Innovative technologies of continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) contribute significantly to metabolic control and improve quality of life of diabetic patients. In this study, the attitudes of expert physicians regarding the value of innovative glucose self-monitoring technologies in Greece were investigated. Two Advisory Boards (AdB) were set up by Key Opinion Leaders-KOLs (from Academia, National Health System Hospitals and Private Sector): the first consisted of Internists/ Diabetologists (N = 12) and the second consisted of Endocrinologists/Pediatricians (N = 11). Participants were asked to complete a structured questionnaire developed by experts on health services research, in which answers were given through a five-point Likert scale. A common data analysis (taken into consideration both internists/ diabetologists and endocrinologists/pediatricians answers) was conducted using the SPSS.20v. The vast majority of participants (96%) recognized the importance of innovative self-monitoring technologies for the effective management of diabetes mellitus (DM) and was willing to use them in their clinical practice. In particular, 96% of physicians considered as quite/very important the Ambulatory Glucose Profile (AGP) report provided by the FGM technology. Moreover, participants reported that FGM technology contributes to reducing fluctuations in glucose levels (100%), increasing the time in range (TIR) and reducing the time in hypoglycemia (96% of participants). Additionally, the majority of physicians (87%) stated that FGM technology contributes to achieving savings by reducing complications.Thus, 84% of physicians considered FGM technology should be reimbursed for patients with DM2, in addition to patients with DM1.However, participants highlighted the need for further development and improvements of FGM technology (e.g measurement accuracy at off charts values). The vast majority of participants considered the FGM technology as of high value and consequently recommended its coverage by social security schemes for patients with DM.

Flash Glycose Monitoring (FGM) is an innovative technology for glucose control that helps patients to avoid hypoglycemias and remain within Time in Range. Currently, only patients with DM1 are covered for using FGM by the National Organization for the Provision of Healthcare (EOPYY). Thus, we evaluated the economic consequences of FGM reimbursement expansion:a) in DM2 patients subjected to intensive insulin (N≥3 injections daily) b) in all insulin-treated patients with DM2. A Budget Impact Analysis Model (BIAM) was used, with a time horizon of three years. Resource utilization included the cost of all non-durables in regards to self-glycose monitoring and the cost of management of severe and non-severe hypoglycemia events. Analyses were conducted from the EOPYY perspective, taking into consideration a novel reimbursement model of progressive volume based price deduction for sensor and zero price for reader (as it is provided free of charge). In the case of simultaneous coverage of FGM for both DM1 and DM2 patients, savings result from the very first year, increasing with the increase of the number of beneficiaries and peak during the third year. Specifically, savings reach the amount of a) € 1.9 million in the case of coverage of intensive insulin DM1 and DM2 patients and b) € 0.78 million in the case of coverage of all patients under insulin. The cumulative savings over three years amount to € 3.266 million for case (a) and € 1.3 million for case (b). Given the reduction of severe and non-severe hypoglycemia events for patients using the FGM technology, when compared with the SMBG (based on the relevant literature), and consequently, the cost savings achieved for EOPYY, the FGM technology is considered as of high value and, thus, the expansion of reimbursement coverage to DM2 patients is recommended.

Introduction: Medications currently taken by patients with NAFLD target concomitant metabolic diseases such as hypertension, dyslipidemia and diabetes. Aim: The aim of the study was to examine the effectiveness of lixisenatide and dapagliflozin in NAFLD patients with type 2 diabetes mellitus (T2DM) compared with sitagliptin and pioglitazone. Methods: T2DM patients with NAFLD (n=306) were included in the study. Patients were divided in 4 groups according to their treatment with lixisenatide (n=62), dapagliflozin (n=85), pioglitazone (n=67) and sitagliptin (n=92). All patients also received metformin. Mean follow-up period was 76 weeks ± 2 weeks. The evaluation of liver fibrosis depended on calculation of aspartase aminotransferase (AST) to platelet counts ratio (APRI) index. All patients went through an ultrasonography before being included in the study and after the end of the study. Results: There were no differences between groups in patient age (p=0.256), duration of T2DM (p=0.283), Body Mass Index (BMI) (p=0.337) and HbA1c (p=0.156). There was a greater improvement of APRI index for the lixisenatide group (1.07 (0.46-1.23) vs. 0.74 (0.38-0.90) p<0.001) compared to dapagliflozin (1.12 (0.59-1.22) vs. 0.83 (0.32-1.01) p=0.010) to pioglitazone (1.10 (0.49-1.27) vs. 0.90 (0.41-1.04), p=0.014), and sitagliptin (1.01 (0.39-1.14) vs. 0.99 (0.38-1.15) vs. 0.98 (0.36-1.14) p=0.366). APRI index’s improvement was accompanied by a significant change of fatty liver in ultrasonography. The decrease of body weight in the lixisenatide (p<0.001) and in the dapagliflozin group (p=0.028) was statistically significant. Conclusions: Administration of lixisenatide and dapagliflozin led not only to good control of T2DM but also improvement of liver inflammation, alteration of liver fibrosis, and reduction of body weight, which are particularly important factors in patients with T2DM. Disclosure A. Koutsovasilis: None. A. Sotiropoulos: None. M. Pappa: None. D. Papadaki: None. V. Kordinas: None. C. Tamvakos: None. M. Bourikou: None. S. Bousboulas: None. T. Peppas: None.

The aim of this study was to examine (1) suicide trends by most prevalent methods in Queensland, Australia, during 2000–2015, and (2) characteristics of people by choice of suicide method in 2000–2013. Data were obtained from the Queensland Suicide Register, which includes police and toxicology reports, post-mortem autopsy and Coroner's findings. Poisson and Joinpoint regression were used to study the first aim, and uni-variate and multi-variate logistic regression analyses were applied to investigate the second aim. Suicide method trends showed a significant increase in hanging for both sexes and poisoning with drugs for females, while there was a decline for poisoning by other means for both sexes, and ‘other methods’ decreased for males. Changes in the trends have altered the order of suicide methods, especially in males. Analyses of 8140 suicides were composed by the choice of method, distinguishable profiles by their demographic, clinical and social characteristics, such as having mental or physical illness or different recent life stressors were identified. This suggests that socio-cultural acceptability, and availability are the key drivers in the choice of suicide methods. Continuing increases in hanging is a big challenge in suicide prevention due to its lethality, easy realisation and its increasing acceptability.

Microvascular complications are common in patients with type 2 diabetes mellitus. According to the results of recent studies (ADVANCE, VADT, ACCORD), achievement of glycemic control and blood pressure targets have only minor impact on microvascular complications. In 2005, the FIELD study showed that fenofibrate reduces the need for laser treatment of retinopathy and slows the progress of renal dysfunction. Furthermore, the FIELD eye sub-study concluded that fenofibrate reduces the risk of retinopathy and its progression. A later analysis of the FIELD study concluded that fenofibrate also reduces the risk of non-traumatic amputation in patients with diabetes. The ACCORD study produced similar results, showing that fenofibrate use significantly reduced the progression of retinopathy and albuminuria, independently of its effect on lipids. The results of these studies confirm the important role of fenofibrate in the prevention of significant microvascular diabetic complications.

Objectives: Acute Ischemic stroke (AIS) consists an intense social and economic problem since it is responsible for 50% of neurological problems and is implicated in 4,5 million deaths per year worldwide. The aim of the study was the investigation of factors determing the short-term outcome of AIS and possible differences among diabetic and non-diabetic patients.

Several instruments have been developed for the assessment of emotional distress in patients with diabetes. The Problem Areas in Diabetes Scale (PAID) is a brief self-report scale that evaluates diabetes-related distress. There is a lack of validated instruments for the evaluation of psychological aspects in patients with diabetes in Greek language. The current study was conducted to translate and adapt the PAID scale in Greek language and to evaluate the psychometric properties in two different study populations of patients with diabetes. The aim of this study was to translate the Problem Areas in Diabetes (PAID) scale into Greek, adapt it culturally to Greece and determine its psychometric properties. The translation process included two forward translations, reconciliation, backward translation and pre-testing steps. The validation incorporated the exploration of internal consistency (Cronbach's alpha), test-retest reliability (interclass correlation coefficient), construct validity (exploratory factor analysis) and responsiveness (Spearman correlation coefficient). Participants included 101 consecutive patients from a rural primary healthcare centre and 101 patients from an urban hospital. All patients completed the PAID scale and the Short Form-36 (SF-36) version 2. Internal consistency considered good (Cronbach's alpha = 0.948). Interclass correlation coefficient was 0.942 (95% CI 0.915-0.961). Factor analysis yielded three factors: 'Diabetes-related emotional problems' (51.79% variance, Cronbach's alpha = 0.910), 'Food-related problems' (9.55% variance, Cronbach's alpha = 0.824) and 'Social support-related problems' (5.96% variance, Cronbach's alpha = 0.704). Screen plot test and conceptual congruency of items supported a three-factor solution. Total PAID showed a negative correlation with both SF-36 mental component summary (r = -0.733, P < 0.0001) and SF-36 physical component summary (r = -0.594, P < 0.0001). Our findings indicate that the Greek version of the PAID questionnaire is reliable and valid for patients with diabetes mellitus in Greece.