Day 2 :
Keynote Forum
Quincy Almeida
Wilfrid laurier university, Canada
Keynote: Parkinson’s disease: A systematic evaluation of underlying mechanisms leading to motor symptoms
Time : 09:30-10:10
Biography:
Quincy Almeida is the Director of the Sun Life Financial Movement Disorders Research & Rehabilitation Centre at Wilfrid Laurier University. His research has been featured in the Toronto Star, the Globe & Mail, on CBC and CTV national news as well as featured in Maclean’s magazine. He has been funded by NSERC, and multi-million dollar grants from the Canada Foundation for Innovation and CIHR, and has won several awards including the Franklin Henry Young Scientist Award for motor control in Canada, Parkinson’s Society of Canada Young Investigator’s Award, Polanyi Prize for Physiology and Medicine, the Queen’s Elizabeth II Diamond Jubiliee Medal and the Early Career Distinguished Scholar Award from the NASPSPA Organization. He has spoken about his novel approach to understanding Parkinson’s disease across the world including widely across South America, Europe and Australia
Abstract:
Parkinson’s disease (PD) is a progressive disorder that affects 4.1 million world-wide and costs health care systems billions of dollars annually. While dopaminergic therapies remain the gold standard of treatment, pharmaceutical interventions only mask the symptoms of PD, rather than addressing the underlying cause of symptoms. In addition, many motor symptoms are resistant to dopaminergic treatments, while causing additional motor complications or side effects (including wearing off, motor fluctuations, dyskinesias; see Almeida & Hyson, 2010 review). Mobility deficits are arguably the most debilitating symptoms associated with PD, and studying them can serve as a valuable model that can shed light on mechanisms underlying all motor symptoms in PD and other movement disorders). One example is the so-called ‘freezing phenomena’, in which patients report feeling like their feet are glued to the ground leaving them unable to make their next step. This symptom is argued by many to be unresponsive to typical drug treatments, and often leads to an increased risk of trips and falls. Thus, it is considered the most severe gait disorder associated with advanced PD. Considering the vast neural networks essential for the planning and control of human locomotion, the interactions between sensory, perceptual, cognitive and emotional networks are not easy to disentangle. Sensory and perceptual systems are required to accurately detect and make judgments about objects and obstacles that we interact with. These systems are also needed to interpret the progression of successful (or unsuccessful) waking relative to environmental obstacles or threats. In addition, higher level emotional and cognitive processes (anxiety, attention, executive function) play an important role in recognition and semantic processing of environmental stimuli. Thus the goal of the presentation is to systematically consider the underlying factors that may underlie motor symptoms as well their interactions, in order to identify novel treatment strategies for PD
Keynote Forum
Jose Mario Franco de Oliveira
Fluminense Federal University, Brazil
Keynote: What is and what is not type 2 diabetes
Time : 10:10-10:50
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:
Albeit diagnosed and defined as a “primary sugar disease of the adult”; i.e., also as namely a disease of the carbohydrate metabolism by most authors; so called type 2 diabetes mellitus should be better defined as a “No Man’s Land” state of disease in adults, at most diagnosed by a fasting glycaemia equal or higher than 126 mg/dL, and why this reality? Because in a global epidemic, which is badly out of control, among other reasons there is not much time to loose. So let’s get into some facts! Despite all controversies surrounding the etiology, pathogenesis, and therapeutic roles for hyperglycemia in type 2 diabetes mellitus, new anti-hyperglycemic drugs are still getting into the market at a high speed, due to the overconfidence in HbA1c as a surrogate outcome for microvascular complications; albeit all large recent randomized clinical trials and meta-analysis have shown that trying to achieve glycemic levels close to the normal range did not reduce the most clinically important microvascular or macro-vascular hard endpoints as end-stage renal disease, vision loss, stroke, cardiovascular and total mortality, with the added harm of substantial increase in the number of hypoglycemic episodes, and even death rates. If glucose or HbA1c were good surrogate disease markers, then why there is increased mortality in the ACCORD trial and the recent rosiglitazone saga, among other anti-hyperglycemic drugs? The above, among other core issues, will be covered during the presentation.
Keynote Forum
M V Raghavendra Rao
Avalon University, Netherlands
Keynote: Diabeto-protective role of natural plants: Exploring the alternative
Time : 11:10-11:50
Biography:
M V Raghavendra Rao has worked as a Professor of Microbiology, Parasitology, Immunology and Epidemiology in many universities, many medical colleges in India, China, Nepal, Libya, and Philippines. Currently, he is working as PrAofessor of Microbiology, Parasitology, Immunology and Dean (Student Affairs) at Avalon University School of Medicine, Curacao, Netherland Antilles. He has more than 42 years of teaching and research experience. He has supervised 3 students for PhD, 4 students for MPhil, 4 students for pre MPhil degrees. He has authored 18 text books. He has presented 8 full length papers exclusively during 2014 to 2015 in different international journals. In 2016, he has published two full length papers in international journals.
Abstract:
Background: Diabetes is a multi-system metabolic disease with varied clinical presentations. Free radical injury is an important aspect of tissue injury in metabolic diseases. Free radicals have a wide spectrum of tissue damage and can be targeted effectively by secondary plant metabolites. This experimental study explores the usefulness of secondary metabolites from two natural plants, Albizzia lebbeck and Syzygium cumini, for their possible antioxidant and diabeto-protective properties.
Methods: An experimental study was conducted in controlled experimental animals (rats) beginning with the exposure to Streptozotocin (STZ), for generation of free radicals. This initiated lipid peroxidation which was documented with subsequent change in the serum levels of malondialdehyde. The overall effect of STZ in relation to change in serum glucose and lipids level, body weight and antioxidant parameters were also measured. After co-administered with aqueous methanolic extract of natural plants, the protective role of the plant products against the free radicals was noted after. Finally hepatic histopathological studies were conducted to document the effect of the experiment.
Results: There were major reductions in the levels of endogenous antioxidant enzymes like superoxide dismutase, catalase and reduced glutathione after 30 days of experiment with STZ, suggesting the generation of free radicals. The co-administration of aqueous methanolic extract from natural plants significantly increased these antioxidant enzymes and reduced the elevated serum levels of malondialdehyde. There was also reduction in the blood sugar and lipids level, and decrease in body weight in contrast to STZ indicating the diabeto-protective effect. The histopathological evidences consolidated the findings by showing prevention of damage to the ultrastructure of liver rather than regeneration.
Conclusion: The established diabeto-protective actions of various extracts of natural plants in experimental rats widen the scope for further investigations in the field of research. It is also necessary to isolate and characterize the active chemical constituent of this plant extracts and efforts should be taken to establish such isolates as potential drug in clinical practice.
- 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.