Day :
Keynote Forum
Muhammad Abul Hasanat
Bangabandhu Sheikh Mujib Medical University, Bangladesh
Keynote: Thyroid autoimmunity in the background of universal salt iodization
Biography:
Muhammad Abul Hasanat has completed his MPhil and MD in Endocrinology from Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh in 1990 and 1997 respectively. He is currently working as a Professor and Chairman in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. He has more than 40 original articles published in national and international journals. His major research areas are diabetes (including GDM), PCOS and infertility, thyroid diseases and other endocrine problems. He is also working as Editor (American Research Journal of Endocrinology and International Journal of Diabetes) and Assoc. Editor (Obesity and Diabetes International) of different open access journals.
Abstract:
Autoimmune and iodine nutrition related problems are widely analyzed under various global programs. However, the link between these two issues is not yet clear. It is assumed on the basis of implementation of universal salt iodization (USI) that iodine deficiency disorders (IDD) has been improved. Frequency of antibodies was found increased after salt iodization program in Japanese children living in the sea-shore areas where sea-weeds rich in iodine content are the principal food of them. Few studies on animal model also revealed triggering of autoimmunity in thyroid by excess iodine intake. We have observed and apprehended some degree of relationship between thyroid autoimmunity and USI. During the last two decades, we have investigated antithyroid antibodies and urinary iodine level in various subgroups of subjects including pregnant and lactating mothers in the interface of ongoing USI. National survey in Bangladesh in 1993 found >69% of the population to be sufficient with iodine nutrition and found further improvement by the 1999-national survey. Among the limited studies on thyroid autoimmunity, Hasanat et al. observed an increased frequency of antithyroid antibodies in thyroid patients (27-34%) as well as controls (7-13%) in the face of normal or increased UI indicating a possibility of some link between iodization and autoimmunity. In this context, we have followed a higher frequency of positive antibodies in nodular goiter (43%), hypothyroid patients (81%), subclinical hypothyroidism (50%) and even in pregnancy (18%). On the other hand, investigations on UI revealed variable results – sufficient in diffuse and multi-nodular goiter as well as subclinical hypothyroidism and breast feeding mothers; but deficient in about 50% Grave’s disease, in pregnancy as well as in school going children judged in light of urinary cut-off values for IDD. It is concluded that thyroid autoimmunity might have been altered by the intervention of USI program.
- Endocrinology and Diabetes | Challenges of Endocrinology and Diabetes| Diabetic Disorders and Treatment | Current Advancement in Endocrinology
Chair
Weiqin Chen
Augusta Univeristy, USA
Session Introduction
Weiqin Chen
Augusta University, USA
Title: Metabolic complications in an animal model of congenital generalized lipodystrophy type 2
Biography:
Weiqin Chen studied the role of dyslipidemia on Diabetic Retinopathy, a microvascular complication in diabetic patients with Dr. Julia Busik at Michigan State University and received her PhD degree in Molecular Genetics in 2005. Subsequently, she worked as a Post-doctoral associate for five years with Dr. Lawrence Chan at Baylor College of Medicine, where she was promoted as an Instructor in 2010. At BCM, she established two animal models based on genes that are associated with non-alcoholic fatty liver disease (NALFD) and human congenital generalized lipodystrophy (CGL) and characterized their functions in energy metabolism. In 2012, she was recruited as an Assistant Professor in the Department of Physiology at Georgia Regents University. The focus of her current research is to dissect the mechanisms underlying adipose tissue dysfunction and development of obesity and lipodystrophy using both in vivo and in vitro strategies.
Abstract:
Mutations in BSCL2 gene underlie human Congenital Generalized Lipodystrophy type 2 (CGL2) diseases. CGL2 is an autosomal recessive disorder characterized by a near total absence of body fat from birth or infancy associated with earlier diabetes onset and debilitating metabolic complications. We recently inactivated Bscl2 in mice to examine the mechanisms whereby absence of BSCL2 leads to adipose tissue loss and metabolic disorders. Bscl2−/− mice recapitulate many of the major metabolic manifestations in CGL2 individuals, including lipodystrophy, organomegly, hepatic steatosis and insulin resistance. Lipodystrophy has been attributed to unbridle cyclic AMP-dependent protein kinase A-activated lipolysis which inhibits terminal adipocyte differentiation in Bscl2-/- mice. However, the development of metabolic complications in CGL2 has been less characterized. We found Bscl2-/- mice exhibit a fasting-dependent insulin signaling in liver and muscle. They are hyperphagic, and rely exclusively on glucose as the main energy source. They display improved glucose homeostasis and insulin response under hyperinsulinemic-euglucemic clamp after overnight fast. The oxidative soleus muscle, but not gastrocnemius muscle, exhibits elevated glucose uptake rate in Bscl2-/- mice. Unexpectedly, different from other lipodystrophic animals, Bscl2-/- mice display reduced triglyceride contents in both soleus and gastrocnemius muscles; while significant elevation of glycogen levels was only observed in the oxidative soleus muscle but not in gastrocnemius muscle of Bscl2-/- mice. More importantly, lipid pre-infusion in Bscl2-/- mice mitigates glucose uptake in soleus muscle under hyperinsulinemic-euglucemic clamp, suggesting extreme lower NEFA after prolonged fasting could sensitize muscle insulin sensitivity in lipodystrophic Bscl2-/- mice. Moreover, Bscl2-/- mice also develop cardiac hypertrophy accompanied with cardiac dysfunction. These data provide a systemic view of metabolic disorders in lipodystrophic Bscl2-/- mice, which have important clinical implications in treating patients with CGL2.
Jose Mario Franco de Oliveira
Universidade Federal Fluminense, Brazil
Title: “The times they are-a-changinâ€: High intelligence diabetes treatment
Biography:
Jose Mario F De Oliveira is an Associate Professor of Medicine in the Department of Medicine at the Universidade Federal Fluminense, in the State of Rio de Janeiro, Brazil. He is also one of the Deputy Editors for Diabetes of the British Medical Journal. He has published a number of papers and has served as a reviewer and has author for many prestigious medical journals like Hypertension, American Journal of Hypertension, Journal of the American Society of Nephrology, British Medical Journal and New England Journal of Medicine. His main interests are in the clinical research of Diabetes and Hypertension. He is a Certified Preventive Cardiologist, Nephrologist, and Adult Intensive Care Unit Physician. He was a Post-doctoral Clinical and Research Fellow at the Endocrinology-Hypertension-Diabetes division at Harvard Medical School, in Boston, USA.
Abstract:
Since this masterpiece of Bob Dylan created in 1964, when diabetic end-organ failures like visual blindness and neuropathy were much more common than today, the traditional therapeutic viewpoints have been the rule rather than the exception. The published results of the UKPDS the reduction of HbA1c levels has been the universal, and even more than that, ubiquitous paradigm in clinical guidelines, in older times for macrovascular diabetic complications and in the more recent times for microvascular diabetic complications. This overconfidence in the reliability of “safe” HbA1c levels, unfortunately, has increased over the last decades the frequency of severe hypoglycemic episodes, a high speed delivery into the market of unsafe new anti-diabetic drugs, forgetting about the endpoints that mostly matter to the diabetic patient survival and quality of life based on each day shorter and biased clinical trials. The purposes of this talk will be to explain for the audience; the concepts of a soft, a hard, and a surrogate outcome in the clinical spectrum of diabetes; and the relevance of highly intelligent strategies for diabetes therapeutics.
Jenesh Singh Shrestha
B.P Koirala Institute of Health Sciences, Nepal
Title: A study of treatment compliance in regular follow up, routine investigation and complication screening among diabetic patients presenting in BPKIHS, Dharan
Biography:
Jenesh Shrestha has completed his MBBS from B P Koirala Institute of Health Sciences, Dharan, Nepal. His articles are based on different types of cancers, endocrinological diseases, gastrointestinal diseases, economy associated with health problems, etc., has been reviewed by the few renowned journals of South Asia and the United States. He is currently a Member of Nepal Medical Association, American Medical Association and Nepal Medical Council. He is also an active member of Physician for Social Responsibility Nepal. He is an ECFMG Certified Doctor in US.
Abstract:
Background: Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy because of the number of complications with which it is associated.
Objective: To find the association between treatment compliance (adherence in regular follow up, routine investigations and complication screening) and other related variables.
Method & Materials: One hundred and twenty consecutive out-patients of internal medicine BPKIHS for follow up of diabetes who are diagnosed as diabetic for at least 1 year. Face to face interview was taken to fill the semi-structured questionnaire which included patients detail and information regarding regular follow up, routine investigations and complication screening.
Results: Out of 120 respondents, most were of age group more than 60 years with female preponderance 76 (63.3%).60 (50%) respondents were compliant for follow up and reasons of missing the appointment were 21 (35%) reported due to poor accessibility, 19 (31.6%) reported lack of time, 15 (25%) reported being unable to come by oneself (geriatric patients), 4 (6.7%) reported financial problem and 1 (1.7%) reported ignorance about follow-up.71 (64.5%) had some complications which are 47 (42.7%) had hyperlipidemia, 11 (10%) had diabetic retinopathy, 9 (8.1%) had nephropathy, 4 (3.6%) had neuropathy, 6 (5.4%) had cataract and 3 (2.7%) had glaucoma.
Conclusion: We found that the compliance in the routine investigation (i.e.90.0%) and screening of the complication (i.e. 91.8%) was much better than that in follow-up (i.e. 50.0%).
Rajiv Kumar Jaiswal
Esani Diabetes and Mutlispeciality Research Centre, India
Title: ‘Yoga’- An asset to diabetes management
Biography:
Rajiv Kumar Jaiswal has completed his Post-graduation in Internal Medicine from St. Petersburg State Medical Academy and then to pursue Pain Management, he had completed his Post Graduation Diploma in Anesthesiology. He is working as a HOD for pain clinic in Esani Diabetes and Multispecialty Research Centre in India. He has published more than 11 papers in reputed journals.
Abstract:
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia due to defects in secretion of insulin, action of insulin, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the heart, kidneys, eyes, nerves, and blood vessels. In India, there is rampant increase in the incidence and prevalence of type 2 diabetes mellitus. Kutty BM, Raju TR et.al. (2010) have shown that nearly 30 million people are suffering from diabetes and this figure is expected to increase to 60 million by 2017. In 2011, at united nation general assembly there was discussion on control and prevention of non-communicable disease, because it has been shown that the incidence of death due to non-communicable disease (like cancer, cardiovascular disease, diabetes) is far greater than communicable disease. Yoga-based programs should be low-cost intervention strategy to improve physical and psychological well-being. Yoga provides slow rhythmic movements; by easy extensions and bending without over-stimulate muscles which can results in stimulation of the organs and glands. Yoga could be also useful in patient suffering from insulin resistance syndrome. The insulin resistance syndrome or metabolic syndrome is a characterized by hyperglycemia, obesity (central), hypertension and dyslipidemia. Patient with metabolic syndrome have insulin resistance due to i) cardiovascular reactivity enhancement ii) decreased parasympathetic tone and iii) Increased sympathetic activity. Major recent advanced researches have shown that chronic stress (psychological) and negative affective states are the contributing factors towards the pathogenesis and progression of insulin resistance, intolerance of glucose, hypertension, and other IRS-related conditions. Diabetes poses a biggest challenge to health system for coming up with newer modalities of treatment. Hence, it is necessary to look at adjuncts to effective management of diabetes; adjuncts which are not resource intensive and are nearer to the community that people live in. Yoga holds promise as a therapeutic intervention and health promotion measure. This brief communication explores the studies done to date on the beneficial effects of Yoga on Diabetes.
Marwa Sayed Abdel Latief Eassa
Cairo University School of Medicine, Egypt
Title: Diagnostic value of sonography, FNAC and genetic alteration in diagnosis of malignant thyroid nodules
Biography:
Marwa Sayed Abdel Latief Eassa graduated from Cairo University in 2005 with an excellent degree. She finished her BCS degree in Internal Medicine in Cairo University in 2010, and her thesis was insulin resistance as predictor for response to interferone based therapy in HCV infected patients. Currently, she is a MD candidate, and finished her MD thesis. She is working as Teaching Assistant in Internal Medicine Department, and in Endocrine Out Patient Clinic and Department in Kasralainy Hospital, Cairo University. She is a member of primary aldosteronism group undersupervision of Pro. Dr. Mona Mansour.
Abstract:
Background: Thyroid nodule is common, malignancies found in ≈ 9-15% of the nodules evaluated with FNAB (1). High resolution US and FNAB are the most important steps in diagnostic workup of thyroid nodule. 20–40% of FNABs yield undetermined cytology (2). Surgery is required in indeterminate FNAB, but only quarter of them prove to be malignant after surgery (3), so 77% underwent unneeded surgery. So, finding a mean to diagnose malignant nodule preoperative is important. Advances in molecular genetics can be applied to develop a new diagnostic markers for FNA samples.
Objective: Evaluating the diagnostic value of high resolution U/S, FNAC, and BRAFV600 in diagnosing malignant thyroid nodules.
Patients & Methodology: 50 patients from Kasr alainy endocrine outpatient clinic with solitary or multiple thyroid nodules. All subjected to full history and examination, thyroid profile, high resolution neck U/S, U/S guided FNAC and BRAFV600E analysis on FNAB using DNA sequencing then HRMA for confirmation.
Results: The incidence of BRAFV600E mutation among PTC patients was 55.6%, P value < 0.001. The sensitivity of BRAFV600E mutation was 42.9%, specificity was 100%. Ultrasound sensitivity in detecting malignancy was 88.2%, specificity 72.7%. Addition of ultrasonography to BRAFV600E analysis increased ultrasound sensitivity in detecting PTC preoperative to 92%. There was a positive correlation between most suspicious ultrasonography findings and presence of BRAFV600E mutation (increased AP/T diameter, Increase intra-nodular blood flow, cervical lymphadenopathy, absent or incomplete halo (all p value < 0.001), irregular border p value 0.004, micro calcifications p value 0.007.
Conclusion: 1. High resolution US and FNAB are the most important steps in diagnosis of thyroid nodule. 2-BRAFV600E mutation detected mainly in PTC. 3. Adding BRAFV600E analysis to U/S and FNA will increase the sensitivity of preoperative diagnosis of PTC especially in indefinite nodules. 4. BRAFV600E positivity was associated with most known suspicious U/S finding and significantly present in cases with cervical lymphadenopathy that may give it a prognostic value. 5. HRMA is simple, accurate, and a low cost tool for BRAFV600E analysis.
Ruchika Mittal
Panjab University, India
Title: Commiphora Mukul in experimental paradigms of STZ-induced diabetic neuropathy
Biography:
Ruchika Mittal is the student in Panjab University.
Abstract:
Diabetes mellitus is a serious global health problem and its prevalence is estimated to be 366 million worldwide by the year of 2025. Streptozotocin (STZ, 55 mg/kg), Commiphora mukul (50 and 100 mg/kg, i.p.) and Ramipril (0.2 and 2.3 mg/kg, p.o.) were tested in this study on experimental animals. Animals with a blood glucose level more than 250g/dl are considered diabetic and are used for further studies. All the behavioural parameters were performed on day 0, 2nd, 4th, 6th and 8th week. On the last day (of 8th week), blood was collected retro-orbitally and mean nerve conduction velocity (MNCV) was assessed. The animals were then sacrificed sciatic nerves were isolated for further biochemical estimations. Commiphora mukul (50 and 100 mg/kg) for 8 weeks significantly protected all the behavioral alterations, oxidative damage and change in MNCV induced by STZ. Further, the combination of Commiphora mukul (50 and 100 mg/kg) with Ramipril (0.2 mg/kg) significantly reversed all the behavioural, biochemical and changes in MNCV as compared to their effect per se in STZ-induced diabetic neuropathy. The present study suggests the protective effect of Commiphora mukul against STZ-induces diabetic neuropathy. Study further provides evidence that Commiphora mukul produces better effect in combination with Ramipril against STZ-induces diabetic neuropathy.
Zahra Banazadeh
University of Medical Sciences, Iran
Title: Body composition in adults, newly diagnosed with type 2-diabetes: Effect of metformin
Biography:
Zahra Banazadeh is currently working as Internist at University of Medical Sciences, Iran. She specially works in internal Medicine. She served for about 14 months in school health clinic in the Olympic Village of Tehran. She is having certification in ICDL.
Abstract:
Background: The aim of this study was to measure the body composition in adults with newly diagnosed type 2 diabetes mellitus and to explore the effect of metformin therapy on the various components of body composition, insulin sensitivity and glucose homeostasis.
Methods: This was an observational study consisted of 51 newly diagnosed people with type 2 diabetes on 1000 mg metformin twice daily for 6 months. The body composition of each subject was measured by dual energy X-ray absorptiometry at enrollment and 24 weeks after metformin mono-therapy. Sarcopenia was defined and compared based on the ratio of appendicular skeletal muscle and height squared, skeletal muscle index and residual methods. Homeostasis model assessment-insulin resistance and Quantitative Insulin Sensitivity Check Index were used for estimating insulin sensitivity. The level of physical activity was assessed using self-administered International physical Activity questionnaire.
Results: Forty one subjects (80.4%) completed the study. The mean age of the participants was 52.67±10.43 years. Metformin treatment was associated with a significant decrease in total fat mass (-1.6 kg, P=0.000). By week 24, the lean to fat ratio increased (P=0.04) with men showing greater significant changes. Twenty percent of the female participants were detected to have sarcopenia. In addition, there was a significant improvement of glucose homeostasis and insulin sensitivity.
Conclusions: Metformin therapy results in significant improvement in body composition and insulin sensitivity of adults with newly diagnosed type 2 diabetes. Furthermore, sarcopenia begins in women with diabetes much earlier than expected as an age related phenomenon.
Adel Ahmed Mohmed Ahmed Elnaggar
Ain Shams University, School of Medicine, Egypt
Title: ®Case report of new onset of adult diabetes due to obesity with socioeconomic barrier
Biography:
Adel Ahmed Mohmed Ahmed Elnaggar is a Medical Endocrinologist with an extended expertise in adult diabetes and obesity; as regard prevention and early detection/diagnosis and management and risk reduction of their outcomes. He also share diabetes & obesity clinical trials link and research work concerning both. He is also working on community planning against chronic diseases/disabilities affecting community productivity; prevention & management. He is experienced in thyroid diseases and female endocrine health problems. He is a graduate and earned undergraduate and internship and completed Postgraduate residency in Internal Medicine & Endocrinology from Ain Shams University, School of Medicine, Cairo, Egypt. He is a member of Endocrine & Diabetes Society in Saudi Arabia. He is an active member of Diabetes Club & Endocrine Club, Saudi Arabia. He is also a member of Diabetes Investigators of Ministry of Health, Saudi Arabia sponsored by Sanofi Pharmaceutical company. He is member of European Society of Endocrinology and International Diabetes. He gives lectures on diabetes & obesity management to local Endocrinologists & Internists & GPs and takes part in diabetes health educational programs for the patients & health care professionals.
Abstract:
Diabetes Mellitus (DM); defined as a group of diseases (cardio-metabolic disorders/complex metabolic disorders) characterized by hyperglycemia due to an absolute or relative lack of insulin or to a cellular resistance to insulin. Diabetes had multiple health hazards & high incidence of cardio metabolic comorbidities due to the nature of disease progress, leading to diabetic complications & disabilities, which impair individual productivity towards the community. Prevalence of adult diabetes worldwide is growing forcibly to affect the adolescence especially in gulf areas & America due to unhealthy life styles & physical inactivity. The most common cause of adult diabetes is the obesity. Diabetes & obesity are the highest prevalence of the gulf area; Saudi Arabia is considered the highest real country worldwide in diabetes & obesity prevalence. This patient’s case of adult type 2 DM with obesity is commonly seen worldwide; especially in gulf (Middle East) & America. Such cases are missed by routine management of blood sugar level apart from the focus on the main cause of their diabetes, which is the obesity in adults. Control of diabetes not only means blood sugar control, but also should be causality control. Role of weight reduction is very important here towards causality control for patient’s diabetes, furthermore multiple cardio metabolic risks outcomes associated with both diabetes & obesity. Aim of lowering insulin resistance by encouraging weight loss is beneficial, although unhealthy life style in gulf area & patient’s socio-economic status, which is affecting drug choices ideally preferred in such cases like injectable Glucagon-like peptide-1 (GLP-1) Analogues; liraglutide (high cost) & Sodium-glucose co-transporter 2 (SGLT2) inhibitors, which are not yet launched in Saudi Arabia. Due to these challenges; I chose first basal insulin detemir plus metformin_sitagliptin oral anti_diabetic combination as regard to weight concern/cost/glucotoxicity control/preserve pancreatic beta cell function; then maintenance on metformin_sitagliptin combination plus weight reduction motivation by good doctor-patient relationship & play on good psychological support. Specify the target aim for patient’s control of this diabetes by weight loss regimen, which by regular follow-up leads to achieving our target for both, controlling patient’s diabetes & obesity.
- Case Reports and Others | Endocrine Diseases: Treatment and Diagonosis | Diabetic Disorders and Treatment | Pediatric Endocrinology
Chair
Michael Lawrence
Baylor Scott & White Research Institute, USA
Session Introduction
Michael Lawrence
Baylor Scott & White Research Institute, USA
Title: Targeting pancreatic beta cell-derived isletokines to improve islet cell transplantation
Biography:
Michael Lawrence, PhD, is currently investigating mechanisms that regulate and affect pancreatic islet endocrine function in health and disease. Impairment or dysfunction of beta cells of the pancreatic islets leads to hyperglycemia and diabetes. He is identifying methods and approaches to prevent loss of pancreatic beta-cell function from metabolic and inflammatory stress to reverse and prevent diabetes. His current focus is on 1) protecting pancreatic beta cells from inflammatory and immune destruction in the pathogenesis of diabetes and in islet transplantation; 2) cell-mediated repair and restoration of islet function via pancreatic-derived mesenchymal stem cells; and 3) engineering islet endocrine tissue from islet precursor cells for islet cell transplantation. He also is actively involved in clinical islet cell isolation procedures for the islet cell transplant program at Baylor University Medical Center at Dallas and Baylor All Saints Medical Center at Fort Worth.
Abstract:
Pancreatic islets are central to the regulation of glucose metabolism and homeostasis. The loss or impairment of islet beta cells results in diabetes and high risk of cardiovascular disease with detrimental health consequences. Islet cell transplantation represents a cell replacement therapy to prevent or reverse diabetes. One major hurdle to the success of islet transplantation is the early loss of islet cells due to an acute innate inflammatory response within the first 24 hours of islet cell infusion. We have identified cytokines and chemokines produced by beta cells that evoke acute islet inflammation. These “isletokines” are upregulated in stressed beta cells by calcineurin/NFAT and MAPK signaling and contribute to early islet cell graft loss. Here, we discuss our latest findings of key cellular events that induce beta cell isletokine expression and islet inflammation. We also identify molecular targets to prevent beta cell-induced islet inflammation and develop therapeutic strategies to improve islet cell transplantation.
Mashfiqul Hasan
Bangabandhu Sheikh Mujib Medical University, Bangladesh
Title: TCF7L2 gene rs7903146 polymorphism confers risk of GDM in relatively young and lean mothers
Biography:
Mashfiqul-Hasan has completed his MD in Endocrinology from BSMMU, Dhaka, Bangladesh in 2016. He is currently working as an Endocrinologist in National Institute of Neurosciences, Dhaka, Bangladesh. He is also a Research Associate of study group lead by Prof. M A Hasanat in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. He has 6 original articles published in national and international journals. His major research area is Diabetes (including GDM).
Abstract:
Pregnant women without past history of glucose intolerance [N=100; age 26.22±4.56 years; body mass index (BMI) 26.39±3.85; mean±SD; GDM=50, normal glucose tolerance (NGT=50)] were studied for TCF7L2 rs7903146 polymorphism using Sanger sequencing technique (genotype CC=63, CT/TT=37). CC and CT/TT genotype of TCF7L2 rs7903146 polymorphism had no significant difference of age (p=0.723) or BMI (p=0.548). HbA1c was significantly higher with CT/TT genotype (p=0.038) whereas family history of DM was similar in both groups. No significant difference was observed for age, BMI and HbA1c between women with CC genotype and those with CT/TT within GDM and NGT groups. While GDM women with CC genotype had higher age and BMI than NGT women (GDM vs. NGT: age 27.96±3.79 vs. 24.60±4.45 years, p=0.002; BMI: 27.67±3.93 vs. 25.04±3.50 kg/m2, p=0.006; mean±SD), GDM women with CT/TT genotype had no significant difference of age and BMI with NGT women (GDM vs. NGT: age 27.00±5.22 vs. 25.60±4.10 years, p=0.390; BMI: 26.48±3.63 vs. 27.00±4.13 kg/m2, p=0.688; mean±SD). In women of age <25 years, frequency of GDM was significantly higher in those with CT/TT genotype than those with CC [CT/TT vs. CC: 58.3% vs. 17.4%, p=0.022] having an odds ratio (OR) of 6.650 (95% CI 1.377-32.114) for GDM; but not in women ≥25 year old (CT/CC vs. CC 60% GDM in both groups, p=1.000, OR=1.000, 95% CI 0.361-2.773). Using BMI cut-off at 25 kg/m2, women with BMI <25 kg/m2 had significantly higher frequency of GDM in those with CT/TT genotype than those with CC (CT/TT vs. CC: 61.5% vs. 18.2%, p=0.024) with an OR of 7.200 (95% CI 1.518-34.139); but not in women having BMI ≥25 kg/m2 (CT/TT vs. CC 58.3% vs. 58.5%, p=0.987, OR=0.992, 95% CI 0.357-2.86). It is concluded that polymorphism of TCF7L2 rs7903146 may confer increased risk of GDM even in mothers with young age and lean BMI.
Ngozi F Nnolum-Orji
Nelson Mandela Metropolitan University, South Africa
Title: High-fat-diet induced insulin resistance and prevention with Sutherlandia frutescens – Role of 11βHSD-1
Biography:
Ngozi F. Nnolum-Orji is currently completing her MSc degree in Biochemistry at Nelson Mandela Metropolitan University. Her research interest is focused on Diabetes prevention and treatment using medicinal plants, hence, has secured admission for her PhD studies on properties of identified anti-diabetic medicinal plant at the Department of Pharmacology, University of Pretoria.
Abstract:
The activity of 11βHSD-1, involving glucocorticoid receptor (GR) and phosphoenolpyruvate carboxykinase (PEPCK), has been implicated in the development of insulin resistance observed with high-fat-diet (HFD). 11βHSD-1 (11β-Hydoxysteroid dehydrogenase-1) is an enzyme that converts inactive cortisone to cortisol within peripheral tissues and regulates tissue cortisol levels, thus influences glucose regulation. In a study at NMMU, rats developed insulin resistance (IR) within 56 days of consuming HFD. In the same study, extract of Sutherlandia frutescens, a South African plant, prevented IR in rats fed HFD. We investigated the role of 11β-HSD1 in the development of observed IR and the effect of S. frutescens on the enzyme expression. Using quantitative RT-PCR, periodic (days 7, 14, 28, 56, 86) mRNA expressions of 11β-HSD1, GR and PEPCK were measured in rat liver tissues, while 11β-HSD1 protein expression was analysed using immunohistochemistry. Our results showed no significant change in 11β-HSD1 expression up till day 56. However, significant increase in both mRNA and protein levels were observed at day 86 (i.e 30 days after IR had developed). Increased mRNA levels of PEPCK was observed prior to IR in rats fed HFD, indicating increased gluconeogenesis, but did not increase in rats fed HFD and S. frutescens. No pattern of GR regulation was observed with mRNA levels of GR. Increased 11β-HSD1 activity is possibly a consequence of IR rather than cause, but may contribute to the development of type 2 diabetes by exacerbating IR. Other mechanisms induced increased gluconeogenesis in rats fed HFD, which was prevented in rats fed HFD and S. frutescens.
Sakir Ozgur Keskek
Keskek, Numune Training and Research Hospital, Turkey
Title: Low serum high density lipoprotein level is associated with proliferative retinopathy in patients with diabetes mellitus
Biography:
Sakir Ozgur Keskek has completed his education from Istanbul University, Cerahpasa Medical School and Internal Medicine studies from a training and research hospital of Health Ministry in Turkey in 2004. He is Associate Professor of Internal Medicine and the Director of Internal Medicine Clinic of Adana Numune Training and Research Hospital. He has published more than 50 papers in reputed (international and national) journals. He has also more than 100 poster presentations in national and international congresses. He has had education on essential clinical research and good clinical practice. He has been serving as reviewer for more than 20 journals.
Abstract:
Introduction: Diabetes mellitus (DM) is a common chronic metabolic disease associated with serious complications. Diabetic retinopathy (DR) is one of the most common microvascular complications of DM. The aim of this study was to investigate the association between diabetic retinopathy and dyslipidemia.
Methods: A total of 1363 subjects were included in this retrospective study. The participants were divided into three groups, including a study group of 352 patients with diabetes and retinopathy, a control group of 553 patients with diabetes without retinopathy and a control group of 457 healthy subjects. The study group included 202 and 150 patients with non-proliferative (NPDR) and proliferative diabetic retinopathy (PDR), respectively. Groups were compared according to the demographic properties, high density lipoprotein (HDL), triglyceride, low density lipoprotein (LDL), HbA1c and serum fasting glucose levels. MedCalc 15.8 (MedCalc Belgium) was used for the statistical analysis.
Results: Groups were comparable in terms of age and sex (p>0,05 for each one). Not surprisingly, serum fasting glucose and HbA1c levels were high in patients with diabetes (p<0.05, respectively). Serum HDL levels of the patients with diabetic retinopathy were lower than those in diabetic patients without retinopathy (39.3±10.4 vs. 42.4±10.4 p<0,001). Patients with PDR had lower HDL levels than patients with NPDR (37.6±9.4 vs. 40.5±11.0, p=0.011). There was an association between low HDL levels and PDR (OR: 2.1, Cl %95 1.4-3.1 p=0.003).
Conclusion: In this study we have found low serum levels of HDL in patients with PDR. Low serum HDL level is associated with atherosclerosis and other vascular problems. Diabetic patients with low serum HDL level may be more predisposed for retinopathy. Diabetic patients should be evaluated for dyslipidemia to delay the development of vascular complications.
Riyaz Mohammed
Esani Diabetes and Mutlispeciality Research Centre, India
Title: Efficacy and tolerance of cost effective teneligliptin with metformin in type 2 diabetes mellitus- a short study
Biography:
Riyaz Mohammed has completed his Post-graduation in Internal Medicine from Prestigious Deccan College of Medical Sciences and then he did his Master’s in Endocrinology from Texila American University and Diploma in Endocrinology from University of South Wales, UK. He is the Director of Esani Diabetes and Multispecialty Research Centre in India. At a young age, he was heading the Department of Medicine and Endocrinology at Basvatarakam Indo American Hospital. He has published more than 30 papers in reputed journals and has more than 20 oral presentations as speaker to his credit. He has been serving as an Editorial Board Member of repute Journal EJMPR, WJPR, and he is also serving as a Reviewer for journal like Journal of Evidence Based Medicine & Health Care, Annals of Internal Medicine, International Journal of Research in Medical Sciences, and Journal of Evolution of Medical and Dental Sciences.
Abstract:
Teneligliptin is a novel, highly selective dipeptidyl peptidase-4 (DPP-4) inhibitor. The aim of the study was to assess the effectiveness of Metformin in combination with teneligliptin in Indian patients with type 2 diabetes mellitus who were inadequately controlled with metformin monotherapy. Patients with Glycated haemoglobin (HbA1c) of 7.0–10.0% and on metformin ≥1000 mg/day were selected for the study. 400 subjects were enrolled out of which only 120 subjects were eligible for the study. The study group of 120 subjects were divided into two groups, Group A (n=60) was given 20 mg teneligliptin plus metformin, Group B were on metformin (n=60). The mean baseline HbA1c in teneligliptin group was 8.0%, when compared to 7.8% in the Metformin group. The primary endpoint of the study was to monitor the changes in HbA1c levels from baseline to week 24. It was observed that the mean HbA1c for teneligliptin group after 24 weeks was 7.17 % versus 7.62 % in metformin group. HbA1c was significantly reduced in the Group A patients. The incidence of gastro-intestinal adverse events was more in metformin group than teneligliptin groups. In patients treated on metformin an additional dosage of teneligliptin once daily was effective and it was well tolerated in Indian patients with type 2 diabetes mellitus. There was neither any significant change observed with respect to lipid profile and body weight.
Behling Cheng
Kuwait University Health Science Center, Kuwait
Title: ACTH stimulation affects rat adrenal mineralocorticoid receptor protein level and tissue distribution, but not subcellular localization
Biography:
Behling Cheng PhD is an academic staff member of the Biochemistry Department, Kuwait University Faculty of Medicine. He served as Chairman of the Department for 14 years (1998-2012) and was as a member of the central committee for medical curriculum reform from discipline-based courses to an integrated organ systems curriculum in 2005. He continues serving as a member in the endocrine system committee for course development and examination. He is currently involved in teaching and research in the areas of endocrine biochemistry, lipid metabolism, and cell biology of aging.
Abstract:
Adrenal cortex is comprised of three distinctive zones: the outermost zona glomerulosa (ZG), the zona fasciculata (ZF), and the innermost zona reticularis (ZR). Repetitive stimulation of rats with ACTH for four consecutive days resulted in an elevated adrenal corticosterone synthesis. This glucocorticoidogenesis was accompanied not only by sustained adrenal aldosterone synthase and 24 hour urine aldosterone levels, but also by upregulation of the glandular mineralocorticoid receptor (MCR) protein level. Immunohistochemistry study revealed that, in the unstimulated state, MCR was expressed principally in ZG. Upon ACTH stimulation, expression of MCR became strikingly increased in ZF and ZR. Adrenal protein level of 11β-hydroxysteroid dehydrogenase-2 (11βHSD-2), the enzyme that protects MCR function from glucocorticoid interference, remained unchanged. After subcellular fractionation, both MCR and 11βHSD-2 were localized in the microsomal fraction; only a small portion of MCR was found in the nuclear fraction. ACTH action did not result in translocation of MCR into the nucleus. Since ZF and ZR (but not ZG) reportedly express11βHSD-2, but ‘gain’ MCR to cope with ACTH stimulation, we hypothesize that aldosterone may be needed to influence ZF and ZR production of corticosterone, and the aldosterone autocrine/paracrine action may be involved in both non-genomic and genomic mechanisms.
Adel Ahmed Mohmed Ahmed Elnaggar
Ain Shams University, School of Medicine, Egypt
Title: Clinical opinion & review : (eyes on diabetes) role of psychological aspects of management of type 2 diabetes and obesity
Biography:
Adel Ahmed Mohmed Ahmed Elnaggar is a Medical Endocrinologist with an extended expertise in Adult Diabetes and Obesity. He is also working on community planning against chronic diseases/disabilities affecting community productivity; prevention and management. He is experienced in Thyroid Diseases and Female Endocrine Health Problems. He is a graduate and has earned his undergraduate and Post-graduate Residency in Internal Medicine and Endocrinology from Ain Shams University, School of Medicine, Cairo, Egypt. He is a Member of Endocrine and Diabetes Society in Saudi Arabia. He gives lectures on Diabetes and Obesity Management and takes part in Diabetes Health Educational programs for the patients and health care professionals.
Abstract:
The theme of World Diabetes Day 2016 is eyes on diabetes. Real vision not comes from eyes, it comes from hearts. Diabetes is the one leading causes of psychological impairment and depression which is giving bad impacts on the community and global health hazards. Still diabetes management is missing real eyes focusing on the overall patient profile from all the aspects of this complex group of cardio-metabolic global health risk disorders. Diabetes had multiple health problems and high incidence of cardio metabolic comorbidities due to the nature of disease progress, leading to diabetic complications and disabilities which impair individual productivity towards the community. Prevalence of adult diabetes worldwide is growing forcibly to affect the adolescence especially in Gulf areas and America due to unhealthy life styles and physical inactivity. The most common cause of adult diabetes is the obesity. Obesity is defined as a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences. Diabetes and obesity are the highest prevalence of the Gulf area and America; Saudi Arabia considered highest real country worldwide in diabetes and obesity prevalence. Diabetes is linked to depression derived comorbidities due to nature of disease progression and strict life styles modifications and medications complexity non-adherence and long term unpleasant complications. Also, obesity carried the same psychological impacts which interfere with individual compliance and affecting the overall public health and individual productivity. The missing roles in vision of health care providers and experts dealing with diabetic/obese patients from the view of psychological therapy and communication skills and clinical quality care services needed for those special type of patients; leading to increasing health burden of both cardio-metabolic disease which affect the global adult healthy lives. According to latest data from the International Diabetes Federation (IDF): Diabetes is a huge and growing burden: 415 million adults were living with diabetes in 2015 and this number is expected to increase or even be doubled by 2040. One third of global adults around puberty age diagnosed as insulin resistance metabolic syndrome and type 2 diabetes due to the invading obesity which is caused by genetic, endocrinal, sedentary life styles, depression and physical inactivity. The fast global warning of diabetes and obesity among the adults will affect our future and the subsequent life expectancies for our productivity powers. We should put our eyes (hearts) towards our adult futures by understanding the overall challenges to face this global warning, we should improve our skills of communications to fight the depression and psychological barriers of adherence of the diabetics and obese patients to building the structure of trust between health care experts and patients to reduce cardio-metabolic risks of these fast global warning of diabetes and obesity. Also role of clinical quality care services for diabetes and obesity and their complications together with psychological impacts and depression should be improved to be not only medical therapies but also role of quality achievement and psychological support to such patients could be the global key answer for their future problems.
Biography:
Dina Omar has graduated from Faulty of Medicine, Kuwait University in 2006 and joined the Internal Medicine Department in a government hospital in Kuwait. She got the membership of the Royal College of Physicians (London) in 2012, Post-graduate certificate of Fundamentals of Diabetes in 2015 from Joslin Diabetes Center in collaboration with Harvard Medical School (USA), and Master’s degree in Diabetes Care, Education and Management from University of Dundee in 2016. She is a Research Associate in Dasman Diabetes Center (Kuwait) and an Associate Faculty Staff Member in University of Dundee (Scotland).
Abstract:
Aim: This study aims to assess the effectiveness and safety of CSII as an alternative to MDI in the management of children and adolescents with T1D in Dasman Diabetes Institute.
Design: Retrospective prospective cohort study.
Participants: Children and adolescents (<20 years old) with T1D who switched from MDI to CSII during 2011-2013. Data were collected from electronic health records. Effectiveness were measured by improvement in HbA1c and TDD, and safety by reduction in incidence of major complication (severe hypoglycemia (SH) and diabetic ketoacidosis (DKA)). Data were collected for 24 months prior to CSII use, and 30 months after.
Results: The mean age of study cohort (n= 64) was 10.9 ± 4.8 years (mean ± SD). HbA1c dropped from 8.7±1.4% at baseline to 8.1±1.0% (0.6% absolute reduction) at 3 months (p<0.05). Sustainability of improvement was demonstrated only in those with high baseline HbA1c (>9.0%) with an absolute reduction of 2.4% from 10.6±1.3% to 8.8±2.2% at 30 months. There was no significant reduction in insulin requirement. Reduction in the incidence of SH was statistically significant while it was not significant for DKA.
Conclusions: The use of CSII is effective in improving glycemic control of children and adolescents with T1D in the short term (3 months). Those who were in poor control (HbA1c >9.0%) at baseline, showed significant improvement of glycemic control, after 30 months. CSII use in our study cohort was safe as reduction in the incidence of acute major diabetic complications was demonstrated.
Madhumati Varma
Hospital Central de Nampula, Mozambique
Title: Effects of diabetic education on body mass index, fasting blood sugar and knowledge gained by diabetic patients in central hospital Nampula
Biography:
Madhumati varma, Assistant Professor is an Indian, unmarried, medical doctor, and research scholar. She was born on 22 December 1958 in Khargoan, Madhya Pradesh, India. Her father is Dr. L.T. Varma is reputed, respected, successful medical professional, mother late Laxmi Varma was a very intelligent housewife and has a pretty sister Miss Pushpa is professional Artist. Dr. Madhumati Varma has been working with the Ministry of health, Mozambique as Consultant Internist and Diabetologist since 2005 and part time Assistant professor of medicine in Unio Lurio, Faculty of medical science since 2009.
Abstract:
Background
Mozambique has 274,700 diabetic patients and 9716 deaths due to diabetes, according to a report of 2015 (IDF 2015). There is a poor knowledge of non-pharmacological treatment of diabetes mellitus among the diabetic population.
Methods
This is Interventional study, 648 of the participants of diabetes mellitus in out-patient diabetic clinic in hospital central Nampula, the participants taken according to inclusion and exclusion criteria, completed the pre-test at baseline and post-test after the second follow up session of education, during each session of education body mass index and fasting blood sugar were recorded. Education commenced with instruction in groups of each session followed by individual advice sessions for each patient with different specialists.
Results
The present study found that educational intervention of diabetes was highly effective to gain knowledge of diabetes compare pre-test and Post-test score (P <.001), fasting blood sugar and body mass index significantly decreased from baseline in the second follow up (P <.001). Age was significantly correlated with body mass index and fasting blood sugar (P<. 001,) Posttest with body mass index and fasting blood sugar was significantly correlated (P<.01). A post hoc Turkey test on body mass index when compared with fasting blood sugar found significantly (P=. 05) at baseline, at first follow up (P=. 005) and at second follow up (P=.005).
Conclusion
The present study found that educational intervention was highly effective in controlling body mass index, fasting blood sugar and improves knowledge of diabetes among participants of diabetes mellitus.
Dheeraj Reddy
Kurnool Medical College, India
Title: Study of dyslipaedemic profile in type 2 diabetes patients with insulin resistance
Biography:
Dheeraj Reddy is in Kurnool Medical College, India.
Abstract:
Aim: The dyslipidemic profile in insulin resistance consists of increased total cholesterol, triglycerides, reduced HDL cholesterol and qualitative change to smaller, denser LDL particles.
Materials & Methods: 206 type 2 diabetic patients with BMI>28 and with insulin resistance are taken up for the study from the O.P of Diabetic Centre, 3rd cross, Sai Nagar, Anantapur, India from June 2015 to January 2016. Lipid Profile is done to all the patients, which includes total cholesterol, TG, HDL, LDL, VLDL and Ratio (Total Cholesterol/HDL).
Results: Total Cholesterol (normal value: 130-200) increased in 88%, TG (10-160) increased in 86% HDL (40-60) reduced in 66%, LDL (140-150) increased in 55%, VLDL (20-40) increased in 74% and Ratio (TC / HDL) (2.5-3.5) increased in 59%.
Conclusions: It is concluded that dyslipidemia is common in type 2 diabetes patients with insulin resistance.
Ibrahim Hamad Fahad Alwakid
University of Hail, Saudi Arabia
Title: High incidences of Diabetes Type II in Saudi Male patients with B+ blood group and low incidences in O+ and Rh negative patients
Biography:
Ibrahim Hamad Fahad Alwakid is in University of Hail, Saudi Arabia. He is the co author of Dr M. PARVAIZ. FARSHORI.
Abstract:
Obesity is growing rapidly around the globe. If not controlled, it can cause many serious illnesses such as the heart disease, diabetes type II and many more. There are about 387 million people with diabetes out of which nearly 37 million live in MENA (Middle East and North Africa Region) region. Random community survey of 200 local educated youth (under 18) and the non-college going adult citizens revealed high prevalence of diabetes II among adult male population (27.5%) as compared to the educated youth population (5.5%).
Since diabetes type II is prevalent among adult Saudi population (Alqurashi et. al., 2010, Farshori et al., 2012a and b) we decided to analyze if there is any correlation between the distribution of ABO (A, B, AB, and O) and Rhesus antigen (Rh) blood group in normal adult male (control) Saudi population as compared to the male diabetes II patients.
Our results show that out of 207 control non diabetic subjectss surveyed (males only) 2.89% were A- , 20.8% were A+, 3.38% were B-, 21.2% were B+, 0.96% were AB- (0.96%), 4.3% were AB+, 3.4% were O-, and 42.9% were O+ (42.9%). In summary in control population O+ was the most prevalent blood group (42.9%) and B+ was the second most prevalent blood type (21.2%).
Next we compared the blood group distribution patterns in male diabetes type II patients. Analysis of our results show that 2.3% patients were A-, 22.65% were A+, 0% were AB-, 4.7% were AB+, 0% were B- but 30.5% were found to be B+ as compared to the 21.2% B+ among control group. Only 0.78% were O- and 39.1% were O+. When we looked at the distribution of Rh antigen in the control population we found 89.4% people to be Rh+ and 10.6% Rh- however among diabetics 96.9% patients were Rh+ and 3.13% were Rh-. These results suggest a 3.4 fold decrease in Rh- individuals among diabetics (3.13% Rh-) as compared to the control population (10.9% Rh-).
In conclusion our results show that the blood group B+ is expressed in much higher percentage (30.5%) in male diabetes type II patients as compared to the controls (21.2%). Also O+ is expressed in 42.9% controls but show a slight yet significant reduction in its distribution (39%) among diabetes II patients. These results suggest that male patients with B+ blood show least resistance to diabetes II with high frequency of distribution (p value .094 at p- Ë‚ .10), and the O+ blood type individuals show some resistance (low frequency of distribution) in diabetes type II patients (t-value 3.43 and the p value .0754, at p- Ë‚ .10). Therefore frequency of distribution of B+ blood group is significantly higher in male diabetes II patients. Our results also show more than 3 fold decrease in Rh-individuals among diabetes patients. Significance of this decrease in Rh- individuals among diabetics is not clear at this time. Larger clinical studies need to be done to further investigate the reason why as compared to control population O+ blood group tend to show lower incidences and B+ high incidences of type II diabetes among Saudi male patients.
- Reproductive Endocrinology and Infertility | Endocrinology and Diabetes: Prevention and Management | Case Report and Clinical research
Location: Dallas
Chair
Jose Mario Franco de Oliveira,
Universidade Federal Fluminense, Brazil
Session Introduction
Sakir Ozgur Keskek
Numune Training and Research Hospital, Turkey
Title: Direct medical cost of diabetes mellitus and diabetic ketoacidosis in Adana,Turkey
Biography:
Åž Ö KeÅŸkek has completed his education from Istanbul University, Cerahpasa Medical School and Internal Medicine studies from a training and research hospital of Health Ministry in Turkey in 2004. He is Associate Professor of Internal Medicine and the Director of Internal Medicine Clinic of Adana Numune Training and Research Hospital. He has published more than 50 papers in reputed (international and national) journals. He has also more than 100 poster presentations in national and international congresses. He has had education on essential clinical research and good clinical practice. He has been serving as reviewer for more than 20 journals.
Abstract:
Diabetes mellitus (DM) is a common chronic metabolic disease associated with serious complications and significant economic burden. We aimed to investigate direct medical costs of DM and diabetic ketoacidosis (DKA). A total of 136 diabetes patients were included in this retrospective study. The study group consisted of 64 patients with DKA and the control group consisted of 72 diabetes patients without any complications. Invoices of all patients were obtained from the billing department of the institute. The direct medical cost of each patient was calculated according to the costs of drugs (oral anti-diabetics, insulin preparations, antibiotics, intravenous fluids), equipments (catheters, syringes, blood glucose strips), and cost of services (hospitalisation fee, venous access, injection, laboratory services, radiological imaging) in United States Dollars. MedCalc 12.7 software program was used for statistical analyses. Patients with DKA were younger than the patients with diabetes mellitus (35.0±11.1 vs. 54.7±13.2, p<0.001). The groups were comparable according to gender (p=0.17). Costs of drugs and equipments of the study and control groups were 165.4±62.2 and 141.9±62.3, respectively. Costs of services were 323.6±141.3 and 253.6±115.0, respectively. Both of the costs were higher in patients with DKA. The differences were statistically significant (p=0.03, p=0.002, respectively) HbA1c levels were higher in DKA group (10.2±1.1 vs 9.4±1.4; p<0.001). HLOS (hospital stay) of groups were comparable (4.3±1.5 vs 4.5±1.0 days; p=0.3). Diabetes imposes a high economic burden on individuals and societies since a substantial amount of money is spent for this disease and its complications worldwide.
Mohammad Nurul Islam
North South University, Bangladesh
Title: Co-existence of arthritis in type 2 diabetic patients alter lipid biomarkers and the liver enzyme
Biography:
Mohammad Nurul Islam received his PhD in Molecular Pharmacology from Tokushima University, Japan, in 2012. Presently, he is an Associate Professor of Pharmacology at the Department of Pharmaceutical Sciences, North South University. His research interest includes both allergic and diabetic inflammation and co-authored a significant number of research articles and they were published in various recognized journals. He also attended a number of scientific seminars and presentations both nationally and internationally and received good number of awards.
Abstract:
Chronic co-morbidities are substantial in people with diagnosed diabetes where arthritis is nearly twice as likely to co-occur indicating a diabetes-arthritis connection. In this study, the impact of quality of life on the prevalence of arthritis as a co-morbid condition with type 2 diabetes (T2D) was assessed and alteration of lipid biomarkers (HDL, LDL, TG and TC) and liver enzyme (alanine aminotransferase) with this co-morbidity cluster was observed. A cross-sectional analysis was conducted on 528 T2D patients with and without arthritis as a co-morbid condition. Data was collected using the structured interview with the questionnaire and using retrospective data for a period from February 2016 to July 2016.The correlation of glycated haemoglobin (HbA1c) with individual lipid indexes and liver enzyme were analyzed among the subjects. Female were more susceptible to arthritis as a co-morbid condition with T2D. Higher BMI was found in cases of patients with arthritis who also had lower tendency to meet the recommended level of physical activity. 74% of patients with arthritis, had uncontrolled HbA1c, p=0.03 as well as their triglyceride and total cholesterol was seen to be elevated, p=0.01, p=0.92 respectively. 54% of the patients with uncontrolled HbA1c were experiencing high LDL (p=0.01). Among the patients with high ALT level, 26% of them exhibited controlled HbA1c and 51% had an uncontrolled HbA1c level (p= 0.01). Patients with diabetes and arthritis co-morbidity faced difficulties to control their HbA1c and this uncontrolled situation further lifted up other biochemical parameters (LDL, TG, TC, ALT) as well.
Behling Cheng
Kuwait University, Health Science Center, Kuwait
Title: Does repetitive stimulation of the rat with ACTH accelerate migration of adrenocortical glomerulosa cells?
Biography:
Behling Cheng is an Academic Staff Member of the Biochemistry department, Kuwait University Faculty of Medicine. He served as the Chairman of the Biochemistry department for 14 years (1998-2012) and was as a Member of the Central Committee for medical curriculum reform from discipline-based courses to an integrated organ systems curriculum in 2005. He continues serving as a Member in the Endocrine System Committee for course development and examination. He is currently involved in teaching and research in the areas of Endocrine Biochemistry, Lipid Metabolism and Cell Biology of Aging.
Abstract:
Adrenocortical glomerulosa cells express aldosterone synthase (CYP11B2) and synthesize aldosterone. Literature indicates that postnatal glomerulosa cells migrate centripetally and undergo a lineage conversion to fasciculata-like cells. The process is described to take from weeks to months in experimental animals. ACTH stimulation which elevates glucocorticoidogenesis suppresses CYP11B2 gene expression. This study investigated whether repetitive stimulation of rats with ACTH for four consecutive days would affect adrenal tissue distribution and protein level of the enzyme, using immunohistochemistry and Western blot techniques, respectively. The experimental outcomes are summarized as follows: Cells stained for CYP11B2 were localized principally in zona glomerulosa (ZG) of the control. Strikingly, ACTH-stimulation caused pronounced appearance of CYP11B2-stained cells in the inner cortex. Concomitantly, the intensity of staining decreased in ZG. Cells stained for 11β-hydroxylase (CYP11B1) were seen all over the inner cortex, but not in ZG of the control. However, CYP11B1-expressing cells were found in the ZG after ACTH stimulation, reflecting hypertrophy of zonal fasciculata. ACTH-stimulated rats showed comparable CYP11B2 and CYP11B1 protein levels in the adrenal homogenate as the control. The above findings suggest that repetitive ACTH-stimulation accelerates migration of glomerulosa cells into the inner cortex. As a consequence, the inner cortex becomes a mixture of aldosterone-producing cells and corticosterone-producing cells. To the best of our knowledge, this phenomenon has not been reported before.
Chirag Prajapati
Hemchandracharya North Gujarat University, India
Title: Lonicera japonica protects spargue-dawley rat against 11β-HSD1 induced endothelial dysfunction in metabolic syndrome
Biography:
Chirag Prajapati is the Project assistant officer .
Abstract:
Objective: To study the pharmacological evaluation of Lonicera japonioca with reference to metabolic syndrome in order to restore 11β-HSD1 induced endothelial dysfunction in SD rats.
Introduction: Metabolic syndrome is multidisciplinary metabolic disorder in which Diabetes Mellitus, Hypertension and Obesity are presented jointly. Chlorogenic acid is a major bioactive component in the flower buds of Lonicera japonica having 11β-HSD1 property. 11β-HSD1 induced endothelial dysfunction has been postulated to be a major contributor to the pathogenesis of Metabolic Syndrome.
Methods: Present studies were aimed towards investigating the effectiveness of this LJALE extract against STZ-HFD induced diabetes and associated complications, fructose induced hypertension and HFD induced obesity respectively using SD rats. Parameters like ex vivo 11β-HSD 1 inhibition assay, vascular reactivity study, Nitric Oxide and Peroxynitrile have been measured.
Results: Chlorogenic acid isolated from LJALE could dose dependently inhibit the 11β-HSD1 activity. LJALE attenuate the 11β-HSD1 induced endothelium dysfunction in rats. LJALE treated obese animal reflect significant increased Nitric oxide and decreased Peroxynitrile.
Conclusion: From all above statements, it has been concluded that Lonicera japonica protects SD rats against 11β-HSD1 induced endothelium dysfunction in Metabolic Syndrome.
Okeke Chukwubike Udoka
Federal University of Technology, Nigeria
Title: Effects of antiretroviral drugs on estradiol and progesterone in HIV infected pregnant women
Biography:
Abstract:
Background: Prevalence of human immunodeficiency virus (HIV) among pregnant women is on the increase in sub-sahara Africa. The use of antiretroviral drugs has ameliorated the adverse effect of HIV on pregnancy. The study was to investigate the effect of the antiretroviral drugs on estradiol and progesterone among HIV-infected pregnant women.
Materials & Methods: 120 pregnant women participated in this study which comprised of 60 HIV seropositive at 2nd trimester, and 60 HIV seronegative throughout the gestation period. The HIV-infected group commenced antiretroviral treatment (Nevirapine, Zidovudine, and Lamivudine) at 2nd trimester through full term. The serum estradiol/ progesterone levels were estimated at 2nd and 3rd trimester of pregnancy of these subjects by ELISA method.
Result: It was observed that there was progressive increase in progesterone and estradiol levels in 2nd through 3rd trimester in both groups of women, irrespective of their HIV status. There was no significant difference (p > 0.05) in progesterone levels between HIV-infected and non-infected groups at 2nd trimester (210.94±7.04 ng/ml and 222.27±6.81 ng/ml respectively). There was also no significant difference (p > 0.05) in progesterone level in 3rd trimester between the two groups (HIV–infected group 253.05±6.81 ng/ml, and non-infected group 241.09±5.72 ng/ml). It was observed that the estradiol levels in non-infected group (8,812.85±415.93pg/ml) was significantly higher (p <0.05) than HIV –infected group (5,359.82±260.79 pg/ml) at 2nd trimester. This significant difference in estradiol levels was also observed in 3rd trimester between the two groups (non-infected 10.212.50 ±566.76 pg/ml and HIV –infected 7,664.23±268.72 pg/ml).
Conclusion: The significant decline in estradiol level among HIV-infected pregnant women at 2nd trimester shows that HIV infection significantly reduces the secretion of estradiol. It does not have significant effect on progesterone secretion among these women in second trimester. This indicates that untreated HIV infection can affect development and maintenance of pregnancy in women. The progressive increase in estradiol from 2nd trimester through 3rd trimester showed that antiretroviral drugs significantly ameliorate the possible effects of HIV on estradiol, thereby prevent some adverse HIV effects on the pregnancy outcome.
Satish Niraula
BP Koirala Institute of Health Sciences, Nepal
Title: Prevalence of metabolic syndrome and associated factors among diabetic patients in Eastern Nepal
Biography:
Satish Niraula is doing his M.D. from B.P. Koirala Institute of Health Sciences, Nepal. He compleated his M.B.B.S from Tribhu
Abstract:
Background & Objectives: Owing to increased life expectancy, change of nutrition pattern, opting of sedentary lifestyle, and many other factors prevalence of diabetes mellitus (DM) is rising. Along with diabetes, cardiovascular risk factors associated like obesity, high blood pressure (BP) and dyslipidemia which are collectively termed as Metabolic Syndrome (MetS) is also growing. While DM is itself an independent risk factor for development of Cardiovascular Diseases, presence of MetS in DM increases the risk by several folds. This study aims to determine the prevalence of MetS and its components as well as the factors associated with it among Diabetic patients of Eastern Nepal attending GOPD of BPKIHS.
Materials & Methods: This is a descriptive cross-sectional study among new and previously diagnosed diabetic patients attending general OPD of BPKIHS from August 2013 to July 2014. Relevant socio-demographic, lifestyle and clinical information were collected using a semi-structured performa. Revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) definition of metabolic syndrome with ethnic threshold on abdominal obesity was used.
Results: 135 diabetic patients were studied, 116 (85.9%) were found to have MetS, consisting of 56 (48.7%) males and 60 (51.13%) females. 38 (32.76%) participants fulfilled three components, 46 (39.65%) four components while 32 (27.59%) all the five components of MetS as per revised NCEP ATPIII criteria. Regarding each component within the patients having MetS, high waist circumference was present in 109 (94.00%) individuals, followed by high BP in 85 (73.30%), then high triglyceride in 77 (66%) individuals and low HDL in 71 (61.2%) individuals. Lack of dietary control and physical inactivity showed significant association (p=0.003 and 0.042 respectively) with MetS.
Conclusion: The study showed that MetS is highly prevalent among diabetic patients, more common in females, with significant association of lifestyle factors like lack of dietary control and physical inactivity. Among the components of MetS central obesity (as indicated by waist circumference) was the most common followed by high BP.
Lorraine Mongiello
New York Institute of technology,USA
Title: Diabetes risk and risk perception among Asian Americans
Biography:
For more than 30 years, Dr. Mongiello, a registered dietitian/nutritionist and a certified diabetes educator, has specialized in public health, nutrition and the prevention and treatment of diabetes. She was the director of the Campaign against Diabetes at The City University of New York (CUNY) and was the director of the Diabetes Care Center at St. Charles Hospital on the North Shore of Long Island, where she implemented a diabetes education program serving more than 500 people annually. Additionally, she had has provided medical nutritional therapy in obesity programs, nursing homes, hospitals, an early intervention program, a dialysis center, pediatric clinics and in private practice. Currently, Dr. Mongiello is a professor in the clinical nutrition and interdisciplinary health sciences departments at New Your Institute of Technology (NYIT) in Old Westbury, New York. Dr. Mongiello received her doctor of public health degree at the CUNY Graduate Center, master’s degree in nutrition and public health at Teacher’s college, Columbia University and bachelor’s degree in food and nutrition science at Lehman College in New York City. Her current research focuses on the social determinates of health and how the environment impacts health behaviors among young adults.
Abstract:
Although the rapid increase of type 2 diabetes is crossing all socioâ€economic groups, it is still most prevalent among minorities and the poor. Recent data suggest that non-Hispanic African-American (16.0%) and Mexican-American (15.7%) adults exhibited higher age-adjusted prevalence than non-Hispanic white adults (8.8%). What is also alarming, and less known, is that Asian-Americans are 30-50% more likely to have diabetes than their white counterparts and Asians also develop diabetes at an earlier age and at lower ranges of body mass index (BMI) than other groups.Despite these disturbing numbers, my research of 1600 young adults shows that there is significant variation in the understanding of risk among racial/ethnic groups; only 0.02% of Asians, 14.0% of Hispanics and 22.8% of black college students recognized that their race increased their risk.Explanations for the excess diabetes risk in Asians are unclear; but there is existing evidence that higher rates may be associated with increased insulin resistance, lower abdominal obesity, cardiorespiratory fitness and physical inactivity. These theories and how they impact diabetes prevention and treatment will be presented. Additionally, South Asian men may need to undertake greater levels of moderate physical activity compared to other groups to achieve similar benefits. Because of these differences between Asians, Asian subgroups and other races/ethnicities, specific BMI and exercise standards have been developed for Asians. Applying these Asian-specific standards as well as culturally appropriate nutrition therapy will be discussed.