38.5 cm for men and 34.5 cm for women were the optimal cutoffs for identifying visceral obesity. There were no statistically significant differences between the proportions of metabolic disorders identified by an increased NC and waist circumference. Therefore, NC has the same power as waist circumference for identifying metabolic disorders in a Chinese population.E. Y. Lee, Y. Yang, H.‐S. Kim, S.‐H. Lee, J. H. Cho, B. Y. Cha and K.‐H. YoonDepartment of Internal Medicine, College of Medicine, The Catholic University of KoreaAimWe investigated the association of low serum 25(OH)D levels with incident diabetes and its combined effects with metabolic syndrome (MetS) in Korean population.MethodsWe studied 1,038 subjects aged ≥40 years and diabetes was diagnosed with 75 g oral glucose tolerance test.ResultsDuring 4 year follow‐up, incident diabetes was developed in 161 (18.4%) subjects. Low serum 25(OH)D levels alone was not associated with incident diabetes. However, subjects with low 25(OH)D and MetS had significantly increased odds for incident diabetes when compared to those with high 25(OH)D and without metabolic syndrome.ConclusionsLow serum 25(OH)D levels were associated with incident diabetes only when it was combined with MetS.1, Y. Murayama1, M. Nakandakari1, T. Ikematsu1, C. Koduka1, T. Ikema1, T. Sirakura2, M. Tamura2, M. Shimabukuro3 and H. Masuzaki1S. Sunagawa1Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology , Graduate School of Medicine, University of the Ryukyus2Teijin Pharma Limited3Division of Diabetes, Endocrinology and Metabolism, Fukushima medical UniversityBackgroundIt has been recognized that oxidative stress produced by xanthine oxidase (XO), a key enzyme in uric acid production, would be related with vascular endothelial dysfunction in patients with metabolic syndrome (MetS).MethodsWe enrolled 60 patients with T2DM and MetS (BMI over 25) and we consecutively measured plasma XO activity.ResultsP < 0.01) and HOMA‐R (r = 0.68 P < 0.01). In contrast, plasma XO activity was not correlated with values of ages, HbA1c, BMI and serum uric acid.Plasma XO activity was correlated positively with fasting FIRI  higher serum MMP‐2 (39.13 ± 19.96 ng/mL) and MMP‐9 (73.93 ± 33.59 ng/mL) levels were detected in cases. Expression levels of MMP‐2 (1.39 ± 0.26) and MMP‐9 (1.82 ± 0.41) in cases were significantly higher than controls . There was no significant difference detected in MMP‐1 expression. Expression levels of MMP‐2 and MMP‐9 was significantly correlated with clinical factors of MetS. Clinical implication of results may help to identify the individuals with high risk of MetS and further complications.This case control study emphasized on the effect of impaired expression of genes MMP 1,2,9 in metabolic syndrome (MetS) and their correlation with clinical factors. A significantly  in euthyroid Chinese in a community based population.MethodsWe included 9372 subjects with normal thyroid function in a cross‐sectional survey.Results4166 met the diagnosis criteria of NAFLD. The increasing trends in prevalence of NAFLD were observed along with elevated free triiodothyronine (FT3) quartiles. Multivariable logistic regression showed that higher FT3 levels were associated with prevalence of NAFLD, (OR (95%CI): 1.58 [1.39–1.80] for men and 1.75 [1.57–1.95] for women), While thyroid stimulating hormone and free thyroixine were not.ConclusionHigh normal FT3 levels were positively associated with prevalence of NAFLD.1, S. Y. Oh1, M. J. Lee1, J. H. Kim1, Y. K. Jeon1, B. H. Kim1,2 and I. Kim1,2E. Kim1Department of Internal Medicine, Pusan National University College of Medicine2Department of Internal Medicine, Pusan National University Hospital and Biomedical Research InstituteP < 0.001), MetS  than those in the fourth quartile.The aim of this study was to determine if, and to what extent, epicardial fat thickness (EFT) and non‐alcoholic fatty liver disease (NAFLD) are related to vitamin D deficiency in patients with metabolic syndrome (MetS). A total of 1,162 consecutive patients in health screening center who underwent abdominal ulasrasonography, echocardiography and measurement of vitamin D levels were enrolled. EFT was significantly higher in patients with NAFLD compared with group without NAFLD. Patients in the first quartile of 25‐(OH) vitamin D level had a greater occurrence of NAFLD (odds ratio (OR) 3.17 [confidence interval (CI) 2.19–4.59]; 1, C. Francisco2, E. Gonzales3, M. Alejandria2, E. M. Salvana2, P. F. Reganit3, P. Maningat1 and O. Sison4M. G. Yu1Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Philippine General Hospital2Section of Infectious Diseases, Department of Medicine, Philippine General Hospital3Section of Cardiology, Department of Medicine, Philippine General Hospital4Department of Clinical Epidemiology, College of Medicine, University of the Philippines ManilaMethodsWe reviewed 635 Filipino HIV cases from 2004 to 2016, using multivariate regression to determine risk factors for hyperlipidemia and hyperglycemia before and after antiretroviral (ARV) use.ResultsIn ARV‐naïve patients, male sex, hyperglycemia, and ARV delay>320 days from diagnosis were risk factors for hyperlipidemia, while hyperlipidemia was a risk factor for hyperglycemia. After ARV initiation, hyperglycemia, ARV use>36 months, WHO Stage 4 HIV, and an efavirenz‐based regimen were risk factors for hyperlipidemia, while age>30, hyperlipidemia, overweight BMI, and a zidovudine‐based regimen were risk factors for hyperglycemia.ConclusionVarious factors contribute to hyperlipidemia and hyperglycemia among Filipino HIV cases.Withdrawn.1, J.‐H. Lee1, B. Kang2, E.‐Y. Lee2, Y. Yang2, Y.‐H. Choi2, B.‐K. Suh3 and K.‐H. Yoon2S.‐Y. Lim1Catholic Institute of U‐healthcare, The Catholic University of Korea2Department of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea3Department of Pediatrics, College of Medicine, The Catholic University of KoreaP = 0.045). In intervention group, BMI percentile significantly decreased from 93.1 to 90.9. These findings show that effective management and treatment of childhood obesity will be available by using platform in local community.We aim to assess the effectiveness of the improvement in BMI percentile by applying integrated platform developed to treat and manage of childhood obesity in local community. This study was performed over 12‐months as a randomized clinical trial. A total of 154 subjects randomly assigned to two groups at baseline. Of those, 71 study subjects followed up were included for analysis. A 2 by 2 mixed model ANOVA was done to compare the change of BMI percentile. There was a significant interaction between group and time  Assessment appropriate maternal weight gain for gestational week, (2) Prescription total calories considering pre‐pregnancy weight and gestational week. And Suggestion of a recommended diet, (3) Providing nutritional information (4) Expert's evaluation of dietary records, user‐entered. This application was meaningful in that it was easy and convenient for using and helpful for self‐nutritional management of pregnant women with DM.1, C.‐C. Liao2 and T.‐L. Chen2Y.‐C. Chou1Department of Physical Medicine and Rehabilitation, China Medical University Hospital2Department of Anesthesiology, Taipei Medical University HospitalBackgroundThe effects of influenza vaccination (IV) on diabetic outcomes remains unknown.MethodsWe used Taiwan's insurance claims data of 2008–2013 to conduct a study of 11976 patients ≥ 66 years receiving IV before diabetic admission within 1 year. Frequency matching was used to select 11976 non‐IV diabetic patients.ResultsPatients with IV had lower risk of 30‐day mortality , decreased risk of postoperative intensive care, shorter length of hospital stay and lower medical expenditures after diabetic hospitalization compared with non‐IV patients.ConclusionOlder patients with IV showed better outcomes after diabetic hospitalization compared with non‐IV diabetic patients.1,2, J. Y. Jeon1, H. J. Kim1,2, K.-W. Lee1 and D. J. Kim1,2K. H. Ha1Department of Endocrinology and Metabolism, Ajou University School of Medicine2Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of MedicineWe investigated the association between severe hypoglycemia and risk of dementia in person with DM. A total of 67,485 people with DM include in the analysis. During a median of 10.5 years of follow‐up , 8,951 people had a first diagnosis of dementia. Those who experienced a hypoglycemic event had a 2‐fold increased risk for developing dementia compared with those who did not have a hypoglycemic event . Our results provide evidence for an association between severe hypoglycemic events and dementia in person with diabetes.1,2,3A. A. Macalalad‐Josue1Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Philippine General Hospital2Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila3Department of Medicine, The Medical CityGlycemic variability (GV) affects the outcome of critically ill patients. To determine the effect of GV on inpatient mortality in the elderly, we did a retrospective cohort study with patients ≥65y/o admitted to ICU. GV indices were higher among those who died but there was no significant association. There was a trend towards greater inpatient mortality with increasing GV with mean glucose>180 mg/dL. Hence, GV is not a significant prognostic factor in critically elderly patients.Y. Huang, J. Yan, C. Hu and W. JiaDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's HospitalAims14 loci were selected to investigate the effect on predicting changes in insulin sensitive in a 9‐year prospective cohort in the Chinese population.Methodsn = 1,179). Gutt‐ISI index and HOMA‐ISI index were used to evaluate insulin sensitive.14 SNPs were selected and genotyped in a 9‐year prospective cohort (ResultsP = 0.04) and rs3923113  were significantly associated with changes in Gutt‐ISI index. Subjects carrying CC genotype of rs2943641, and those carrying GG genotype of rs3923113 were more insulin resistant assessed by Gutt‐ISI.rs2943641  in subcutaneous and visceral fat was increased at the very early stage of obesity and correlated with BMI.The expression of FSTL3 was upregulated in fat samples of db/db mice. Overexpressing of FSTL3 exhibited impaired glucose metabolism and downregulation of FSTL3 improved insulin sensitivity.FSTL3 is known to bind to Activin, and we found that expression level of G6Pase and PEPCK, key regulators of gluconeogenesis, was suppressed by treatment with recombinant Activin in primary hepatocyte.We found that the effect of impaired glucose metabolism of FSTL3 appears to be though inhibition of Activin which exhibited lower glucose levels by suppression of gluconeogenesis.1, J. T. Kim1, M. S. Oh2, H. S. Choi3, H. Nam Cho4, W. H. Park5 and Y. P. Kim5H. K. Lee1Department of Internal Medicine, Eulji University2Department of Statostics, Ewha Women's University3Department of Internal Medicine, Kangwon National University Medical CollegeN4Department of Preventive Medicine, Ajou University Medical College5Department of Physiology, Kyunghee University College of MedicineP < 0.001) and ex‐smoker still had higher AHRTA  than non‐smokers. Serum AHRTA and MIA reflected previous diabetic state; those subjects who had diabetes in 2002 had higher AHRTA and MIA and more diabetes had developed during 2002–2008 period among the subjects belonging to higher AHRTA and MIA quartiles. These observations suggest diabetogenic chemicals persist in human body.Serum AhR transactivation activity and mitochondrial inhibitor activity are predictive of future development of T2D among Koreans, suggesting that persistent organic pollutants is involved in the pathogenesis. Further analysis of Korean Genome Epidemiology study samples showed smokers had higher AHRTA . Additionally pro‐inflammatory cytokines such as TNFα contributes to insulin resistance. Previously we reported that Fyn regulates AMPK activity by direct phosphorylation of Y426 of AMPKα. TNFα increased Fyn kinase activity and siRNA knockdown of Fyn prevented TNFα inhibition of AICAR stimulated AMPK activation. TNFα induced inhibition of autophagy was not observed when AMPKα was mutated on Y436. These data demonstrate that Fyn plays an important role of TNFα on autophagy via phosphorylation of AMPK.1,2,3,4,5, X. Zhang6,7, Y. Deng8, J. Han1,2,3,4,5, J. Yang6,7, S. Chen1,2,3,4,5, Q. Fang1,2,3,4,5, Y. Yang1,2,3,4,5 and W. Jia1,2,3,4,5L. Ju1Shanghai Institute for Diabetes2Shanghai Key Laboratory of Diabetes3Shanghai Clinical Medical Centre of Diabetes4Shanghai Key Clinical Centre of Metabolic Diseases5Shanghai Jiao‐Tong University Affiliated Sixth People's Hospital6Institute of Endocrine and Metabolic Diseases7Ruijin Hospital, Shanghai Jiaotong University School of Medicine8The Affiliated Hospital of Qingdao UniversitySurvivin is a gene that has been found to abundantly expressed in fetal tissues and the most common human tumors, and was considered absent in normal tissues in initial studies.Here, we report that Survivin can be expressed upon insulin stimulation in vitro and under high fat diet feeding conditions in vivo. The ectopic expression of Survivin in 3T3‐L1 cells does not affect adipocyte differentiation, but rather inhibits isoproterenol‐stimulated adipocyte lipolysis via the β‐Adrenergic/cAMP pathway. Survivin also attenuates DNA damage‐related stress responses, as well as TNFα‐induced lipolysis. Taken together, the current findings suggest that Survivin may facilitate adipocyte maintenance in response to obesity‐induced adipocyte stress.1, T. Satoh1, T. Tomaru1, S. Yoshino1, T. Takamizawa1, T. Watanabe1, T. Okamura1, S. Matsumoto1, K. Horiguchi1, Y. Nakajima1, S. Ishii1, A. Ozawa1, N. Shibusawa1, M. Mori2 and M. Yamada1A. T. Katano1Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine2Metabolic and Obese Research InstituteUnderstanding of molecular mechanism for adipocyte differentiation would contribute to the management of glucose intolerance, an obesity‐related disease. We previously identified HELZ2, a coregulator of PPARγ. To further elucidate the pathological process of obesity, we here isolated splicing factor proline/glutamine‐rich (SFPQ), a pre‐mRNA splicing factor as a protein that interacts specifically with tyrosine‐phosphorylated HELZ2. Knockdown of Sfpq in 3T3‐L1 cells resulted in reduced fat accumulation due to aberrant expression of transcription factors that play essential roles in the early stage of adipocyte differentiation and deranged pre‐mRNA alternative splicing. SFPQ may be a novel target for the treatment of obesity‐related disease.1, S. Bolze1, M. Kergoat2, P. Fouqueray1 and K. Takeda1S. Hallakou‐Bozec1Poxel2Métabrain ResearchImeglimin (IME) is a novel glucose‐lowering agent improving insulin secretion in response to glucose (GSIS) and insulin sensitivity. IME is currently in phase 2b in Japan.IME increases NAD content involving the NAD synthesis salvage pathway. Its GSIS effect does not involve classical insulin secretion effectors and is synergic with GLP‐1. In T2D patients IME increases insulin secretion.IME increases b‐cell mass, decreases the number of apoptotic b‐cells and increases the proportion of proliferative b‐cells.These results demonstrate that IME‐induced GSIS involves the NAD synthesis salvage pathway and may protect b‐cell mass.K. NonogakiDepartment of Diabetes Technology, Tohoku University Graduate School of Biomedical Engineeringy mice. Treatment with FGFR2‐IIIc antibody significantly suppressed body weight gain and epididymal white adipose tissue weight by increased lipolysis without affecting food intake and blood glucose levels in KKAy mice.We examined the effect of liraglutide, a glucagon‐likepeptide‐1 (GLP‐1) receptor agonist, and monoclonal fibroblast growth factor receptor 2c (FGFR2c) antibody on the development of obesity and type 2 diabetes in mice. Systemic administration of liraglutide significantly decreased food intake, body weight, blood glucose levels and the expression of FGFR2 in epididymal white adipose tissue at 24 h after its administration while having no significant effects on plasma insulin and glucagon levels in individually housed KKA1, H. Aihara1, W. Xu1, M. Jin1,2, Y. Tomida1, T. Yamaoka1, N. Tanaka2, Y. Ikeda3, T. Tamaki3 and K. Tsuchiya1L. Miyamoto1Department of Medical Pharmacology, Institute of Biomedical Sciences, Graduate School of Tokushima University2Department of Pharmacognosy, Institute of Biomedical Sciences, Graduate School of Tokushima University3Department of Pharmacology, Institute of Biomedical Sciences, Graduate School of Tokushima UniversityCitrus Sudachi is a small sour typical seasoning in Japanese cuisine. A daily administration of Sudachi peel extended lifespan of ZDF rats. Here we determined active compounds of the sudachi peel. We successfully identified a limonene‐derivative as an active molecule by an index of TG‐reducing effects in cultured cells. It increased sirt1 expression levels, and the TG‐lowering effects was sensitive to nicotinamide, suggesting involvement of sirt1. In HFD‐fed mice, the compound improved glucose tolerance, fatty liver, serum TG and cholesterol levels with increase in sirt1 activities. Thus, it should be one of the active components of Sudachi peel regulating metabolism, which is supposed to be mediated by sirt1 upregulation.S. Wang, R. Zhang, F. Jiang, C. Hu and W. JiaShanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Jiao Tong University Affiliated Sixth People's Hospitaln = 6355). Hp genotyping was performed using TaqMan‐based real‐time PCR. Results showed that Hp2 allele was negatively correlated with carotid diameter (P = 0.0242), carotid intima‐media thickness (P = 0.0312) and Hp serum levels (P < 0.0001). After adjusting for variables, we found a significant association with diabetic macroangiopathies . Our data indicate that Hp polymorphisms were associated with diabetic macroangiopathies in a Chinese population.Haptoglobin (Hp) is an acute‐phase protein that is crucial for the neutralization of oxidative damage. We aimed to investigate the relationship between polymorphisms in Hp  and macroangiopathies in Chinese patients with type 2 diabetes  and two novel deleterious mutations  were identified in five patients, which didn't exist in 300 normal subjects. The proximate prevalence of MODY2 in the Chinese population ranged from 0.09% to 0.15%. Our study indicates MODY2 is not rare in Chinese population.1,2,3, C. Hu1,2,3 and W. Jia1,2,3F. Jiang1Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital2Shanghai Key Laboratory of Diabetes Mellitus3Shanghai Clinical Center for Diabetesn = 2,547) of Chinese population. Three SNPs  of G6PC2 were genotyped. Only rs16856187 has predicting effects on incidence of T2D and IGR with trend (P = 0.074) after adjusting for age, sex, BMI at baseline in logistic regression. Moreover, none of the three SNPs show predicting effects on changes in glucose metabolism traits. In this study we did not identify the predicting effects of G6PC2 variants on blood glucose deterioration and change in glucose metabolism traits.The aim of this study was to investigate the predicting effects of common variants of G6PC2 on deterioration of blood glucose and change in glucose metabolism traits in in a community‐based 9‐year prospective cohort  are vital enzymes in inflammation, proved to be associated with type 2 diabetes (T2D). We aimed to test whether polymorphisms in COX1 and COX2 are associated with T2D and glucose metabolism in Chinese.MethodsWe included 6822 individuals with OGTT data and genotyped tag SNPs of COX1 and COX2.ResultsP = 0.031). Moreover, variants in both COX1 and COX2 displayed association with glucose related traits, including glucose level, insulin secretion and sensitivity (P = 0.002–0.049).rs3218625 of COX2 was correlated with T2D after adjusting for age, gender and BMI  or A190A (C>T) in KCNJ11 are associated with early‐onset T2DM in Chinese.Methodsn = 57) or not , and 182 control subjects, who were genotyped by PCR‐sequencing.A case‐control study was conducted in 175 early‐onset T2DM patients who receive insulin . A190A‐TT had higher SBP than CC In ins+ group (P < 0.05).Higher E23K‐GA+AA and lower A190A‐TT in T2DM, especially in the ins+ group; higher 2 h plasma glucose and lower 2 h insulin in E23K‐AA (vs. E23K‐GG) of control group were observed  susceptibility in a Chinese T2DM cohort.Methodsn = 998 and 1,373, respectively). All patients underwent full ophthalmological examination.We genotyped rs10229583 in T2D patients with DR, and without DR whose duration is over 5 years  in logistic analysis. Similar result was found  after adjusting for the diabetic duration, HbA1c, blood pressure and BMI.No evident significant association was found between DR and rs10229583  levels and its value for identifying subclinical atherosclerosis in normoglycemic subjects with a first‐degree family history of diabetes (FHD). Serum FGF23 levels were higher in 312 subjects with a first‐degree FHD than in 1407 subjects without a FHD. A first‐degree FHD was positively and independently associated with serum FGF23 levels. In subjects with a first‐degree FHD, only those with serum FGF23 levels in the upper quartile were more likely to have an increased C‐IMT. As conclusion, the influence of a first‐degree FHD on serum FGF23 levels should be considered to avoid overestimating the cardiovascular disease risk.D.‐J. Kim, J. Noh and J. HongDepartment of Internal Medicine, Inje University Collegel of Medicine Ilsanpaik HospitalAmong the 24,594 participants who participated in the 2011–2013 Korea National Health and Nutrition Examination Survey (KNHANES), 12,923 participants were analyzed in this study. Logistic regression analyses showed that, when using the group that abstained as the control, the group that consumed alcohol ≥ 30 g/day was negatively associated with the risk of an HbA1c level of ≥5.7%, ≥6.1%, and ≥6.5% even after adjusting for confounding factors, including the FPG concentration, in this nationally representative sample of Korean adults. These results suggest that excessive drinking shifts the HbA1c level downward, which might complicate use of the HbA1c level for the diagnosis of diabetes or prediabetes.X. Cai, X. Gao, X. Han and L. JiPeking University People's HospitalTo learn the baseline characteristics and the glucose control in early onset newly diagnosed type 2 diabetes patients, we performed an observational and prospective study in a cohort of newly diagnosed T2DM patients in China. A total of 5770 patients from 79 hospitals were included. The early onset patients were defined as patients with the diagnosed age no more than 40 years old. Totally 666 patients were early onset diabetes patients. Comparisons between early onset and late onset patients of the baseline characteristics indicated that in China, in newly diagnosed patients, early onset patients tended to be more males, more smokers, more obese, higher baseline HbA1c level, but decreased more after one year of treatment.Withdrawn.1,2, R. Zhang1,2, C. Hu1,2 and W. Jia1,2T. Wang1Shanghai Diabetes Institute,Shanghai Jiao Tong University Affiliated Sixth People's Hospital2Shanghai Key Laboratory of Diabetes Mellitus,Shanghai Clinical Center for DiabetesP = 6.93 × 10−6) and it remained significant even adjusting for multiple testing . Moreover, we observed that CYP2C9 rs1934967 and CYP2J2 rs10789082 and rs1593461 were associated with insulin secretion and sensitivity indies (P = 0.02–0.04). It is indicated that CYP2C9 and CYP2J2 may play an important role in glucose metabolism.CYP450‐mediated epoxyeicosatrienoic acids exert favorable effects on glucose homeostasis. We aim to test the impacts of CYP2C9 and CYP2J2 variants on type 2 diabetes (T2D) risk in Chinese populations. We totally genotyped 22 tagging loci of CYP2C9 and CYP2J2 in 6822 participants and collected the clinical measurements. We found that CYP2C9 rs1819173 was associated with T2D  were 104, 10, and 34 respectively. The age of onset of acute type was significantly younger than that of SPIDDM. The serum C‐peptide level and prevalence of retinopathy in SPIDDM were significantly higher than in other types.The dose of bolus insulin in patients on pump one year after the induction of pump therapy was significantly lower than that of before the induction. The pump therapy, however, provided no improvements in HbA1c and indexes of blood glucose variability.1,2, D. B. M. Wickramarathne3 and P. H. P.Fernando4A. N. Sanjeewani1Department of Pharmacy, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University2Postgraduate Institute of Agriculture, University of Peradeniya3Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya4Department of Biochemistry, Faculty of Medicine, University of PeradeniyaObjective was to investigate effect on BGC of ELEAP in rats. A group‐500 mg/kg/day of ELEAP and B group‐water. OGTT and starch tolerance test (STT) was done at day 10 and 17. Significant increase in BGC was observed in the A group. Shows hypoglycemic activity (HA) to control normal BGC. There is no anti‐HA,insulin like or releasing activity, or amylase activity.A. Ozawa, T. Watanabe, T. Tomaru, S. Ishii, N. Shibusawa, S. Okada, T. Satoh and M. YamadaDepartment of Medicine and Molecular Science, Gunma University Graduate School of MedicinePatients with adrenal insufficiency require glucocorticoid replacement. Some patients receiving sufficient doses of glucocorticoids occasionally exhibit morning headache, which may be caused by unrecognized hypoglycemia. CGM identified unrecognized hypoglycemia at midnight or early in the morning in 10 patients out of 11. Based on these findings, fine‐tune the dosing and regimens of glucocorticoid replacement were done. After the optimization, hypoglycemia disappeared and symptoms were improved in all patients. These findings demonstrated that CGM may represent a powerful tool for identifying hypoglycemia and optimizing therapies in patients with centarl hypoadrenalism.Withdrawn.1, Y. Takayanagi1, Y. Maeda1, E. Tsuchiya1, T. Nishikawa2, M. Mimura1 and R. Moriwaki3K. Nemoto1Department of Internal Medicine, Chiba Rosai Hospital2Department of Internal Medicine, Yokohama Rosai Hospital3Department of Emergency and Critical Care, Chiba Rosai HospitalObjectiveTo compare the prevalence and cause of hypoglycemic attacks in diabetic patients visiting emergency room both year 2010 and 2015.MethodsDiabetic patients with severe hypoglycemia in 2010 and 2015 were evaluated at emergency visit.ResultsAmong the cases, 33 and 22 patients were detected severe hypoglycemia in 2010 and 2015. Most of severe hypoglycemic patients were attributed to either SU or insulin in both observed years.Patients attributed to using SU significantly decreased from 77% to 36%. In contrast, patients attributed to insulin increased from 36% to 64%.ConclusionAs DPP4 inhibitors have been widely used in Japan, severe hypoglycemic cases related to SU administration seems to have decreased in number.M. Kishimoto, N. Ishimura, Y. Nagai and N. TajimaDepartment of Internal Medicine, Sanno HospitalAs the number of foreign visitors and residents in Japan increase, Japanese medical staff is increasingly likely to encounter foreign patients with diabetes. However, there are several factors complicating diabetes management for these patients. Diet therapy may be especially difficult to implement because eating habits are unique to each culture and ethnicity. Differences in language, cultural habits, healthcare insurance, and medications are other potential barriers. Based on our experiences, we analyzed these problems and concluded that to provide better diabetes care to foreign patients, efforts should be made to understand their cultural backgrounds, food habits, and the diabetes treatment guidelines used in their native countries.1,2, H. Y. Jin1,2, H. S. Baek1,2 and K. A. Lee1,2T. S. Park1Department of Endocrinology and Metabolism, Chonbuk National University Medical School2Research Institute of Clinical Medicine, Chonbuk National University HospitalWe evaluated OGTT results from 494 subjects who had performed an OGTT. We measured the OGTT parameters , insulin, C‐pep, HbA1c during OGTT. OGTT parameters significantly correlated with HbA1c, insulin, and C‐peptide in total subjects. OGTT parameters using the possibility of HbA1c ≥6.5% is the highest in G0 and G60 is the lowest. Using G0, G60 and G120, the highest rate of HbA1c ≥6.5% when G0 and G120 were used together, and the lowest when using G60 and G120. However, odds ratio of HbA1c ≥6.5% is the highest when G60 and G120 were used combined. From our results of OGTT, the useful result of diabetes diagnosis is G0 and G120, so the measurement and usefulness of G60 value in OGTT should be reviewed from large studies.H. Su, X. Ma, J. Yin, Y. Wang, X. He, Y. Bao, J. Zhou and W. JiaDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory oThe goal of this study was to explore short‐term changes in serum 1,5‐anhydroglucitol  levels after a glucose load. A total of 681 participants without a prior history of diabetes mellitus (DM) were enrolled. Serum 1,5‐AG levels were slightly elevated after a glucose load, the difference between peak and baseline levels  was significantly lower in DM patients than in individuals without DM. Δ1,5‐AG was positively associated with baseline 1,5‐AG was also found. Although serum 1,5‐AG levels have been shown to decline with long‐term hyperglycemia, the present study showed that serum 1,5‐AG levels slightly increased after a glucose load.S. Tokumoto, E. Okamura, M. Abe, S. Honjo and A. HamasakiCentre for Diabetes and Endocrinology, Tazuke Kofukai Foundation, Medical Research Institute, Kitano HospitalP < 0.05). Fasting insulin levels were negatively correlated with postprandial ASP level reduction, suggesting that insulin could regulate postprandial ASP levels.Asprosin (ASP) has recently been discovered as a glucogenic hormone secreted from adipose tissue. While ASP promotes hepatic glucose release, the pathophysiological role of ASP in patients with glucose intolerance remains unclear. We aimed to evaluate the relationship between ASP postprandial concentration kinetics and other biomarkers. 8 healthy subjects and 23 type 2 diabetes mellitus (T2DM) underwent a 2‐h meal tolerance test. In T2DM patients, postprandial reduction of ASP levels showed a significant negative association with fasting insulin levels , IGT were 3 (20.0%) and abnormal HbA1C were 2 (13.3%).ConclusionsResponses to 75 g glucose tolerance tests are abnormal for all T2DM patients andtwo third of their have a critical high level of blood glucose in last 3 months. Among healthy controls one third have an IFG and one fifth have an IGT.Y. Tagaya, E. Yamada, Y. Nakajima, A. Osaki, Y. Shimoda, R. Shibusawa, T. Saito, T. Sato, S. Okada and M. YamadaDepartment of Medicine and Molecular Science Gunma University Graduate School of MedicineAimsOptimum therapy for patients with diabetes depends on both acute and long‐term changes in plasma glucose (PG) as assessed by HbA1c. We examined this relationship using continuous glucose monitoring (CGM).Methods51 patients  were examined. HbA1c were compared with PG determined by CGM.ResultsP < 0.0001) with mean PG measured by CGM. However, when HbA1c was more than 8.0% there was no statistically significant relationship .Changes of HbA1c up to 8.0% showed a statistically strong relationship  and metabolically healthy but obese  in total 2,917 adults Vitamin D was significantly decreased in subjects with MONW (15.7 ± 7.1 ng/mL) compared with MHO (16.9 ± 6.4 ng/mL). However, fatty liver index (FLI) and cystatin C were significantly increased in subjects with MHO  compared with MONW . There were no significant differences in CRP, homocysteine, GGT, and HOMA‐IR between two groups. Low vitamin D may be more related with metabolically obese, but high FLI and cystatin C may be more related with obesity itself.The aim of this study was to compare multiple markers between metabolically obese but normal weight . No significant association was observed of rs7903146 and DR after adjusting duration, HbA1c, blood pressure and BMI in logistic analysis . In conclusion, TCF7L2 rs7903146 had no significant effects on DR in Chinese population.TCF7L2 has been confirmed to be associated with T2D and diabetic retinopathy (DR) in Caucasians. However, the effects of TCF7L2 variants on DR in Chinese is still unknown. We genotyped rs7903146 in T2D patients with and without DR , non‐mydriatic retinal camera,and quantitative sensory testing (QST). Peripheral artery disease was also assessed by ankle brachial index (ABI). We will check the rate before and after the service.ResultsThe percentage of four examinations were increased. Retinal examination from 67.6% to 72.8%, UAE from 63.5% to 79.8%, QST from 0% to 45%,and ABI from 89.9% to 95.1%.ConclusionsOne stop survey complications of diabetes were a patient‐center service. Integrated care of patient could increase the percentage of diagnosed complication.1, W. Ren2, X. Li1 and G. Xi2J. Guo1Department of Endocrinology, The second Affiliated Hospital of Shanxi Medical University2Department of Endocrinology, Shanxi Medical University, Shanxi Academy of Medical Sciences & Shanxi Dayi HospitalBackgroundIn this study, We investigated the association of FTO polymorphisms with BMD and other parameters in patients with T2DM.Methods120 patients were included in this study. The FTO polymorphisms rs1861868, rs1421085 and rs9939609 were determined. BMD Other clinical parameters were measured.ResultsPatients with osteoporosis were more likely to carry the rs9939609 A allele compared to normal patients with BMD. Two haplotypes (ACA and GCA) were associated with higher risk of osteoporosis. Patients without the ACA allele showed lower T‐score at the femoral neck and an increased risk of osteoporosis.ConclusionGenetic variations in FTO are associated with osteoporosis among patients with T2DM.C.‐C. Liao and T.‐L. ChenSchool of Medicine, Taipei Medical UniversityWe evaluated diabetes risk in chronic obstructive pulmonary disease (COPD) patients. We identified 14720 adults with COPD exacerbations (COPDe) and 29440 non‐COPD controls in 2000–2008. Diabetes events in 2000–2013 were identified in the follow‐up period. Adjusted HR of diabetes associated with COPD were calculated. The incidences of diabetes for patients with no COPD and COPDe were 2.4 and 5.2 per 1,000 person‐years, respectively. Patients with COPDe (HR 2.53) had increased risk of diabetes. The association between COPDe and diabetes risk was significant in both sexes and every age group. We concluded that COPDe was associated with diabetes risk.S. Kubota, T. Kurose, S. Ueno, S. Okamoto, Y. Sakuramachi, K. Okamura, H. Kuwata, K. Watanabe, T. Hyo, N. Tanaka, Y. Hamamoto and Y. SeinoCenter for Diabetes, Endocrinology and Metabolism, Kansai Electric Power HospitalWe have attempted to evaluate the characteristics of sleep parameters and sleep quality of patients with diabetes mellitus using questionnaires on individual sleep quality. The participants asked the Pittsburgh Sleep Quality Index (PSQI). We analyzed 100 patients with diabetes mellitus. The average total score of PSQI was 4.39 ± 0.23. Patients with over 6 scores of PSQI are considered to have sleep disorder, and 32 patients out of 100 patients meet this definition and grouped as high PSQI. 68 patients were classified as low PSQI group. Systolic blood pressure in the group of the high PSQI was significantly higher than in low PSQI group. In addition average BMI of high PSQI was 23 ± 0, significantly lower than 26 ± 1 in the low PSQI group.Y.‐L. Chen and K.‐J. TienDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical CenterP < 0.0001). Patients with diabetic ketoacidosis had a higher risk of ischemic stroke than those without . After adjustment for patient characteristics and comorbidities, diabetic ketoacidosis patients were 1.55 times more likely to have a stroke than those without diabetic ketoacidosis .We extracted claims data for 3572 type 2 diabetic patients with DKA and 7144 controls between 2000 and 2002. All patients were tracked until new stroke diagnosis, death, or end of 2011. Two hundred seventy of the 3572 patients with diabetic ketoacidosis and 404 of 7144 of the controls were diagnosed as having a new stroke, incidence rate ratio (IRR) 1.56  and 1‐h postprandial glucose levels (1hPPG) had negative correlation. Interestingly, eGFR, 1hPPG and FMD were all associated with the composite endpoint by logistic regression analysis. Postprandial hyperglycemia‐mediated endothelial malfunction may predict future adverse events.K. Park, J. Kim, S. Lee, J. You, J. Park, J. Nam, C. Ahn, K. Kim and Y. KimDepartment of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of MedicineP < 0.05). These results show that Apo B/Apo A‐1 and Lp(a) have a synergistic impact on prevalence of CAC.We investigated the influence of Apo B/Apo A‐1 and Lp(a) on coronary artery calcification (CAC) among healthy Korean adults. A total of 1081 participants were enrolled. Anthropometric profiles and Apo B, Apo A‐1, and Lp(a) were measured. Multi‐detector CT was used to measure coronary artery calcium score (CACS) and CACS>0 was defined as the presence of CAC. The prevalence of CAC significantly increased with Lp(a) and Apo B/Apo A‐1 levels. In the logistic regression analysis adjusted for multiple risk factors, odds ratio for the prevalence of CAC comparing the lowest Lp(a) and Apo B/Apo A‐1 group to the highest group was 2.554 (1.26–5.20)  levels and carotid intima‐media thickness (C‐IMT) in men with a low‐to‐moderate cardiovascular disease (CVD) risk assessed by Framingham Risk Score (FRS). This study enrolled 392 and 372 men with a low and moderate CVD risk, respectively. The results showed that men with high serum FGF23 levels, and no matter with a low or moderate CVD risk, were more likely to have an increased C‐IMT than those with low serum FGF23 levels and a low CVD risk. Serum FGF23 levels were independently and positively associated with C‐IMT. As a conclusion, serum FGF23 levels strengthen the capacity of the FRS for identifying subclinical atherosclerosis.K. NonogakiDepartment of Diabetes Technology, Tohoku University Graduate School of Biomedical EngineeringDespite lifestyle interventions and anti‐hypertension agents, hypertension remains difficult to control in some patients with type 2 diabetes. Here we show the effects of low‐frequency and low‐intensity ultrasound applied to the forearm on blood pressure (BP) and pulse rate in Japanese subjects with type 2 diabetes and hypertension. Systolic and diastolic BP, pulse rate, pulse pressure in the ultrasound treatment group were significantly lower than the baseline values in hypertensive subjects with type 2 diabetes, and lower than those of placebo controls. Low‐frequency and low‐intensity ultrasound irradiation to the forearm might have potential usefulness as a therapeutic application for clinic hypertension in subjects with type 2 diabetes.1,2,3,4, T. Wang1, F. Liu1,2,3,4 and W. Jia1,2,3,4R. He1Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People's Hospital2Shanghai Key Laboratory of Diabetes3Shanghai Institute for Diabetes4Shanghai Clinical Medical Centre of DiabetesObjectiveTo evaluate the inflammatory signals involved in the effects of Negative pressure wound therapy (NPWT) on diabetic foot ulcers.MethodsWe enrolled 22 patients with diabetic foot ulceration, eleven treated with NPWT and others treated with traditional debridement. All the patients were treated and observed for 1 week. Granulation tissue harvested and analyzed using ELISA, Western blot and real‐time PCR.ResultsP < 0.05).NPWT promote wound healing and significantly decreased the expression of TNF‐α, IL‐6 and iNOS. Western blotting and real‐time PCR indicated that NPWT decreased the level of IkB‐α and NF‐kB P65 and increased the level of ATF‐3  . We studied the potential for the additive effects of diabetes upon existing hypertension for the development of neuropathy. Neonatal STZ‐diabetes was induced in SHR and Wistar rats. SHR complicated with diabetes (SHR+DM), hypertension only (SHR), diabetes only (DM), and two controls; WKY and Wistar rats were studied. Nerve conduction velocity in SHR+DM was the slowest at age of 28 and 44 weeks. Morphological abnormalities, e.g. axonal atrophy of myelinated fibers, in SHR+DM was greater than in SHR or DM. These findings suggest that diabetes contributes to worsening of hypertensive neuropathy.D. C. Bernardo, A. M. Lat and C. M. Sison‐PenaSection of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General HospitalThis study aims to identify clinical and demographic factors associated with post‐discharge follow up among patients admitted for one of the most common complications of diabetes, the diabetic foot.Records of adults admitted for diabetic foot in the Philippine General Hospital from December 2011 to 2013 and subsequently discharged to the outpatient clinics were reviewed. Multiple logistic regression was done to derive associations between clinical, demographic variables and follow up.P = .047). and may be a marker for good treatment‐seeking behavior in this population.Post‐discharge follow up rate is 22%. Among all other variables, non‐drinking status is associated with post‐discharge follow‐up ; NCA,9.8 μV (196 legs). Neuropathy severity was normal, mild, moderate, and severe in 112, 49, 32, and 10 legs, respectively. (1) NCV correlates with foot lesions, high HbA1c, diabetic complications, and smoking. (2) NCA correlates with diabetic complications and some vascular disorder indicators. (3) Severity of neuropathy was found to correlate with diabetic complications. Thus, DPN Check is useful in analyzing foot ulcer risk.1, O. Bavuu2 and S. Sonomtseren2T. Boldbaatar1Endomed Clinic2Mongolian National University of Medical ScienceObjectiveThe aim of this study was to evaluate healing progress of DFU.MethodsCohort study included T2DM patients with foot ulcer visited Endomed diabetic foot clinic, Mongolia last two years.ResultsMean age of DM was 59.4 ± 9.56 years old and mean diabetes duration was 11.44 ± 6.4 years and mean HbA1C was 10.09 ± 1.96%. DFU healed er with foot amputation was 5 patients . Recurrence of DFU was 72% . Primary healed DFU <1 month was 60%, 1–3 months were 20%, 3–6 months were 12%, non healed more 6 months 4%, and mortality was 4%.ConclusionsTwo third DFUs were primary healed <1 month, one fifth within 1–3 months, one tenth within 3–6 months and one fifth healed with amputation.N. Kato, M. Kato and H. ToshimaKato Clinic of Internal MedicineWe developed a simple test of autonomic function in diabetes.Materials and MethodsIn 77 patients with diabetes and 22 healthy volunteers, the cardio‐ankle vascular index  was measured on a blood pressure/pulse wave apparatus . The standard deviation /mean ratio for the height of 5 consecutive pressure pulse waves (CVWH) was used to assess sympathetic function.ResultsP = 0.0001). In patients on oral agents, CVWH was positively correlated with vibratory sensation and negatively correlated with CAVI.CAVI was significantly higher and CVWH was significantly lower in the diabetes group .Results suggest that in patients with DM and CKD stage 3, 4, 5, the risk of all cause mortality is not increased when serum uric acid levels are <8.0 mg/dl. However, in patients without DM, all cause mortality is not increased when serum uric acid levels are <8.0 mg/dl. The risk of RRT was associated with increased serum uric acid levels. However, no difference in risks of RRT was noted in the two groups.J. Kim, K. Park, J. Yu, S. Lee, J. Nam, J. Park, C. Ahn, K. Kim and Y. KimDepartment of Internal Medicine, Gangnam Severance Hospital, Seoul, KoreaBackgroundWe measured various hemorheologic parameters in type 2 diabetes patients and assessed their possible role as a diagnostic tool for diabetic nephropathy.MethodsHemorheologic parameters, including erythrocyte deformability, elongation index (EI), critical shear stress (CSS), and aggregation index (AI) were measured.ResultsThere were significant differences in Elongation index at 3 Pascal (EI at 3 Pa) in CKD and diabetic nephropathy. Fibrinogen/EI at 3 Pa suggesting 860 mg/dL% as a cut off point for diabetic nephropathy with the sensitivity of 74% and specificity of 62%.ConclusionsFibrinogen/EI is a sensitive parameter measured via point‐of‐care testing for screening diabetic nephropathy in patients with type 2 diabetes.L. Liu, L. Zhuang, X. Ge, J. Zhang, M. Li, R. Zhang, W. Zhao, Y. Chen, J. Yin, Y. Bao and W. JiaDepartment of Endocrinology & Metabolism, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes, 600 Yishan Road, Shanghai 200233, ChinaObjectiveTo evaluate the association of the SLC12A3‐Arg913Gln variation with ESRD risk in Chinese T2DM patients.Methodsn = 372) with diabetic retinopathy were classified into the non‐DN control group  and the DN‐ESRD group , who were genotyped by PCR‐sequencing.T2DM patients (ResultsP < 0.01); GA+AA carriers had higher UAER and DBP than GG in control subjects (both P < 0.05).Higher GA+AA genotype in DN‐ESRD subjects was observed compared to control group  decreased but caspase 3 and collagen 1 increased in DM kidney and HG‐cultured HK‐2 cells. CRBP1 transfection recovered STRA6 signal and renal injury in HG‐cultured HK2 cells. ROS inhibitor and MnSOD transfection rescued aberrant STRA6 signal and renal injury. This study indicates that aberrant STRA6 and CRBP1signaling involve the process of DKD via mitochondrial dysfunction.L. Jin, C. Hu and W. JiaShanghai Diabetes InstituteP = 0.047, OR = 0.5525), and it also showed association with AER . Our data suggests the variant rs955333 was not associated with DKD but showed association with DR in the Chinese T2D patients.Genomewide association studies found rs955333 was associated with DKD in EA, AA and MA. We aimed to investigate the association between the variant rs955333 with DKD susceptibility in 1884 Chinese T2D patients. Associations of the variant rs955333 with DKD as well as DR susceptibility and related quantitative traits were evaluated. The variant rs955333 was not associated with DKD in our samples, while subjects with genotype GG were associated with DR . Fasting plasma glucose and HbA1C remain independently associated with impaired thermal thresholds after adjusting for confounding factors. Abnormal sensory test of lower limbs is associated with peripheral artery disease in type 2 diabetes.We enrolled 725 type 2 diabetic patients with quantitative sensory test for thermal thresholds and ankle‐brachial index/ toe‐brachial index (TBI) examinations. Excluding patients with a history of apparent cardiovascular disease, arrhythmia, end‐stage renal disease, malignancy, and diagnosed peripheral neuropathy. A total of 539 study subjects had impaired thermal thresholds. After adjusting for gender and age, abnormal thermal thresholds was significantly associated with low TBI and low eGFR  proteoglycans (PGs) comprise a core protein to which extracellular sugar chains are attached. We recently found that HS core protein Syndecan‐4 (Sdc4) are necessary for maintaining insulin secretory mechanism. So analysis of the regulation of Sdc4 expression is important for better understanding diabetes. We analyzed the sequence, methylation in Sdc4 promoter, and executed the deletion reporter assay using Sdc4 expressing and non‐expressing mouse pancreatic β‐cell line, MIN6 cells. Sdc4 promoter sequences showed no change in both cells, while specific methylation on the promoter was detected in Sdc4 non‐expressing cells only. Furthermore, deletion analysis revealed two important promoter regions for Sdc4 expression.M. J. Kim, Y.‐H. You, J.‐W. Kim and K.‐H. YoonDepartment of Endocrinology, The Catholic University of KoreaWe have developed a highly efficient step‐wise protocol to direct insulin‐producing cell from diabetes patient‐specific iPS cell lines. For differentiation into insulin producing cells, we divided into 4 stages. We regulated the glucose concentration and used several small molecules in each steps and adenovirus for Pdx‐1 overexpression in the stabilizing stage. In final step, we reaggregated the cells like an islet cluster. Interestingly, aggregated cells showed expression of insulin gene and insulin positive cells. To functional test, we performed glucose‐stimulated insulin secretion. Interestingly, insulin secretion was a statistically significantly increased by high glucose treatment in differentiated cells.S. H. Lee, J.‐W. Kim and K.‐H. YoonDepartment of Endocrinology and metabolism, The Catholic University of KoreaAim of our study was to generate the insulin‐producing cells form small intestine using an adenoviruses ). Adenoviruses delivered from duodenum to colon in whole intestine, and identified infection with the Ad‐Pdx1 and triple Ad‐PMB respectively in mouse small intestine. At 4 weeks after injection, insulin mRNA expressed in small intestines. In additionally, insulin+ cells detected in a part of crypts and villus located of small intestine tissues by immunostaining. These data indicated that Pdx‐1, MafA, Beta2/NeuroD facilitate the differentiation into insulin producing cells of mouse intestinal cells. In conclusion, small intestine is an accessible and abundant source of insulin‐producing cells.1, A. Kirkley G2, N. Yokoi1, R. Hoshikawa1, K. Sugawara1, R. S. M2,3 and S. Seino1C. Carmean M1Division of Molecular and Metabolic Medicine, Kobe University2Division of Biological Sciences, University of Chicago3Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of ChicagoClinical cross‐sectional studies have reported a correlation between chronic arsenic exposure and the prevalence of type 2 diabetes mellitus. To investigate the molecular underpinnings of these observations, a mouse model of chronic arsenic exposure was developed. We observed glucose intolerance and impaired β‐cell response to hyperglycemia in mice following 8 weeks of exposure to inorganic arsenic in drinking water. Chronic exposure (3 days) to physiological concentrations of arsenic decreased glucose‐stimulated insulin secretion in the MIN6‐K8 β‐cell line, with no effects observed during acute (30 min) exposure. These studies raise the plausibility that arsenic exerts its diabetogenic effects through β‐cells.B. Chandravanshi and R. BhondeSchool of Regenerative Medicine, Manipal UniversityTransplantation of pancreatic islets is the most reliable treatment for Type 1 diabetes. However cell death mediated by hypoxia is considered as one of the main difficulties hindering success in islet transplantation. The aim of our experiment was to investigate the role of small molecules in survival of Islet like cell aggregates (ICAs) engineered from umbilical cord matrix under oxygen deprived condition (<5%O2). ICAs were analyzed for cell death via fluorosceindiacetate/propidium iodide (FDA/PI) staining, estimation of Caspase 3 and free radical release in presence and absence of small molecules. The samples were also analysed for the presence of hypoxia inducible factor 1α (HIF1α) at both transcriptional and translational level. The addition of small molecules showed profounddefensive effect on ICAs under hypoxicenvironment as evidenced by their viability and insulin secretion compared to untreated ICAs. The combinations of Eicosapentaenoic acid (EPA), Docosahexaenoicacid (DHA) and metformin and EPA,DHAandγ amino butyric acid (GABA) acted as anti‐apoptotic agentsforhuman ICAs when exposed to 1% O2 for 48 h. The combinations of the small molecules reduced the total reactive oxygen species and malonaldehyde (MDA) levels and enhanced the production of glutathione peroxidise (GPx) enzyme under hypoxic conditions. Finally the increase in HIF1α at both protein and gene level confirmed the defensive effect of the additives in hypoxia. These results suggest that the combination of small molecules maintained the viability and functionality of the ICAs in hypoxia by up‐regulating HIF1α expression and down regulating the Caspase 3 activity.1,2,3 and W. Jia1,2,3C. Hu1Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital2Shanghai Key Laboratory of Diabetes Mellitus3Shanghai Clinical Center for DiabetesWe aimed to discover novel mutations leading to special types of diabetes which are misdiagnosed as type 2 diabetes in the Chinese population, and explore potential molecular mechanisms. We performed whole‐exome sequencing in 31 ‘T2D’ patients and found a novel mutation p.Ala2Thr in INS gene as a hot spot mutation of MODY. This variant was observed in 0.09% of cases in the replication study. Functional studies in INS1‐E cells showed that this mutation impaired beta cell function through inducing endoplasmic reticulum stress.R. Usui, D. Yabe, M. Fauzi, S. Tokumoto, H. Tatsuoka, Y. Tahara, M. Ogura, K. Nagashima and N. InagakiDepartment of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine Kyoto University, Kyoto, Japan2+ dynamics simultaneously during GIIS. The whole islets were subjected to two‐photon excitation microscopy to evaluate ATP dynamics in individual b‐cells. ATP increased by 1.2‐fold as early as ˜60s after glucose was increased; with Ca2+ elevation ˜80s after the ratio increase. In the whole islets, the average ratio increased by 1.1‐fold when glucose was increased. The ratio was increased in ˜30% of the cells examined. ATP rise proceed Ca2+ elevation in b‐cells during GIIS. Intracellular ATP did not elevate in some b‐cells, suggesting heterogeneity of b‐cells’ response to glucose.ATP dynamics in b‐cells was evaluated by ATP biosensor GO‐ATeam1. The dissociated islet cells were subjected to fluorescent microscopy to evaluate ATP and CaY. Wang and P. S. LeungSchool of Biomedical sciences, The Chinese University of HongKongAs an unsaturated FFA sensor,GPR120 action in beta cells remains unexplored. Our results showed that GPR120 was expressed in beta cells and its stimulation with DHA or GSK restored palmitic acid (PA) downregulated the expression of insulin and pdx1 in MIN6 and islets. But the pdx1 level could not be rescued within GPR120 knockdown cells. In vivo,GPR120 KO mice displayed hyperglycemia and insulin resistance. We found that the pdx1 expression was decreased and the effects of GPR120 activation were not seen in GPR120 KO mouse islets compared with WT islets. The data suggests that GPR120 is protective against PA‐induced beta‐cell dysfunction via the mediation of pdx1.Y. Wang, S.‐i. Harashima, Y. Liu, R. Usui and N. InagakiDepartment of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 606‐8507, Japan+/+) and their islets, (1) intraperitoneal glucose tolerance test showed a decrease in blood glucose levels and an increase in insulin levels, but no enhancement by exendin‐4 (Ex‐4) in SKIP−/− mice; (2) glucose stimulated insulin secretion (GSIS) was amplified more with no enhanced effect by Ex‐4 in SKIP−/− islets. (3) ATP and cAMP content were not altered between the islets; and (4) depolarization‐evoked, PKA and cAMP‐mediated insulin secretion were not affected in SKIP−/− islets. These results indicate that SKIP modulates GSIS and influences glucose sensitivity in a KATP channel‐ and cAMP‐independent manner.Sphingosine kinase 1‐interacting protein (SKIP) is highly expressed in pancreatic b‐cells but not a‐cells. Compared to wild type  cells to full‐adiponectin at 16.7 mmol/L glucose increased insulin secretion. It was abolished when the cells were pretreated with high levels of glucose/ palmate for 48 h, or APPL1 shRNA. Furthermore, this effect was associated with an inhibition of ATP production. Similar to IGF‐1, addition of adiponectin in INS‐1 (832/13) cells increased p‐Akt and p‐Erk expression and knocking down of APPL1 abolished the phosphorylation of Erk, but not Akt. These findings indicate a role of Akt activation in adiponectin‐enhanced GSIS in pancreatic beta‐cells.1, T. Satoh1, T. Tomaru1, A. Katano‐Toki1, K. Horiguchi1, S. Matsumoto1, Y. Nakajima1, S. Ishii1, A. Ozawa1, N. Shibusawa1, S. Okada1, M. Mori2 and M. Yamada1S. Yoshino1Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine2Metabolic and Obese Research InstituteObesity arises from impairment of energy homeostasis, which is centrally coordinated by leptin by activating the long form of leptin receptor (Leprb). We here show that mice fed a high‐fat diet (HD) and patients with hepatosteatosis exhibit upexpression of hepatic Helz2, which functions as a transcriptional coregulator for nuclear receptors including peroxisome proliferator‐activated receptorγ in vitro. To explore physiological importance of Helz2, we generated Helz2‐deficient mice and analyzed their metabolic phenotypes. Helz2‐deficient mice showing hyperleptinemia associated with central leptin resistance are protected against HD‐induced obesity and significantly upregulates hepatic Leprb expression.Z. He, R. Zhang, C. Hu and P. J. WeiDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University affiliated Sixth Poeple's HospitalP = 0.0304) but not in individuals with T2D . While meta‐analysis showed that miR‐29a was associated with NAFLD . In this study, we showed that miR‐29a was associated with NAFLD.The aim of this study was to examine the association of miR‐29 with NAFLD. Totally 276 individuals were enrolled in this study, including 67 individuals with both NAFLD and T2D, 73 individuals with NAFLD but no T2D, 68 individuals with T2D but no NAFLD and 68 controls. Logistic analysis was used to evaluate the association of miR‐29a‐c and NAFLD. It showed that miR‐191 was the most stably expressed reference miRNA. miR‐29a expression level was showed to be associated with NAFLD in individuals without T2D  mice with or without GIP (SKIP−/−/GIP−/−) were generated. In SKIP−/−, body weight and fat composition were gained; fatty liver was not induced; TG and T‐Cho levels were significantly decreased; pro‐inflammatory makers in liver were not increased; insulin, GIP and GLP‐1 secretion were promoted during OGTT. SKIP−/−/GIP−/− eliminated the phenotype of SKIP−/− except a decrease in TG and T‐Cho levels. In conclusion, depletion of SKIP induces metabolically healthy obesity by regulating insulin and incretin secretions and lipid metabolism.SKIP is expressed in pancreatic b‐cells and intestinal K‐ and L‐cells. We examine the role of SKIP in incretin secretion and metabolic changes under normal diet conditions. SKIP‐mCherry knock‐in  mice. The body weight changes of db mice were occurring in adulthood. The impairment of db mice thermogenesis has shown in neonatal period and adulthood. The hypothalamus feeding neuron gene expression in neonatal db mice showed similar to wild type of mice. Leptin receptor is fully functional for energy homeostasis and food intake regulation in adulhood. However, the feeding regulation of leptin signaling shows age‐dependent manner,in contrast to energy homeostasis regulation.W. Chen, G. Xu and Z. ShenInstitute for Cardiovascular Science of Soochow UniversityDiabetic cardiomyopathy is the leading cause contributing to morbidity and mortality in diabetic patients. We and others have demonstrated cardioprotection of follistatin‐like 1 (FSTL1) under excessive nitric oxide, myocardial infarction, and pressure overload. Here, we report that high glucose markedly elevates FSTL1 expression in H9c2 cells. Furthermore, FSTL1 treatment significantly attenuates hyperglycemia‐induced cardiac cell death. Our study provides novel insights into the therapeutic potential of FSTL1 in treatment of diabetic cardiomyopathy.M. Shahidul Islam, C. I. Chukwuma and R. MopuriDepartment of Biochemistry, University of KwaZulu‐Natal (Westville Campus)The study investigated the anti‐diabetic effects of erythritol and possible mechanisms at ex vivo and type 2 diabetic rats. Ex vivo results revealed that erythritol dose‐dependently enhanced muscle glucose uptake with or without insulin. Results from type 2 diabetic rats showed that erythritol delayed gastric emptying and reduced small intestinal glucose absorption as well as postprandial blood glucose rise, especially in diabetic animals. Additionally, erythritol improved glucose tolerance, insulin secretion, muscle/liver hexokinase and liver glucose‐6 phospahtase activities and muscle Glut‐4 and IRS‐1 mRNA expression in diabetic animals. Hence, erythritol may be a useful dietary supplement for managing hyperglycemia, particularly for T2D.1, J. T. Kim2, J. M. Mim1, K. H. Joung1, J. H. Lee1, K. S. Kim1, H. J. Kim1, M. Shong1 and B. J. Ku1H.‐S. Yi1Department of Internal Medicine, Chungnam National University School of Medicine2Department of Medical Science, Chungnam National University School of Medicine+ T cells from patients with prediabetes. This study suggests a causal link between T cell senescence and prediabetes in humans.Chronic inflammation is associated with metabolic diseases. However, functional characteristics of T cells in patients with prediabetes are not understood. Gene expression profiling of peripheral blood mononuclear cells from normal controls and drug‐naïve patients with diabetes was undertaken using microarray analysis. Gene annotation enrichment analysis showed that most of the upregulated genes in the diabetes group are implicated in T cell activation and the inflammatory response. Pro‐inflammatory cytokine and cytotoxic granule proteins were also highly expressed in senescent CD81, Y. Song1, Z.‐y. Zhao2 and Q.‐s. Hu2Z.‐c. Liu1The Diabetes Research Institute of The Shijiazhuang Second Hospital2The Shijiazhuang Second HospitalObjectiveTo investigate the relation between immune homeostasis and the development of diabetic symptoms in Type 1 diabetes model.MethodsOne group of C57 mice received combined antibiotics treatment for 4 weeks before STZ injection, and than were injected with STZ. Another group of mice received only STZ injection. T cells were test after 72 h when the whole STZ‐injection process was finished.ResultsThe cumulative diabetes incidence was significantly lower for the combined antibiotic group. The percentage of Treg cells and CD4 + T cells in mesenteric lymph nodes was higher than the control group.ConclusionThese results indicate that oral combined antibiotic influencd the diabetes incidence in STZ‐induced diabetes model.P. Gao and J. LiuDepartment of Endocrine, Shanghai No.6 Hospital Affiliated to Shanghai Jiaotong University, Shanghai, ChinaTGFβ1 is a well‐distinguished mediator of progressive renal fibrosis in diabetic nephropathy (DN). Herein, we reported that Apps was a critical upstream regulator of TGFβ1 expression in the early stage of DN. The increased expression of Apps was negatively correlated with TGFβ1 in AAV‐renal vein‐injected/STZ induced mice. However, the expression of Apps decreased in the late stage of DN, when the expression of TGFβ1 was highly upregulated and the renal fibrosis got worsen. Apps synergistically interacted with Nrf2 in a time‐ and dose‐dependent manner. After activation by Nrf2, Apps was recruited into the nuclear and bound to the promoter of TGFβ1. Our findings may provide novel clues for the treatment of DN in early stage.K. Yamamoto, H. Miyoshi, K. Y. Cho, A. Nakamura and T. AtsumiDivision of Rheumatology, Endocrinology and Nephrology at the Graduate School of Medicine, Hokkaido UniversityPerilipin 1 (PLIN1) is expressed in macrophages, presumambly playing a role in the development of atherosclerosis. We assessed the effect of PLIN1 overexpression. PLIN1 transgenic mice (Tg) were crossed with apolipoprotein E knockout mice (KO). C57BL/6J, KO and Tg/KO received a normal chow for 20 weeks. Aorta were collected at the end of the study for quantification of atheroma lesions and histology. Atherosclerotic lesions and M1 macrophage content increased in KO. PLIN1 in macrophages helps protect against atheroma progression via the change of macrophage polarity.1, K. Ohno1, H. Tokunaga1, K. Akesaka1, T. Ueda1, M. Tamaki1 and Y. Hara2O. Ebisui1Department of Diabetes and Endocrinology, Ehime Prefectural Central Hospital2Department of Diabetes, Ehime Prefectural Imabari HospitalPurposeWe evaluated the effects of exenatide on HbA1c for 6 and 24 months in type 2 diabetics in our hospital.Methods1. Subjects: 97 patients . 2. Before the administration of exenatide, HbA1c were evaluated every month for two years.ResultsThe mean age, and HbA1c were 57.5 ± 12.5 years, and 9.7 ± 1.4%, respectively. <After 6 months> (1) The mean HbA1c was 8.1 ± 1.5%. (2) A 1% or greater decrease in HbA1c was achieved in 60 (61.8%). <After 24 months> (1) The mean HbA1c was 8.42 ± 1.6%. (2) A 1% or greater decrease in HbA1c was achieved in 48 (49.5%).ConclusionBased on these results, exnatides significantly improved glycemic control in about half of type 2 diabetic patients for 6‐and 24‐month.1, D. Yabe2, Y. Hamamoto1, T. Kurose1 and Y. Seino1Y. Sakuramachi1Center for Diabetes, Endocrinology, and Metabolism, Kansai Electric Power Hospital, Kyoto, Japan2Department of diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, JapanP = 0.57; SUIT: 37.2 ± 10.5 vs. 38.4 ± 4.9, P = 0.92). ΔHbA1c of 54 weeks and CPI or SUIT index did not show significant correlation. In conclusion, HbA1c‐lowering effect of combination therapy of liraglutide and basal insulin when switched from intensive insulin therapy is suggested to be independent of remaining β‐cell function.Twenty‐four patients who changed from intensive insulin therapy to combination therapy of liraglutide and basal insulin were retrospectively analyzed to identify associations of C‐peptide index (CPI) and SUIT index with achievement of HbA1c < 7.0% at 54 week. When 6 patients achieved HbA1c target was compared with 18 patients did not, CPI and SUIT index were not significantly different  titrated with renal function level. In order to evaluate the efficacy and safety of alogliptin based on renal function in T2DM, we designed prospective observational study (eGFR study).Results2, body weight was 65.8 ± 13.8 kg, the dosage of alogliptin was 22.2 ± 5.7 mg.Study participants were all Japanese and 724 male and 373 female. Mean age was 63.5 ± 12.0 years, HbA1c was 7.6 ± 1.1%, fasting plasma glucose was 144.3 ± 35.0 mg/dl, eGFR was 74.8 ± 21.7 mL/min./1.73 mP < 0.01), fasting plasma glucose was 134.6 ± 38.3 mg/dl (ns), eGFR was 68.8 ± 20.1 mL/min./1.73 m2 (P < 0.01), and body weight was 62.5 ± 12.0 kg (P < 0.01).After 156 weeks follow up HbA1c was 7.1 ± 0.8%  was significantly higher in the evoglipitin group than placebo.ConclusionIn this 24‐weeks study, evoglipitin monotherapy significantly improved glycemic control and was well tolerated in patients with type 2 diabetes.1, Y. Hamamoto2, S. Honjo1, E. Okamura1, M. Abe1, J. Fujikawa3 and A. Hamasaki1Y. Wada1Center for Diabetes and Endocrinology, Tazuke Kofukai Foundation Medical Research Institute Kitano Hospital2Division of Nutrition and Metabolism, Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Hospital3Laboratory Medicine, Tazuke Kofukai Foundation Medical Research Institute Kitano HospitalBackgroundWe investigated to compare the effectiveness between teneligliptin and linagliptin in Japanese patients with CKD.Methods2, serum creatinine: 1.5 ± 0.7 mg/dl, HbA1c:7.5 ± 1.3%) who were administered 20 mg of teneligliptin  or 5 mg of linagliptin  switched from 50 mg of sitagliptin were retrospectively extracted. Only those who with eGFR less than 60 mL/min/1.73 m2 at baseline were selected.A total of 28 outpatients  is a severe adverse event induced by dipeptidyl peptidase‐4 (DPP‐4) inhibitors. Here we report BP in the elderly treated with the agent.Case presentationTwo men at the age of 86 and 81 and a woman at the age of 83 developed generalized pruritic skin blisters. Two men were treated with lingaliptin for 9 and 15 months, respectively; a woman with linagliptin for 15 months switching to sitagliptin for additional 10 months. BP was diagnosed histologically. Antibodies to BP180‐NC16A were detected in all the cases.ConclusionIt took longer time to develop BP in our cases. BP should be noted no matter if older people with type 2 diabetes are safely treated with DPP‐4 inhibitors over time.N. Yenseung, S. Jirarungsaritkul, S. Sarakom, Y. Thewjitcharoen, E. Wanothayaroj, S. Krittiyawong, S. Nakasatien and T. HimathongkamDiabetes and Thyroid Center, Theptarin HospitalBecause of its unique mechanism of action, the use of SGLT2 inhibitors in patient treated with DPP4i may provide synergistic effect. This retrospective study used data between Nov 2014 and Jun 2016. A total of 156 patients who continue to use at least 6 months (baseline A1C 8.8 ± 1.5%) were included in analysis. Among DPP4i‐treated patients, overall mean A1C reduction when compared with non DPP4i‐treated patients was 0.9 ± 1.3% and 0.4 ± 1.2%, respectively. The proportion of DPP4i‐treated patients achieving HbA1c <7% was only 27.3%. While the combination of the two drug classes are being increasingly incorporated into clinical practice, careful patients selection accompanied by appropriate realistic treatment goal counseling should be done.B. W. Lee, S. Kim, Y. Lee, E. Kang and B. ChaYonsei UniversityP < 0.001), as well as increase in spot urinary glucose concentration  and spot UGCR (urinary glucose creatinine ratio) . Change of HbA1c was positively correlated with that of spot UGCR . After multivariate adjustment, greater increase of UGCR were associated with delta HbA1c (after minus before HbA1c)  and eGFR CKD‐EPI .At baseline, subjects showed wide range of HbA1c (7.55% to 9.05%) levels. SGLT2i therapies showed a significant decrease in HbA1c . We divided 62 NASH cases  into two groups. By infusing Laennec®, serum ferritin level declined from 274.2 ± 310.4 ng/mL (before)to 58.3 ± 42.7 (after) (P < 0.01). Serum ALT and HbA1c level declined significantly. The improvement of type 2 diabetes complicating with NASH by Laennec® suggests the importance of iron regulation on type 2 diabetes which shows of hyperferritinemia.Recently it was elucidated that hepcidin can express in pancreatic βcells, which means that the pancreas could contribute to both glucose and iron metabolism. In type 2 diabetes complicating with NASH, remarkable declines of serum ferritin and HbA1c were observed after treating with Laennec1, S. Y. Rhee1, S. W. Han1, S. K. Cho1, S. Chon1, S. H. Kim2, K. J. Ahn1, S. H. Baik3, Y. Park4, M. S. Nam5, K. W. Lee6 and J. T. Woo1I. G. Ha1Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine2Division of Endocrinology and Metabolism, Department of Medicine, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University, Seoul, Korea3Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine,Korea University, Seoul, Korea4Department of Internal Medicine, College of Medicine, Hanyang University, Guri, Korea5Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea6Department of Endocrinology and Metabolism, College of Medicine, Ajou University, Suwon, KoreaThis study was designed to identify the clinical characteristics and determinants of metformin use in clinical practice in Korean T2DM patients by using the baseline data of prospective, multicenter clinical registry.Metformin users had significantly higher glycated hemoglobin, waist and hip circumference than non‐users. Lipid profile, creatinine, malignancy, depression and microvascular complication such as retinopathy, neuropathy, overt proteinuria were significantly lower in metformin users. But there was no difference in the prevalence of macrovascular complication.ConclusionThere were significant differences in clinical characteristics and prevalence of comorbidities according to the use of metformin in Korean T2DM patients.1 and Y. Omlor2M. Gushiken1Department of Global health, Ryukyu University School of Medicine2University of the Ryukyus Hospital, Okinawa, JapanThe aim of this study was to assess the effectiveness of CGM in self‐management of diabetes.P < 0.05).The Problem Areas in Diabetes (PAID) survey was conducted for twenty patients before and after the use of CGM. The student't‐test were used to analyze associartion between the PAID score and the eight factors:gender, academic backgrund, having job or not, diabetic type, duration of diabetes, treatment, diabetic complications, and educational history in diabetes. The total PAID score was 25.6 ± 16.2 before and 21.8 ± 14.9 after using CGM (n.s.). HbA1c (NGSP) was 8.2 ± 2.2 (%) before and 7.8 ± 1.4 (%) after (n.s.). PAID score showed a significant association with patients having jobs in reducing the emotional burden due to the treatment , diabetes support , happiness  and age . When divided by median age, multiple regression analysis showed that HbA1c , diabetes support  and perceived limitations  were significant independent predictors for happiness in the younger group. Intervention focusing on diabetes support and perceived limitation might be the next step to improve diabetes care.We investigated the impact of diabetes on happiness in an interdependent culture, Japan. We did a survey on 241 outpatients with diabetes using questionnaires and analyzed the data from 193 patients with type 2 diabetes. HbA1c had significant correlations with diabetes self‐care . They were categorized into five groups according to their goals in life: ‘to live a long life (group A)’, ‘to improve their health (B)’, ‘to enjoy their job or hobby (C)’, ‘to dedicate to others (D)’ and no comments (E).Patients who participated in Diabetes Educational Program (P < 0.05). Drug reduction rate in 12 months was significantly higher in C+D (P = 0.0353).HbA1c levels at 12 month were significantly lower in C+D than E  nurses’ implementation of assessment of diabetes oral health behavior tool in patients with diabetes and (2) their opinion on the items of DiOHAT©, and discuss how to help the patients carry out oral health behavior.MethodsSelf‐written questionnaire.ResultsResponse rate 48%;15 female nurses; mean age 46 yr. The average rate of implementation of all items was 44% and individual factors were perceptions 56%, status 49%, behavior 39%, and information 37%. The proportion counting the patient's total number of teeth was 40%.ConclusionThe implications of assessing oral self‐care and counting the number of teeth showed low rates. More research is needed to motivate nurses to carry out oral assessments.1, K. Hirayama1, T. Takenaka1, Y. Sakiyama1, R. Kushiro1, D. Kira1, A. Nakamura1, S. Sakai1, H. Kuramoto1 and Y. Takagi2Y. Kouchi1Diabetes Support Team, Orimoto Hospital2Nephrology, Orimoto HospitalIntroductionTreatment of diabetes mellitus is based on team approach. We describe the characteristics and efficacy of our DST.MethodsThe monthly numbers of patients with diabetes of changing in HbA1c were analyzed.ResultsP < 0.001).There were 96 outpatients/month . The mean HbA1c level of outpatients improved from 7.7 ± 1.8% to 6.7 ± 0.7% 4Institute for Medical Genetics, Tokyo Women's Medical UniversityHNF1A mutations are the cause of MODY3, in which because of the decreased expression levels of HNF4A and SGLT1/SGLT2, insulin secretion is disrupted and urinary glucose excretion is enhanced.A 22‐year old woman who had urine sugar pointed out by school medical examination at the age of 14 and had shown impaired glucose tolerance on 75 gOGTT at the age of 19. We found 6 nucleotides (GGGGTT) insertion mutation in the 5′UTR of HNF1A. CentridFold predicted it may form a new stem‐loop structure and IPknot revealed that this structural change may affect the translational efficiency and decrease protein expression of HNF1A. We observed a significant reduction in expression of the mutant allele compared to that in wild type in the reporter assay.J. P. P. PacairaSection of Endocrinology, Diabetes and Metabolism, University of the Philippines‐Philippine General HospitalA 34‐year‐old pregnant Filipino female presented with a giant phyllodes tumor (PT) of the right breast. She had persistent hypoglycemia episodes despite continuous glucose infusion and increased carbohydrate intake. Investigations pointed to a non‐islet cell tumor hypoglycemia (NICTH). Hypoglycemia improved with Dexamethasone therapy prior to right total mastectomy with split thickness skin grafting. Histopathology of the right breast confirmed a benign PT. Hypoglycemia did not recur after tumor removal. NICTH from PT is a rare cause of hypoglycemia. Treatment involves tumor removal after hypoglycemia is controlled. Glucocorticoids may be used to rapidly induce hyperglycemia via its insulin antagonistic effects prior to definitive therapy.S. Okada and M. YamadaDivision of Endocrinology and Diabetes Gunma University HospitalA 69‐year old male patient had been regularly visiting our hospital for the management of sigmoid colon cancer with multiple liver metastases. Because he developed postprandial hyperglycemia, we arranged the dosage of his insulin and added dapagliflozin. Immunohistochemistry study confirmed that sigmoid colon cancer cells express SGLT2. Because cancer cells became resistant against chemotherapies, monotherapy of Cetuximab was started. One month later, not only his CEA level reduced to 112.4 from 1104 (ng/mL) but also multiple metastatic tumor lesions were dramatically shrunken up according to the computed tomography examination. This patient suggests us the possibility of drug repositioning of SGLT2 inhibitors as a cancer treatment.A. J. SarmientoSection of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of the Philippines – Philippine General HospitalA 33‐year old male was admitted for obstructive jaundice secondary to pancreatic head mass, rule out malignancy. The patient was diagnosed with diabetes mellitus 3 years prior to this admission manifesting as anorexia and generalized weakness. Surgical plan for the patient was exploratory laparotomy, pancreatoduodenectomy. Intraoperative findings revealed multiple nodules on liver, pancreas and omentum. Frozen section was done on respective implants revealing chronic granulomatous inflammation with caseation necrosis and Langhans‐type giant cells, compatible with a tubeculous etiology. Quadruple anti‐ TB medications were started and patient improved.1, Y. Luo1, X. Ma1, X. Pan1, Y. Xu1, Q. Xiong1, Y. Xiao2 and W. Jia1Y. Bao1Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute; Shanghai Key Laboratory o2Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's HospitalSerum lipocalin 2 (LCN2) plays an important role in the regulation of the obesity‐associated dysmetabolic state and cardiovascular disease. We aimed to examined the associations of total body fat content and abdominal fat distribution with serum LCN2 levels in 1203 Chinese men aged 22–78 years from the Shanghai Obesity Study. Subjects with a high fat% had higher serum LCN2 levels than those with a normal fat%. A trend of increasing VFA was observed with increasing serum LCN2 levels. VFA was positively associated with serum LCN2 levels, independent of overall obesity and other confounding factors. Serum LCN2 levels were positively associated with not only total body fat but also visceral fat area in Chinese men.1, W. Hou1, X. Meng2, A. Zhao1, W. Zhao1 and J. Pan1F. Liu1Department of Endocrinology & Metabolism, Shanghai Jiao‐Tong University Affiliated Sixth Peoples Hospital2Department of Obstetrics and Gynecology, Shanghai Jiao‐Tong University Affiliated Sixth Peoples Hospitaln = 131)and control pregnant women (n = 138). The results demonstrated women with GDM had higher lithocholic acid (LCA) levels compared with healthy subjects. LCA was independently associated with GDM. In conclusion, LCA was an independent risk factor of GDM.The aim of the current study is to clarify serum bile acid metabolism alteration gestational diabetes mellitus (GDM). a targeted metabolomics study was performed to explore the changes in serum bile acid metabolism of GDM  to screen for T2DM in Asian Americans. The objective of is to confirm age and gender specific BMI CO in Japanese individuals using 5,370 participants.Results2 for men aged <45 with OR of 1.35, and BMI was not a risk factor aged ≥60 men. BMI CO for women were 19 kg/m2 with OR of 4.09 for those aged <45 and 20 kg/m2 with OR of 1.92 for those aged 45–59 years, and BMI was not a risk factor for women aged ≥60.The BMI CO for diabetes within 5 years was 23 kg/mConclusions2 was appropriate for Japanese men aged <45, whereas a lower BMI may be more suitable for women. BMI was not a risk factor for the development of diabetes in men or women aged ≥60.A BMI CO of 23 kg/mD. Yan, C. Hu and W. JiaDepartment of Endocrinology, Shanghai Jiao Tong University Affiliated Six People's HospitalAimsWe aimed to evaluate the association of osteocalcin with glucose metabolism.MethodsWe recruited 945 males and 4,259 postmenopausal females from Shanghai area. Associations between osteocalcin and glucose metabolism were evaluated.ResultsP = 5.2E‐06), insulin sensitivity and insulin secretion. In males, osteocalcin was correlated with HOMA‐β , GUTT‐ISI  and Stumvoll first‐phase insulin secretion index .In females, osteocalcin was associated with T2DM  and obese (≥30). Hedonic hunger was assessed by the Power of Food Scale. Good glycemic control (HbA1c <7) was independently associated with male gender, higher BMI, lower waist circumference, DM duration and hedonic drive in the obese group. The odds ratio for an independent association between lower hedonic hunger and good glycemic control was 0.388 (95% CI 0.186–0.810). In conclusion, hedonic hunger was negatively associated with good glycemic control in obese Chinese patients with T2DM.1, W. Zong2, C. Hu1, F. Yan3, X. Hou1, W. Wang3 and W. Jia1Y. Liu1Shanghai Diabetes Institute, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China2Health Research and Informatics Center of Zhabei district, Shanghai, China3Department of Social Medicine and Biostatistics, School of Public Health, Fudan University, Shanghai, ChinaTo assess the accuracy of various lipoprotein fractions and their ratios for detecting metabolic syndrome (MetS) among Chinese, we used the data of 10,640 participants aged 35–60 years old. The two‐stage, stratified sampling survey was conducted from 2009 to 2010. The area under the Receiver Operating Characteristic curve (AUC) and Youden Index were used. Triglyceride/HDL cholesterol (TG/HDL‐C) had the largest AUC of 0.86 (95% CI 0.85–0.87) and 0.82 (95% CI 0.81–0.83) by the criteria of the modified National Cholesterol Education Program's Adult Treatment Panel III and the International Diabetes Federation definition 2005 respectively. TG/HDL‐C was more accurate than other lipid measurements in primary risk screening of MetS among Chinese.