Introduction & Purpose: Statin treatment is an integral part of cardiovascular prevention. Recent studies have highlighted their potential diabetogenic action, mostly in a dose-dependent mode. Pitavastatin has studies showing that this statin may not follow the above rule. The present retrospective study highlights the metabolic effects of initiating pitavastatin vs. rosuvastatin therapy in diabetic and nondiabetic statin-naive patients. Materials & Methods: A total of 74 hyperlipidemic patients included: 41 with DM, mean age 62.4 years (23 on Pitavastatin + 18 on Rosuvastatin)33 non-DM, mean age 62.2 years (15 on Pitavastatin + 18 on Rosuvastatin)Biochemical data were extracted from the medical records of the participants after consent. Results: For the group of patients with DM, we found that those on Pitavastatin showed statistically significant difference in increasing HDL and decreasing total cholesterol, LDL, triglycerides and γGT. Those on Rosuvastatin showed decrease in total cholesterol, LDL, triglycerides without HDL increase. For the group of patients without DM, we found that mean fasting blood glucose was 97.2mg/dl before Rosuvastatin initiation and 104.1mg/dL after 1 year. A statistically significant difference was recorded also in reducing total cholesterol and LDL and increasing γGT. Accordingly, blood glucose was 102 before Pitavastatin initiation and 95.6mg/dL after 1 year. A statistically significant difference was recorded in HDL increase and total cholesterol, LDL, triglycerides, γGT and ALT decrease. Conclusion: In accordance to prospective studies, this retrospective short term “real world” study highlights the rosuvastatin-induced carbohydrate metabolism disorder and the favorable effects of pitavastatin in glucose metabolism and biochemical liver markers, as well as the beneficial effect on lipid profile, regardless the presence of DM. Disclosure D. Lygnos: None. A. Papazafiropoulou: None. S. Soteriades: None. N. D. Loxas: None. M. Xenou: None. I. Zoupas: None. E. Fousteris: None.

Background Latent autoimmune diabetes in adults is an infrequent form of autoimmune diabetes mellitus, while Hashimoto’s thyroiditis, the most common thyroid disease in adults, rarely manifests as thyrotoxicosis. The concurrent initial presentation of these two autoimmune disorders is extremely rare. Case presentation A 29-year-old male of Albanian descent presented after being hospitalized owing to diabetic ketoacidosis. The diagnosis of type 1 diabetes mellitus was placed, and intensified insulin therapy was initiated. Medical history was not of significance except a 5 kg weight loss within 2 months. The patient presented with recurrent episodes of hypoglycemia, and the doses of preprandial and basal insulin were reduced. The differential diagnosis included type 1 diabetes mellitus “honeymoon” period or another type of diabetes mellitus. His serological tests only revealed positive autoantibodies against glutamic acid decarboxylase 65 and C-peptide. The diagnosis leaned toward latent autoimmune diabetes in adults, and the therapeutic approach involved cessation of preprandial insulin therapy, regulation, and subsequent discontinuation of basal insulin and introduction of metformin. Two years later, basal insulin was reintroduced along with a glucagon-like peptide-receptor agonist and metformin. Further physical examination during the initial visit disclosed upper limb tremor, lid lag, excessive sweating, increased sensitivity to heat, and tachycardia. Laboratory tests were indicative of hashitoxicosis (suppressed level of thyroid-stimulating hormone, high levels of total and free thyroid hormones, positive anti-thyroglobulin and anti-thyroid peroxidase, and negative anti-thyroid-stimulating hormone receptor). Thyroid-stimulating hormone level was spontaneously restored, but an increase was observed during follow-up. Levothyroxine was administrated for 2 years until the patient had normal thyroid function. Conclusions The prevalence of thyroid autoantibodies in patients with latent autoimmune diabetes in adults ranges from 20% to 30%. This correlation can be attributed to genetic involvement as well as disorders of immune tolerance to autoantigens. Hence, this report gives prominence to the holistic approach and consideration of comorbidities in patients with diabetes mellitus.

Objective: Assessment of the nephro-metabolic effects of GLP-1 agonists (Group A), SGLT-2 inhibitors (Group B) and both (Group C) in obese patients under metformin therapy with inadequate glycemic control. Materials and Methods: 253 patients with T2DM on metformin with a HbA1c > 7.0%. Results: Group A: reduction of HbA1c at 5.9±0.4% (95% C.I. of difference 1.63-3.03, p<0.001), reduction in body weight 7.1±5.5Kg (95% C.I. 4.98-9.26, p<0.001), ALT (mg/dL) reduced by 8.7±3.1, (p=0.04), reduction of Urine Albumin to Creatinine Ratio (UACR) by 25.0±40.8 (p=0.003) and increase of the estimated GFR (CKD-EPI formula) by 10.4±10.6, (p<0.001). Group B: reduction of HbA1c at 6.26±0.42% (95% C.I. of difference 0,59- 1.04 (p<0.001), reduction in body weight by 3.9±2.2Kg (95% C.I. 2.93-4.89 p<0.001), ALT reduced by -9.6±17.3 (p=0.02), UACR reduction by 36.2±70.2 (p=0.025) and eGFR increase 4.2±14.0 mL/mgCreat (p=0.18). Group C: major reduction of HbA1c by 1.9±1.0% (95% C.I. 1.10-2.09, p<0.001), body weight reduction by 10.6±5.7Kg 995% C.I. 7.97-13.28 p<0.0010, ALT reduction by -15.9±14.8 (p=0.04), UACR reduction by -29.9±31.9 (p<0.001) and eGFR increase by 8.3±10.5 (p=0.002). Conclusions: Triple combination therapy with metformin - GLP1-analog - SGLT2-inhibitor has the greatest effectiveness in weight loss and in improving liver biochemistry. The renal improvement seen with these drugs appears to be driven by a decrease in UACR for SGLT-2-inhibitors and an increase in eGFR for GLP1-analogues in this retrospective 24-month study. Disclosure I. Zoupas: None. A. Papazafiropoulou: None. M. Xenou: None. D. Lygnos: None. E. Fousteris: None.