European Geriatric Medicine - Supplement 1 - Volume 7 - October 2016

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appeared an association between more hospital re-admissions and the
highest degree of fluid thickening being recommended. Improving
discharge documentation of swallowing problems and recommenda-
tions may reduce some hospital re-admissions. For those with greater
swallowing impairments, it could be a prompt to prognostication and
anticipatory care planning.
P-183
Random non-fasting C-peptide can be used as a risk assessment
tool for hypoglycaemia in insulin-treated patients with type 2
diabetes
S.V. Hope1,2, B.A. Knight2, B.M. Shields2, A. Hill2, P. Choudhary3,
W.D. Strain 1,4, A.T. Hattersley1,5, T.J. McDonald1,6, A.G. Jones1,5.
1Department of Healthcare for Older People, Royal Devon & Exeter
Hospital, 2NIHR Exeter Clinical Research Facility, University of Exeter
Medical School, Exeter, 3King’ s College London, London, 4Diabetes &
Vascular Research Centre, University of Exeter Medical School,
5Department of Endocrinology, Royal Devon & Exeter Hospital,
6Department of Biochemistry, Royal Devon & Exeter Hospital, Exeter, UK
Background: Choosing appropriate HbA1c targets in elderly patients
with diabetes can be tricky. Hypoglycaemia is a major limiting factor
in achieving good control. Endogenous insulin levels correlate with
hypoglycaemia in type 1; C-peptide <200 pmol/L represents severe
insulin deficiency and markedly increased hypoglycaemia risk. We
assessed if patients with insulin-treated type 2 diabetes but severe
insulin deficiency experienced more hypoglycaemia than those with
higher levels of endogenous insulin.
Methods: 256 patients with insulin-treated type 2 diabetes answered
Clarke ’s hypoglycaemia questionnaire. 17 with random non-fasting
C-peptide (rCP) <200 pmol/L were matched 1:1 (by HbA1c, gender,
age, diabetes duration and BMI) with 17 patients with rCP > 500 pmol/
L, and underwent 4 days ’ continuous glucose monitoring (CGM).
Results: 35/256 (13.7%) patients with insulin-treated type 2 diabetes
had rCP < 200 pmol/L. They self-reported a median of 4 (interquartile
range 2–4) episodes/month with blood glucose <3.5 mmol/mol.
Those with rCP > 200 pmol/L self-reported 2(0–2) episodes/month,
p = 0.0006. HbA1c levels were 68(59–83) vs 64(56–73) mmol/mol
respectively, p = 0.07.
The CGM groups were matched for HbA1c (72 vs 72 mmol/mol,
p = 0.88). Average glucose levels on CGM were also similar: 10.2 vs
9.9 mmol/L, p = 0.50. Glucose variability (measured by standard
deviation of glucose measurements) was greater in the <200 pmol/L
group: 4.15 vs 3.01 mmol/L, p = 0.0005. There were also more
hypoglycaemia episodes (>20 mins <4 mmol/L): 5.3(1.7– 7.7) vs 0(0–
2.3) episodes/person/week, p = 0.003.
Conclusion: 13.7% patients with insulin-treated type 2 diabetes had
severe insulin deficiency. Despite similar HbA1c levels, self-reported
hypoglycaemia frequency – and objective hypoglycaemia and gly-
caemic variability measured by CGM – was higher in these patients.
Random non-fasting C-peptide levels may prove a useful biomarker in
identifying insulin-treated patients with type 2 diabetes at high risk of
hypoglycaemia, and hence in helping choose appropriate glycaemic
targets.
P-184
Anaemia in elderly patients
J. Jakimovska1, L. Jordanovski1, L. Neloska 1. 1 PHI Gerontology Institute 13
November, Skopje, Republic of Macedonia
Objectives: Anaemia is the most common hematologic condition of
geriatric population. We can divide anaemia in elderly patients in 3
main groups: anaemia caused by lack of nutrients, anaemia in chronic
disease and unexplained anaemia.
Methods: We design retrospectively study that shows the presence of
anaemia in patients hospitalized in PHI Gerontology Institute 13
Novemberfor a period of one year.
Results: In geriatric patients for each value of haemoglobin below
120 g/L we can diagnose anaemia. In 2015 593 patients were
hospitalized in PHI Gerontology Institute. 533 of them were elderly
patients (age 65 years or above) with average age 78.8 years. Anaemia
was diagnosed in 183 patients. By types of anaemia 148 patients has
anaemia caused by nutritional deficiencies. Most of them has iron
deficiency 93% and 7% has vitamin B12 and folic acid deficiency. 35
patients have anaemia in chronic diseases. From them 31.4% of the
patients hadmalignant disease, secondaryanaemia caused by bleeding
orafter surgeryhad51.4%of the patients,11.4%of the patientswerewith
chronic diseases that causes reduced value of erythropoietin or had
liver damage. 19 patients have severe anaemia with value of
haemoglobin under 70 g/L and were treated with blood transfusion
and others were treated with the appropriate cause of anaemia.
Conclusion: Anaemia was present in 34% of the patients. The most
common form of anaemia was nutritional iron deficiency. Anaemia in
geriatric population is a risk factor for increased mortality and
morbidity, which also reduces the quality of life.
P-185
Co-existence of recurrent inguinal hernia and cardiac valve
regurgitation in the Greek elderly men
P. Kiryttopoulos1, M. Charalampidis2, A. Agorastos3, P. Dimitriadis 1,
Z. Migkos1, A. Kalombatsios1, N. Platoyannes1. 1Veria′s Unit, General
Hospital Of Imathia, 2Theagenio Hospital Of Thessaloniki, Thessaloniki,
Greece; 3St. Thomas Hospital, London, UK
Objectives: It is widely accepted that collagen disorders cause a variety
of anatomical and clinical manifestations, such as polycystic disease
of kidneys or Alport’s syndrome. Our goal was to reflect upon the
combination of the recurrent inguinal hernia with the existence of
aortic (AoV) and mitral (MV) valve regurgitation, in Greek elderly men.
Methods: We have studied two groups of men (aged 75– 93 years old).
Group A comprised 43 men with no history of groin hernia, whereas
group B consisted of 45 menwith recurrent groin hernia. All menwere
submitted to cardiac echo in order to determinewhether aortic or/and
mitral regurgitation existed. We ruled out all men who suffered from
rheumatic fever, coronary artery disease and connective tissue
diseases. However, all men included in our study were treated for
hypertension.
Results: In group A only 8 men appeared with AoV or/and MV
regurgitation, when in group B, 37 men had either one or both of their
cardiac valves impaired. Hence, statistical difference between the two
groups was very important (p < 0.001).
Conclusion: It is possible that different types of procollagen andMMP-
1 and MMP-13 may be the reason of detective fibroblast quality,
leading to clinical problems after a certain age. The co-existence of
recurrent groin hernia and cardiac valve regurgitation in elder men
demonstrates that time can be a determining factor for the appearance
of clinical problems such a collagen disorder. Consequently, this may
lead us to assume that prompt genetic therapies might constitute a
possible option in the future.
P-186
Causes of anaemia in the Greek elderly
P. Kiryttopoulos1, M. Charalampidis2, A. Agorastos3, P. Dimitriadis 1,
Z. Migkos1, A. Kalombatsios1, T. Michailidis1. 1Veria′s Unit, General
Hospital Of Imathia, Veria, 2Theagenio Hospital Of Thessaloniki,
Thessaloniki, Greece; 3St. Thomas Hospital, London, UK
Objectives: Anaemia is one of the most common clinical problems on
the planet. Our goal was to determine the frequency of its causes in
Greek men and women above the age of 70.
Methods: We have studied two different groups of anaemic patients.
In group A we determined the causes of anaemia of 100 men of
minimum 70 years of age, and in group B we did the same for 100
coeval women. When a patient suffered from 2 or 3 different types of
anaemia, we have counted each type individually.
Results: The processing of our results reveals a certain difference of
the Greek elderly when compaired to the world population due to the
high prevalence of heterozygous thalassaemia in our country. Another
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S77